ISSN 2398-2942      

Hematology: activated clotting time

icanis
Contributor(s):

Kathleen P Freeman

Synonym(s): whole blood clotting time, WBCT, clotting time, activated clotting time, ACT


Overview

  • Evaluates entire secondary blood clotting system.
  • Test is independent of platelets (unless the platelet count Hematology: platelet count <10 x 10*9)/l).

Sampling

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Tests

Methodologies

Capillary tube

  • Blood collected in fine capillary tube; time noted.
  • Break off end of tube every 30 seconds until appearance of fibrin is noted.
  • Measure time interval.

Activated clotting time

  • Time taken for whole blood to clot inside glass tube containing contact activator (diatomaceous/earth).
  • Less variable and more sensitive than capillary tube method.
  • Performed at room temperature or 37°C (tube must be prewarmed).
  • Special Vacutainer tube required (also allows clot retraction time to be measured).
  • ACT: time taken to notice obvious clotting following addition of blood.

Whole blood clotting time

  • Sample collected into warmed glass tube (37°C) without contact activator.
  • Tube tipped every 30 seconds and kept at 37°C between tipping.
  • Record time until blood clots.
  • Less reliable and accurate than ACT.

Availability

  • In veterinary practice.

Validity

Sensitivity

Predictive value

  • Prolonged ACT → presence of severe coagulopathy.

Technique (intrinsic) limitations

  • Deficiency of factor VII has no effect (extrinsic system of less importance).
  • Does not evaluate extrinsic pathway.
  • Be sure to concurrently evaluate platelets (automated and/or manual count) and correlate with examination of blood smear. Marked thrombocytopenia (<10x10*9/ml) may result in prolongation of ACT or WBCT.

Result Data

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Further Reading

Publications

Refereed papers

  • Recent references from VetMedResource and PubMed.
  • Couto C J (1999) Clinical approach to the bleeding dog or cat. Vet Med May, 450-459.
  • Sheafer S E & Couto C J (1999) Clinical approach to a dog with anticoagulant rodenticide poisoning. Vet Med May, 466-471.

Other sources of information

  • Kaneko J J, Harvey J W & Brass M L (1997) Eds. Clinical Biochemistry of Domestic Animals. 5th edn. Academic Press, USA.
  • Jain N C (1993) Essentials of Veterinary Hematology. Lea and Febiger, USA.

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