[Medical hemostasis. I. the treatment of hemorrhages and hemorrhagic diathesis in veterinary practice].

Bleeding patients are regularly encountered, often as an emergency, in veterinary practice. In many cases local causes will be responsible for the bleeding, but in some there will be a generalised haemostatic defect. The approach to the bleeding patient, suspected of a generalised haemostatic defect, requires a detailed history and careful physical examination in order to differentiate between hereditary and acquired haemostatic disorders and, in the case of an acquired haemostatic disorder, to detect which underlying disease caused the defect and which parts of the haemostatic system are involved. In the majority of cases, however, laboratory testing will be necessary to define the defect. As these tests are not readily available in most veterinary clinical situations, efforts are made to suggest a rational therapeutic approach to the bleeding patient, which is based on clinical diagnosis. Several locally applied substances may provide assistance in the control of persistent bleeding, when the mechanisms of blood coagulation are otherwise intact. When haemostatic defects are present, however, topical agents alone are of little or no value; replacement therapy with blood or preferentially blood products will be indicated. In addition to vitamin K1 (especially in cases of coumarin poisoning), blood (products) and agents for topical use, there are only very few agents having a well-defined effect on haemostasis, which are of proven clinical value. On the other hand, a rather large number of drugs are being propagated as haemostatics. This is the first of two papers on the treatment of haemorrhagic disorders in veterinary practice. Diagnosis, local treatment and replacement therapy with plasma or blood(products) are discussed. Drugs which are contra-indicated in bleeding patients, are also referred to. The second paper will critically evaluate the commercially available haemostatics.