Best haemostatic agents to have on hand for surgery?

RE: Best haemostatic agents to have on hand for surgery?

Beats — Fri, 19 Apr 2024 21:41:28 GMT

If it stopped an animal bleeding to death then for £40 I would be more than happy to pay (OK, £80 as I need a 2-pack and the other one will go out of date, unless we split a pack between us).

The question of course is would it stop an animal from bleeding to death, or more precisely would it be more likely to stop an animal from bleeding to death than something for £10.

I'm happy to stock some other things that I rarely or never use, based on not wishing to be without them at an appropriate moment - that's given me a good idea for another thread - "What do you keep just in case that you don't expect to pay for itself". For instance I throw out and replace the naloxone every so often, but for the once every few years that a puppy chews a fentonyl patch, I can live with the waste.

Further update: Vetigel is now available through a number of UK wholesalers I believe for those interested.

RE: Best haemostatic agents to have on hand for surgery?

Michael Woodhouse — Fri, 19 Apr 2024 21:13:17 GMT

[quote userid="12930" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery/244368#244368"]

Vetigel is now distributed through VI.

vetigel.co.uk

https://veterinary-instrumentation.co.uk/vetigel-haemostatic-gel

[/quote]

And predictably crazy money

2 pack £80, 5 pack £190. Want the accessory kit to use the product? £17.40, please

RE: Best haemostatic agents to have on hand for surgery?

Beats — Thu, 18 Apr 2024 20:45:05 GMT

Vetigel is now distributed through VI.

vetigel.co.uk

https://veterinary-instrumentation.co.uk/vetigel-haemostatic-gel

Surgiflo is a late comer to the discussion that is rumoured to be rather expensive compared to other things being discussed, but I have not chevcked a price myself:

https://www.jnjmedtech.com/en-EMEA/product/surgiflo-hemostatic-matrix-thrombin

Surgicel is another range from Johnson: https://www.jnjmedtech.com/en-EMEA/search-company?search_api_fulltext=surgicel&company=56

price unknown to me presently, but I have a sample of the original one to try - just need something to bleed now.

RE: Best haemostatic agents to have on hand for surgery?

Rob Davis — Thu, 18 Apr 2024 14:20:58 GMT

I've always liked Lyostypt - it's a bit pricey, but as Evelyn said, on the rare occasions I use it that is the least of my concerns....

RE: Best haemostatic agents to have on hand for surgery?

Beats — Fri, 12 Apr 2024 07:24:32 GMT

I have gotten no response from HemaBlock international enquiry email thus far.

Wholesaler is claiming Vetigel discontinued - am going to check this with VetPlus directly.

ANy other suggestions of UK/EU available products appreciated!

RE: Best haemostatic agents to have on hand for surgery?

Evelyn Barbour-Hill — Fri, 05 Apr 2024 12:15:20 GMT

Sorry, no JAK number on it.

If it's of interest to anyone else, it's "microporous polysacharide beads with oxidised cellulose powder" and "completely resorbable, completely sterile".

And it works well. Seemed a tad expensive, I think about £11 a dollop, but in the circumstances where you need it you wouldn't be worrying too much about cost.

Note, completely resorbable. Each time I've used it (which is not often!) I've left it buried.

RE: Best haemostatic agents to have on hand for surgery?

Beats — Thu, 04 Apr 2024 15:39:33 GMT

I phoned JAK and they asked if I could provide the item number if was something they had supplied before. I suspect they no longer supply it, but at a long-shot if you still have some in the cupboard, Evelyn, and it has an item number from JAK on it, then I can see if that helps.

Otherwise, I've emailed the HemaBlock website international enquiries email address to see if i get a response on UK/EU distributor (other than ebay...).

Will post here any response if of interest to others searching this thread in future.

RE: Best haemostatic agents to have on hand for surgery?

Evelyn Barbour-Hill — Thu, 04 Apr 2024 14:46:42 GMT

[quote userid="12930" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery/244237#244237"]Evelyn: can I ask you where you got the Hema-Block from and if it was sterile?[/quote]

From JAK Marketing. Yes, it's presented sterile, in a couple of different forms.

RE: Best haemostatic agents to have on hand for surgery?

Beats — Thu, 04 Apr 2024 08:53:24 GMT

Thanks everyone for suggestions and experiences - really useful!

Evelyn: can I ask you where you got the Hema-Block from and if it was sterile?

I'm assuming this: Home - HemaBlock

Decent number of testimonials on site, but my usual wholesaler can't supply it.

RE: Best haemostatic agents to have on hand for surgery?

Michael Woodhouse — Wed, 03 Apr 2024 22:37:22 GMT

[quote userid="8663" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery/244216#244216"]It's not really teh same thing as the topical agents, clips etc. [/quote]

No, but I find it very useful where things are bleeding. Some good studies showing positive things in human trauma (I believe from warzones initially, not carried by the ambulance service as an early intervention).

I would use it routinely in something I knew was bleeding (splenic bleed) or at high risk (greyhound surgery/dentals). We use it during surgery if things getting a bit bloody and anecdotally it helps with the oozing bitch spay etc. Before TXA opening a haemoabdomen was a messy affair with suction and lap swabs, now it's like a big jelly in there.

RE: Best haemostatic agents to have on hand for surgery?

Jill Butterworth — Wed, 03 Apr 2024 21:12:49 GMT

I used to swear by Lyostypt a 'wet-stable collagen haemostat'.

RE: Best haemostatic agents to have on hand for surgery?

Evelyn Barbour-Hill — Mon, 01 Apr 2024 00:28:26 GMT

[quote userid="8991" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery/244217#244217"]It's a useful tool which effectively stabilises the clot in primary haemostasis. We use it frequently in trauma patients and those with bleeding disorders such as lungworm. It does seem to help quite a bit. [/quote]

Anyone remember Clotol?

Nah, thought not.

RE: Best haemostatic agents to have on hand for surgery?

David Mills — Sun, 31 Mar 2024 21:35:08 GMT

TXA has not been studied that much in veterinary patients but a study in humans led to a reduction in transfusion requirements by a third Vs non treated, and significant reduction in all cause mortality and bleeding disorders. It prevents fibrinolysis which does not appear to be breed dependent, although some dogs may have a greater tendency to have accelerated fibrinolysis.

It's a useful tool which effectively stabilises the clot in primary haemostasis. We use it frequently in trauma patients and those with bleeding disorders such as lungworm. It does seem to help quite a bit.

RE: Best haemostatic agents to have on hand for surgery?

Alasdair Hotston Moore — Sun, 31 Mar 2024 17:00:37 GMT

[quote userid="3169" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery/244203#244203"]Personally a big fan of Tranexamic acid.[/quote]

It's not really teh same thing as the topical agents, clips etc. I believe it only works in dogs prone to fibrinolysis (sight hounds)

RE: Best haemostatic agents to have on hand for surgery?

Evelyn Barbour-Hill — Sat, 30 Mar 2024 14:50:13 GMT

Dunno about best, but Hema-Block seems to do what it claims. I like to have some in stock just in case. In the days when I was full-time-doing-everything I think I used it twice in six years, and was glad to have it. I have used it once in dentistry.

RE: Best haemostatic agents to have on hand for surgery?

Michael Woodhouse — Sat, 30 Mar 2024 00:04:43 GMT

Personally a big fan of Tranexamic acid.

RE: Best haemostatic agents to have on hand for surgery?

Alasdair Hotston Moore — Fri, 29 Mar 2024 22:52:02 GMT

Vetigel does look promising I’m getting some to try soon, and I’ll try and let you know how I find it More likely during teca lbo than pda

[quote userid="12930" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery"]

They quote use of "a topical hemostatic agent" amongst strategies used to stem bleeding after rupture, and this got me wondering what the best topical hemostatic agents might be to have on hand?

[/quote]

RE: Best haemostatic agents to have on hand for surgery?

Alasdair Hotston Moore — Fri, 29 Mar 2024 22:50:20 GMT

[quote userid="12930" url="~/f/clinical-questions/30924/best-haemostatic-agents-to-have-on-hand-for-surgery"]Does vascular clips mean something like I already have in the Weck Horizon Medium/Large vascular clips[/quote]

I think so. Although typically the tear is medial and I’m not sure these would help

RE: Best haemostatic agents to have on hand for surgery?

David Mills — Fri, 29 Mar 2024 21:16:28 GMT

Some of the newer powders were developed in the military for stemming arterial bleeds from femoral or other major arteries - although they need to be used along with pressure, they can't be left in cavities (have to be flushed out) and they do have a risk of embolization - but colleagues have used them and speak highly of their effectiveness. I believe some people use them in dentistry.

Clamps I assume would be any kind of clamping device such as a satinsky, Spencer wells, etc

Clips are used for permanent occlusion and are normally titanium. They are quite widely used in human medicine for PDA occlusion in babies, and there are several reports of use in dogs and cats with PDAs. They theoretically avoid the most risky part of the procedure which is the medial relatively blind dissection "behind" the ductus although AFAIK they haven't been shown to be superior to surgical ligation.