What is Low calcium heparin YL30119
Low calcium heparin is a glycosaminoglycan, which occurs in many mammalian tissues and has important anticoagulant and thrombolytic properties. The chemical structure is composed mainly of two disaccharide repeating units A and B.
A is L-iduronic acid 2-suplhate linked α-(1,4) to 2-deoxy-2-sulfamido-D-galactose 6-sulphate, while B is D-glucuronic acid β-(1,4) linked to 2-deoxy-2-sulfamido-D-glucose 6-sulphate.
Heparin is composed of a family of naturally occurring sulfated glycosaminoglycans that are synthesized by connective tissue mast cells.
By binding to antithrombin (AT), a glycoprotein synthesized in the liver and vascular endothelium, heparin markedly enhances the rate of AT-mediated inactivation of clotting factors (factors IX, X, XI, and XII and thrombin).
The AT-heparin complex, by neutralizing thrombin, suppresses thrombin-mediated amplification of the coagulation cascade and inhibits thrombin-mediated conversion of fibrinogen to fibrin.
Heparin sodium (40 IU/kg IV intraoperatively, followed by 40 IU/kg SC twice a day for 2 days) decreased adhesion formation in ponies after experimentally induced intestinal ischemia.
Based on pharmacokinetic studies using calcium heparin instead of sodium heparin, an initial dose of 150 IU/kg SC followed by 125 IU/kg SC twice a day for six doses followed by 100 IU/kg SC twice a day is recommended to maintain therapeutic anticoagulant levels.
Some evidence suggests that calcium ions inhibit the heparin-AT-thrombin reaction. Consequently, a higher dosage of calcium heparin than sodium heparin is required to reach therapeutic levels, although this finding is questioned.
Plasma AT levels are reported to be decreased in some horses with abdominal disease.123,124 Because heparin acts as a cofactor to AT, heparin therapy would be of limited value if peritoneal AT were depleted significantly.
However, changes in plasma AT levels do not always correlate with changes in peritoneal levels. Peritoneal AT levels have actually been found to be increased in some horses with colic.
The most common complication reported with heparin therapy in horses is anemia induced by erythrocyte agglutination, which resolves in 3 to 4 days following cessation of heparin.
Low-molecular-weight heparin (LMWH) is separated from unfractionated heparin (UFH) by solvent or gel filtration and consists of smaller molecules than UFH. It has less antithrombin activity and higher anti–factor Xa activity than UFH.
In addition, LMWH has constant anticoagulant activities, greater bioavailability, and longer biological half-life. In horses, LMWH causes fewer side effects and can be conveniently administered once daily.
When administered to horses with surgical colic, there were fewer jugular vein changes and fewer side effects in horses treated with LMWH compared to UFH.
When administered to horses following colic surgery, horses treated with LMWH had a lower prevalence and grade of laminitis compared to control horses where heparin was not administered.
Dalteparin can be administered subcutaneously at 50 IU/kg every 24 hours.
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