Reply To: Tranexamic Acid use.

Hey Inga.

Really sorry about delay!

Really interesting question and one of my favorite drugs!

What other drugs is the dog on?

Tranexamic acid is an antifibrinolytic drug. It therefore reduces bleeding but, in certain situations, it may expose patients to a risk of thrombosis. It is used for the treatment of various types of bleeding, including menorrhagia, haematuria, certain surgical procedures and trauma. Its harm-benefit balance is favorable in certain situations associated with serious bleeding. The harm-benefit balance is different in minor bleeding: the expected benefits are smaller because the condition is not serious, and the risk of thromboembolism may be higher without the haemodilution associated with severe bleeding.

Clinical trials (human) conducted in serious haemorrhage or in patients undergoing surgery with a high risk of bleeding have not shown an increased risk of thrombosis with tranexamic acid. In practice, as of early 2013, the harm-benefit balance of tranexamic acid is favorable in severe traumatic bleeding. But when bleeding is not life-threatening, the thrombotic risk is too poorly documented to justify exposing patients to a plausible and inadequately evaluated risk.

I could find one specific human haematuria paper that overall did not represent a massive benefit (https://pubmed.ncbi.nlm.nih.gov/28916142/).

It has also been suggested that there may be a specific contraindication with bleeding in the urinary tract as tranexamic acid prolongs the dissolution of fibrin deposits already formed. Macroscopic haematuria is therefore
regarded as a contraindication for the use of tranexamic acid because this may lead to clots in the urinary tract with possible obstruction. I am not able to find any reports of this in the animal literature.

So, in summary! I would probably only use it if the bleeding was severe and causing more severe side effects like a drop in PCV.

Hope that helps.

Scott 🙂