ORIGINAL RESEARCH article
Front. Vet. Sci.
Sec. Veterinary Emergency and Critical Care Medicine
Determination of Canine ROTEM Sigma Reference Ranges and Comparative Analysis with ROTEM Delta
Provisionally accepted
Aurélie Jourdan1,2*
Julia Noval Montero1,2
Geoffrey Troussier1,2Anna Anderco1,2Caroline Dania1,2Yann Moumadah1,2
Maxime Cambournac1,2- 1Centre Hospitalier Vétérinaire FREGIS, Gentilly, France
- 2IVC Evidensia France, Courbevoie, France
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Hemostatic dysfunctions are frequent in critically ill dogs and can markedly affect clinical outcomes. Conventional plasma-based coagulation testing provides limited insight into the complex in vivo interactions among platelets, red blood cells, and coagulation factors. Viscoelastic testing has emerged to overcome these limitations by assessing the dynamics of clot formation and breakdown in whole blood. Among these, ROtational ThromboElastoMetry (ROTEM) provides a real-time evaluation of the coagulation process, reflecting clot initiation, propagation, and lysis. The recently developed ROTEM Sigma analyzer automates reagent handling and measurement minimizing operator variability and pre-analytical errors. Despite its growing use in human medicine, canine reference intervals for the ROTEM Sigma platform have not yet been established. Objective: To determine the reference intervals for ROTEM Sigma parameters in healthy dogs, to compare these values with published ROTEM Delta data, and to assess the influence of physiological variables such as age, sex, body weight, and neuter status. Methods: A prospective observational study was conducted in 42 clinically healthy dogs. Whole blood samples were analyzed using ROTEM Sigma EXTEM, INTEM, FIBTEM, and HEPTEM assays. Reference intervals were generated using both conventional parametric and robust median–MAD statistical methods. Comparisons were made with previously reported canine ROTEM Delta data. Multivariate regression explored associations between ROTEM parameters and demographic or hematologic variables. Results: Reference intervals were successfully defined for all ROTEM Sigma parameters (CT, CFT, A10, MCF, LI60, and G). EXTEM values agreed most closely with previously published ROTEM Delta data, whereas INTEM and FIBTEM exhibited greater variability. Regression analysis identified maximum clot firmness (MCF) as the only parameter significantly affected by biological variables. MCF decreased with higher body weight, increased with platelet count and showed minor sex-related differences. Conclusion: This study establishes canine-specific ROTEM Sigma reference intervals. The close concordance with Delta data more (particularly EXTEM) suggests cross platform consistency while highlighting the necessity of dedicated Sigma-specific reference ranges. Body weight, sex, and platelet count were the primary determinants of MCF. These validated reference intervals enhance the clinical applicability of ROTEM Sigma for assessing hemostatic function in dogs.
Keywords: Clot strength, coagulation, Hemostasis, Reference intervals, Rotational thromboelastometry, Rotem, viscoelastic testing
Received: 02 Nov 2025; Accepted: 15 Dec 2025.
Copyright: © 2025 Jourdan, Noval Montero, Troussier, Anderco, Dania, Moumadah and Cambournac. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aurélie Jourdan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.