The AFAST-applied Fluid Scoring System has been modified and this is an important change for assessing the bleeding dog and cat (and other species).

The abdominal fluid score (AFS) remains a 0-4 range as previously published; however, for smaller pockets, “soft positives”, the score is a “1/2” instead of a full “1.”  This is especially helpful for the dog or cat with 3 small “soft positives” that would now total 1/2 + 1/2 + 1/2 = 1 1/2 (1.5) rather than a “3.”

The AFS of 1.5 makes this a lower-scoring small volume bleeder and can be tracked to see if static, stays 1.5, or worsening, increasing AFS, or resolving, decreasing AFS.  EXPECT dogs and cats (and likely other species) to resorb the blood in a cavity or space within 48-hours if bleeding has ceased (or coagulopathy has been corrected) through author experience.  No studies to the author’s knowledge have published this information.

The under and over maximum dimension rule for the modification of the AFS.  In cats < 5 mm is an AFS of “1/2” and > 5 mm an AFS of “1” and for dogs < 1 cm for “1/2” and > 1 cm for “1” with the 4 views being totaled as previously published. Copyright 2018 Gregory Lisciandro, DVM, Dipl. ABVP, ACVECC and FASTVet.com with Figures by Hannah Hey, San Antonio, Texas.

A visual showing you how the pocket to the left is a “1/2” and the pocket to the right a full “1” when assessing AFS at each of the 4 AFAST views. Copyright 2018 Gregory Lisciandro, DVM, Dipl. ABVP, ACVECC and FASTVet.com

The AFS helps discriminate between small volume and large volume bleeders.  Small volume AFS 1 and 2s that state AFS 1 and 2 cannot bleed to death from that volume of blood vs. AFS 3 and 4s have enough blood volume in their abdominal cavity to have life-threatening hemorrhage.  Depending on patient subset, decisions for blood transfusion and/or exploratory surgery may be made.

Copyright 2018 Gregory Lisciandro, DVM, Dipl. ABVP, ACVECC and FASTVet.com

See our FASTVet Chart for the Bleeding Patient.

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