This study was in part presented at the 2010 ACVIM Forum, Anaheim, CA.
Hypercoagulability in Dogs with Protein-Losing Enteropathy
Article first published online: 11 FEB 2011
Copyright © 2011 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 25, Issue 2, pages 273–277, March/April 2011
How to Cite
Goodwin, L.V., Goggs, R., Chan, D.L. and Allenspach, K. (2011), Hypercoagulability in Dogs with Protein-Losing Enteropathy. Journal of Veterinary Internal Medicine, 25: 273–277. doi: 10.1111/j.1939-1676.2011.0683.x
- Issue published online: 7 MAR 2011
- Article first published online: 11 FEB 2011
- Submitted March 16, 2010; Revised November 15, 2010; Accepted December 23, 2010.
- Thromboembolic risk
Background: Dogs with protein-losing enteropathy (PLE) have previously been reported to present with thromboembolism; however, the prevalence and pathogenesis of hypercoagulability in dogs with PLE have not been investigated so far.
Hypothesis: Dogs with PLE are hypercoagulable compared with healthy control dogs.
Animals: Fifteen dogs with PLE. Thirty healthy dogs served as controls (HC).
Methods: A prospective study was performed including 15 dogs with PLE. All dogs were scored using the canine chronic enteropathy activity index (CCECAI). Thromboelastography (TEG) and other measures of coagulation were evaluated. Recalcified, unactivated TEG was performed and reaction time (R), kinetic time (K), alpha angle (α), and maximum amplitude (MA) values were recorded. Nine dogs were reassessed after initiation of immunosuppressive treatment.
Results: All dogs with PLE in the study were hypercoagulable with decreased R (PLE: median 7.8, range [2.4–11.2]; HC: 14.1 [9.1–20.3]), decreased K (PLE: 2.5 [0.8–5.2]; HC: 8.25 [4.3–13.1]), increased α (PLE: 56.7 [38.5–78.3]; HC: 25.6 [17–42.4]), and increased MA (PLE: 68.2 [54.1–76.7]; HC: 44.1, [33.5–49]) (all P < .001). Median antithrombin (AT) concentration was borderline low in PLE dogs; however, mean serum albumin concentration was severely decreased (mean 1.67 g/dL ± 5.1, reference range 2.8–3.5 g/dL). Despite a significant improvement in serum albumin and CCECAI, all 9 dogs with PLE were hypercoagulable at re-examination.
Conclusions and Clinical Importance: The hypercoagulable state in dogs with PLE cannot be solely attributed to loss of AT. Despite good clinical response to treatment, dogs remained hypercoagulable and could therefore be predisposed to thromboembolic complications.