• Open Access

Diagnostic Utility of D-Dimer Concentrations in Dogs with Pulmonary Embolism

Authors

  • S.E. Epstein,

    Corresponding author
    1. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
    • Corresponding author: S.E. Epstein, Room 2112 Tupper Hall, Department of Surgical and Radiological Sciences, University of California, Davis, CA 95616; e-mail: seepstein@ucdavis.edu

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  • K. Hopper,

    1. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
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  • M.S. Mellema,

    1. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
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  • L.R. Johnson

    1. Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
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  • The work was performed at the University of California, Davis, William R. Pritchard Veterinary Medical Teaching Hospital

Abstract

Background

Pulmonary embolism (PE) is a complication of systemic disease in dogs. Antemortem diagnosis is challenging because of the lack of a confirmatory test.

Objectives

To retrospectively determine the diagnostic utility of D-dimer concentrations in dogs with necropsy-confirmed PE.

Animals

Ten dogs with PE confirmed at necropsy that had D-dimer concentrations measured and 10 control dogs with D-dimer concentrations available that lacked PE on necropsy.

Methods

The computerized medical record database was searched for dogs with necropsy-confirmed PE that had D-dimer concentrations measured at that visit. An age-, sex-, and breed-matched control group was identified. Signalment, location of PE, and coagulation profiles were collected. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using a D-dimer concentration of 250 ng/mL.

Results

Coagulation profiles were not different between dogs with and without PE. Using 250 ng/mL as a cut-off D-dimer concentration, the sensitivity and specificity were 80 and 30%, respectively, for the diagnosis of PE. The NPV and PPV were 60 and 53.0%, respectively. D-dimer concentration <103 ng/mL had 100% sensitivity for ruling out PE and no value was 100% specific.

Conclusions and Clinical Importance

D-dimer concentrations <250 ng/mL have a high sensitivity for the absence of PE, but PE still can occur in dogs with a normal D-dimer concentration. Increased D-dimer concentrations are not specific for PE.

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