The work was performed at the University of California, Davis, William R. Pritchard Veterinary Medical Teaching Hospital
Diagnostic Utility of D-Dimer Concentrations in Dogs with Pulmonary Embolism
Article first published online: 28 AUG 2013
Copyright © 2013 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 27, Issue 6, pages 1646–1649, November/December 2013
How to Cite
Epstein, S.E., Hopper, K., Mellema, M.S. and Johnson, L.R. (2013), Diagnostic Utility of D-Dimer Concentrations in Dogs with Pulmonary Embolism. Journal of Veterinary Internal Medicine, 27: 1646–1649. doi: 10.1111/jvim.12177
- Issue published online: 13 NOV 2013
- Article first published online: 28 AUG 2013
- Manuscript Accepted: 24 JUL 2013
- Manuscript Revised: 16 JUN 2013
- Manuscript Received: 16 JAN 2013
- Respiratory distress;
Pulmonary embolism (PE) is a complication of systemic disease in dogs. Antemortem diagnosis is challenging because of the lack of a confirmatory test.
To retrospectively determine the diagnostic utility of D-dimer concentrations in dogs with necropsy-confirmed PE.
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.
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.
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.