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Duler L, Visser L, Nguyen N, Johnson LR, Stern JA, Li RHL. Platelet hyperresponsiveness and increased platelet-neutrophil aggregates in dogs with myxomatous mitral valve disease and pulmonary hypertension. J Vet Intern Med 2024; 38:2052-2063. [PMID: 38773707 PMCID: PMC11256165 DOI: 10.1111/jvim.17067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/25/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) in dogs with myxomatous mitral valve disease (MMVD) is caused by increased pulmonary venous pressure. Thrombosis, vascular remodeling, and vasoconstriction mediated by platelets could exacerbate PH. HYPOTHESIS Dogs with PH will exhibit a hypercoagulable state, characterized by increased platelet activation, platelet-leukocyte, and platelet-neutrophil aggregate formation. ANIMALS Eleven dogs (≥3.5 kg) diagnosed with MMVD and PH and 10 dogs with MMVD lacking PH. METHODS Prospective cohort ex vivo study. All dogs underwent echocardiographic examination, CBC, 3-view thoracic radiographs, and heartworm antigen testing. Severity of PH and MMVD were assessed by echocardiography. Viscoelastic monitoring of coagulation was assessed using thromboelastography (TEG). Platelet activation and platelet-leukocyte/platelet-neutrophil interactions were assessed using flow cytometry. Plasma serotonin concentrations were measured by ELISA. RESULTS Unstimulated platelets from dogs with MMVD and PH expressed more surface P-selectin than MMVD controls (P = .03). Platelets from dogs with MMVD and PH had persistent activation in response to agonists. The number of platelet-leukocyte aggregates was higher in dogs with MMVD and PH compared with MMVD controls (P = .01). Ex vivo stimulation of whole blood resulted in higher numbers of platelet-neutrophil aggregates in dogs with MMVD and PH (P = .01). Assessment of hypercoagulability based on TEG or plasma serotonin concentrations did not differ between groups. CONCLUSION AND CLINICAL IMPORTANCE Platelet hyperresponsiveness and increased platelet-neutrophil interaction occur in dogs with MMVD and PH, suggesting that platelets play a role of in the pathogenesis of PH. Clinical benefits of antiplatelet drugs in dogs with MMVD and PH require further investigation.
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Affiliation(s)
- Laetitia Duler
- William R. Pritchard Veterinary Medicine Teaching Hospital, School of Veterinary Medicine, University of California DavisDavisCaliforniaUSA
| | - Lance Visser
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
| | - Nghi Nguyen
- Department of Surgical and Radiological ScienceSchool of Veterinary Medicine, University of California DavisDavisCaliforniaUSA
| | - Lynelle R. Johnson
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California DavisDavisCaliforniaUSA
| | - Joshua A. Stern
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California DavisDavisCaliforniaUSA
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Ronald H. L. Li
- Department of Surgical and Radiological ScienceSchool of Veterinary Medicine, University of California DavisDavisCaliforniaUSA
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Hawes C, Kathrani A. In-hospital mortality in dogs with protein-losing enteropathy and associated risk factors. J Vet Intern Med 2024; 38:2265-2272. [PMID: 38819636 PMCID: PMC11256150 DOI: 10.1111/jvim.17123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Risk factors associated with negative outcomes in dogs with protein-losing enteropathy (PLE) are well documented. However, mortality before hospital discharge and associated risk factors are not well described. HYPOTHESIS/OBJECTIVES Report the percentage of dogs with PLE that do not survive to hospital discharge and identify associated risk factors. ANIMALS One-hundred and seven dogs presented to a referral hospital and diagnosed with PLE caused by inflammatory enteritis, intestinal lymphangiectasia or both. METHODS Retrospective cross-sectional study assessing hospital records. Data on in-hospital mortality and cause were assessed, and presenting signs, treatments prescribed, neutrophil count, lymphocyte count, serum albumin, globulin, and C-reactive protein (CRP) concentrations, and histopathologic findings were compared between survivors and non-survivors. RESULTS In-hospital mortality was 21.5% with the most common causes including financial limitations, failure to improve and aspiration pneumonia. Factors associated with mortality during hospitalization included longer duration of hospitalization (P = .04), longer duration of clinical signs (P = .02) and an increase in serum CRP concentration after 1-3 days of in-hospital treatment (P = .02). Higher mortality was identified in Pugs (odds ratio [OR], 4.93; 95% confidence interval [CI], 1.41-17.2; P = .01) and was a result of presumptive aspiration pneumonia in 5/6 of these dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Protein-losing enteropathy in dogs has substantial mortality during hospitalization. Monitoring for improvement in CRP concentration after treatment during hospitalization may help predict survival to discharge. Pugs have increased in-hospital mortality because of aspiration pneumonia; measures to prevent, recognize, and promptly treat this complication may improve outcomes in this breed.
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Affiliation(s)
- Connor Hawes
- Royal Veterinary CollegeUniversity of LondonLondonUK
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3
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Wolf J, Ruterbories LK, Handel I, Hansen B. The effect of ε-aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs. J Vet Intern Med 2024; 38:1013-1021. [PMID: 38206934 PMCID: PMC10937475 DOI: 10.1111/jvim.16977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND No treatment other than platelet administration is known to protect against spontaneous hemorrhage in thrombocytopenic dogs. OBJECTIVES Primary: determine if treatment with ε-aminocaproic acid (EACA) decreases the requirement for blood transfusions and improves outcome in dogs with severe thrombocytopenia. Secondary: find evidence of hyperfibrinolysis and determine the effect EACA administration on rapid (rTEG) and tissue plasminogen activator-spiked (tPA-rTEG) thromboelastography parameters. ANIMALS Twenty-seven dogs with severe thrombocytopenia were treated with EACA, and data from an additional 33 were obtained from the hospital database as historical control (HC) cohort. METHODS Single arm clinical trial with HCs. The EACA group dogs received EACA (100 mg/kg IV followed by a constant-rate infusion [CRI] of 400 mg/kg/24 hours). Thromboelastography before and during EACA infusion, hospitalization days, number of transfusions, and mortality were compared. RESULTS No difference was found in number of transfusions per dog (median, interquartile range; 1, 0-2.5 vs 0.9, 0-2; P = .5) and hospitalization days (4, 4-6 vs 4.5, 3.75-6; P = .83) between HC and EACA groups, respectively, and no difference in survival was identified by log-rank analysis (P = .15). Maximum amplitude on both rTEG and tPA-rTEG increased after EACA administration (rTEG baseline: 23.6, 9.6-38.9; post-EACA: 27.3, 19.8-43.2; P < .001; tPA-rTEG baseline: 23, 10.9-37.2; post-EACA: 24.7, 16.7-44.8; P < .002). CONCLUSIONS AND CLINICAL IMPORTANCE Although EACA increased clot strength, there was no effect on outcome. Treatment with EACA at this dosage cannot be recommended as a routine treatment but may be considered for dogs with severe ongoing hemorrhage.
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Affiliation(s)
- Johanna Wolf
- Royal (Dick) School of Veterinary StudiesUniversity of Edinburgh, Easter Bush CampusMidlothianUK
| | - Laura K. Ruterbories
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Ian Handel
- Royal (Dick) School of Veterinary StudiesUniversity of Edinburgh, Easter Bush CampusMidlothianUK
| | - Bernie Hansen
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
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4
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Cavalerie R, Jolivet F, Launay M, Baudin Tréhiou C, Piazza S. Cervical vertebral veins and caudal cerebral sinuses thrombosis secondary to corticosteroid therapy for an immune‐mediated polyarthritis in a dog. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Robin Cavalerie
- Neurology Department Centre Hospitalier Vétérinaire Languedocia Montpellier France
| | - Franck Jolivet
- Internal Medicine Department Centre Hospitalier Vétérinaire Languedocia Montpellier France
| | - Maheva Launay
- Diagnostic Imaging Department Centre Hospitalier Vétérinaire Languedocia Montpellier France
| | - Clément Baudin Tréhiou
- Diagnostic Imaging Department Centre Hospitalier Vétérinaire Languedocia Montpellier France
| | - Stéphanie Piazza
- Neurology Department Centre Hospitalier Vétérinaire Languedocia Montpellier France
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5
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Defarges A, Stiller J, Solomon JA. Gastrointestinal angiodysplasias diagnosed using video capsule endoscopy in 15 dogs. J Vet Intern Med 2023; 37:428-436. [PMID: 36866722 DOI: 10.1111/jvim.16677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/16/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Angiodysplasia (AGD) is rarely diagnosed in dogs with gastrointestinal bleeding (GIB) and is reported in case reports in dogs. OBJECTIVE Describe signalment, clinical and diagnostic features of dogs with gastrointestinal (GI) AGD diagnosed by video capsule endoscopy (VCE). ANIMALS Dogs with overt or suspected GIB which underwent VCE. METHODS Dogs for which a VCE was submitted for overt or suspected GIB from 2016 to 2021 were selected retrospectively. Medical records and full-length VCE recordings where AGDs were initially detected, were reviewed by 2 trained internists. AGD was considered definitive if 2 readers detected it. Signalment, clinical signs, blood work, medications, concurrent diseases, findings of previous conventional endoscopy, and surgical exploration (if applicable) of dogs with AGD were recorded. RESULTS Definitive AGD was diagnosed in 15 of 291 (5%) dogs (12 males, 3 females). Twelve (80%) had overt GIB, 11 (73%) had hematochezia, and 6 (40%) had microcytic and hypochromic anemia. AGD was missed by conventional endoscopy in 9/9 dogs and exploratory surgery in 3/3 dogs. Thirteen capsules were administered by mouth (1 incomplete study), and 2 via endoscopy directly into the duodenum. AGD was visualized in the stomach of 3 dogs, in the small intestine of 4, and in the colon of 13 dogs. CONCLUSION AND CLINICAL IMPORTANCE Although rare, AGD should be considered in dogs with suspected GIB after a negative conventional endoscopy or surgical exporation. Video capsuel endoscopy appears to be a sensitive test to identify AGD within the GI tract.
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Affiliation(s)
- Alice Defarges
- University of Guelph, Ontario Veterinary College, Guelph, Ontario, Canada
| | - Jenny Stiller
- Universität Leipzig Veterinärmedizinische Fakultät Klinik, Leipzig, Germany
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Weng J, Levy NA, Abbott HY, Mix JA, Wills RW, Mackin AJ, Thomason JM, Cridge H. Retrospective analysis of immunosuppressive and anti-thrombotic protocols in nonassociative immune mediated hemolytic anemia in dogs. J Vet Intern Med 2023; 37:528-536. [PMID: 36809664 PMCID: PMC10061171 DOI: 10.1111/jvim.16652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Evidence supporting the effectiveness of therapeutic protocols for nonassociative immune-mediated hemolytic anemia (na-IMHA) is weak. HYPOTHESIS/OBJECTIVES Investigate the efficacy of various drugs in na-IMHA. ANIMALS Two hundred forty-two dogs. METHODS Multi-institutional retrospective study (2015-2020). Immunosuppressive effectiveness was determined by time to packed cell volume (PCV) stabilization and duration of hospitalization through analysis by mixed model linear regression. Occurrence of disease relapse, death, and antithrombotic effectiveness, were analyzed using mixed model logistic regression. RESULTS Use of corticosteroids vs a multi-agent protocol had no effect on time to PCV stabilization (P = .55), duration of hospitalization (P = .13), or case fatality (P = .06). A higher rate of relapse (P = .04; odds ratio: 3.97; 95% confidence interval [CI]: 1.06-14.8) was detected in dogs receiving corticosteroids (11.3%) during follow-up (median: 28.5 days, range: 0-1631 days) compared to multiple agents (3.1%) during follow up (median: 47.0 days, range: 0-1992 days). When comparing drug protocols, there was no effect on time to PCV stabilization (P = .31), relapse (P = .44), or case fatality (P = .08). Duration of hospitalization was longer, by 1.8 days (95% CI: 0.39-3.28 days), for the corticosteroid with mycophenolate mofetil group (P = .01) compared to corticosteroids alone. Use of clopidogrel vs multiple agents had no effect on development of thromboses (P ≥ .36). CONCLUSIONS AND CLINICAL IMPORTANCE Addition of a second immunosuppressive agent did not alter immediate outcome measures but might be associated with a reduction in relapse. Use of multiple antithrombotic agents did not reduce incidence of thrombosis.
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Affiliation(s)
- Jennifer Weng
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
| | - Nyssa A Levy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
| | - Haley Y Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
| | - Jose A Mix
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
| | - Robert W Wills
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - Harry Cridge
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
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Hennink I, Peters L, van Geest G, Adamik KN. Evaluation of a Viscoelastic Coagulation Monitoring System (VCM Vet ®) and Its Correlation with Thromboelastometry (ROTEM ®) in Diseased and Healthy Dogs. Animals (Basel) 2023; 13:ani13030405. [PMID: 36766294 PMCID: PMC9913587 DOI: 10.3390/ani13030405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Thromboelastometry provides a real-time assessment of global coagulation in whole blood. A novel bed-side viscoelastic coagulation monitor (VCM) has been developed for use in small animals. The aims of the study were to determine inter-device agreement of two VCM devices, to evaluate the correlation between VCM and rotational thromboelastometry as a reference method (ROTEM), and to determine the sensitivity and specificity of VCM to diagnose hypo-, normo-, and hypercoagulability. ROTEM (extrinsic and intrinsic activation) analysis was performed using citrated blood and VCM analysis using native blood. Twenty healthy and forty diseased dogs with and without coagulopathies were enrolled. The VCM inter-device agreement was moderate to strong for most of the parameters, depending on the grading scale. Correlation between VCM and ROTEM was moderate to strong for parameters of clotting time and clot strength. The VCM most likely detects true hypocoagulability and reliably rules out hypocoagulability. The VCM has a high sensitivity in diagnosing normocoagulability, but incorrectly classified dogs with abnormal coagulation as normocoagulable. The VCM was not able to detect hypercoagulability. ROTEM and VCM cannot be used interchangeably.
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Affiliation(s)
- Imke Hennink
- Department of Veterinary Clinical Medicine, Division of Small Animal Emergency and Critical Care, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
- Correspondence:
| | - Laureen Peters
- Department of Veterinary Clinical Medicine, Clinical Laboratory, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| | - Geert van Geest
- Interfaculty Bioinformatics Unit, University of Bern, 3012 Bern, Switzerland
| | - Katja-Nicole Adamik
- Department of Veterinary Clinical Medicine, Division of Small Animal Emergency and Critical Care, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
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8
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Dionne TL, Ishak AM, Cochran LA. Point-of-care global coagulation assay parameters in normal dogs and dogs with primary immune-mediated hemolytic anemia. J Vet Emerg Crit Care (San Antonio) 2023; 33:81-90. [PMID: 36453474 DOI: 10.1111/vec.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/22/2021] [Accepted: 01/20/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To compare viscoelastic parameters between healthy control dogs and dogs with primary immune-mediated hemolytic anemia (pIMHA) using a new, point-of-care viscoelastic coagulation monitor (VCM).a DESIGN: Retrospective study from 2017 to 2021. SETTING Three regional private referral centers. ANIMALS Eighteen client-owned dogs with pIMHA and 33 healthy control dogs. pIMHA dogs were defined based on established criteria. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records of dogs with pIMHA and VCM performed at diagnosis from 2017 to 2021 and apparently healthy control dogs voluntarily enrolled in the blood donor program from 2017 to 2018 were reviewed. For the healthy control dogs, consent was obtained to perform VCM in addition to traditional screening. Compared to healthy control dogs, dogs with pIMHA had mean VCM parameters consistent with hypercoagulability, demonstrated by lower mean (SD) clot formation time (108 s [30] vs 233 s [55]; P < 0.0001), higher mean alpha angle (62 degrees [6] vs 52 degrees [6]; P < 0.0001), higher mean maximum clot formation (49 VCM units [11] vs 32 VCM units [5]; P < 0.0001), higher mean amplitude at 10 minutes (40 VCM units [11] vs 19 VCM units [3]; P < 0.0001), and higher mean amplitude at 20 minutes (47 VCM units [11] vs 25 VCM units [4]; P < 0.0001). pIMHA dogs also had significantly higher median (interquartile range) lysis index at 30 minutes (100% [100-100] vs 98% [90-100]; P < 0.0001). When compared to 3 established normal canine reference intervals, dogs with pIMHA had a significantly higher proportion of VCM variables (48%-57%) consistent with hypercoagulability, and a significant percentage of pIMHA dogs (78%-89%) had VCM tracings consistent with hypercoagulability overall, irrespective of the interval utilized for interpretation. CONCLUSIONS This study demonstrates hypercoagulability in dogs with pIMHA when compared to healthy control dogs using VCM. Prospective evaluation is warranted to further characterize these findings as well as to evaluate their clinical impact.
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9
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Hafner PM, Mackin AJ, Wills RW, Brooks MB, Thomason JM. Anticoagulant effects of rivaroxaban, prednisone, alone and in combination, in healthy dogs. J Vet Intern Med 2022; 36:2009-2015. [DOI: 10.1111/jvim.16572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/07/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Paige M. Hafner
- Department of Clinical Sciences College of Veterinary Medicine, Mississippi State University Mississippi State Mississippi USA
| | - Andrew J. Mackin
- Department of Clinical Sciences College of Veterinary Medicine, Mississippi State University Mississippi State Mississippi USA
| | - Robert W. Wills
- Department of Comparative Biomedical Sciences College of Veterinary Medicine, Mississippi State University Mississippi State Mississippi USA
| | - Marjory B. Brooks
- Department of Population Medicine and Diagnostic Sciences College of Veterinary Medicine, Cornell University Ithaca New York USA
| | - John M. Thomason
- Department of Clinical Sciences College of Veterinary Medicine, Mississippi State University Mississippi State Mississippi USA
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Bau-Gaudreault L, Arndt T, Provencher A, Brayton CF. Research-Relevant Clinical Pathology Resources: Emphasis on Mice, Rats, Rabbits, Dogs, Minipigs, and Non-Human Primates. ILAR J 2021; 62:203-222. [PMID: 34877602 DOI: 10.1093/ilar/ilab028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 08/16/2021] [Accepted: 09/07/2021] [Indexed: 12/15/2022] Open
Abstract
Clinical pathology testing for investigative or biomedical research and for preclinical toxicity and safety assessment in laboratory animals is a distinct specialty requiring an understanding of species specific and other influential variables on results and interpretation. This review of clinical pathology principles and testing recommendations in laboratory animal species aims to provide a useful resource for researchers, veterinary specialists, toxicologists, and clinical or anatomic pathologists.
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Affiliation(s)
- Liza Bau-Gaudreault
- Clinical Laboratories, Charles River Laboratories - ULC, Senneville, Quebec, Canada
| | - Tara Arndt
- Labcorp Drug Development, Madison, Wisconsin, United States
| | - Anne Provencher
- Clinical Laboratories, Charles River Laboratories - ULC, Sherbrooke, Quebec, Canada
| | - Cory F Brayton
- Molecular and Comparative Pathobiology, John Hopkins University, School of Medicine, Baltimore, Maryland, USA
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11
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A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease. BMC Vet Res 2021; 17:346. [PMID: 34749707 PMCID: PMC8573990 DOI: 10.1186/s12917-021-03058-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/19/2021] [Indexed: 01/15/2023] Open
Abstract
Background Critically ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. Global hemostatic tests examining the initiation of coagulation, clot strength and fibrinolysis, such as the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) have not been evaluated in horses. This study aimed to evaluate CAT and apply plasma-TEG in horses. Test performance of CAT was evaluated on equine platelet poor plasma with intra- and inter-assay variability (CV) and a heparin dilution curve. To examine clinical performance of both tests, group comparisons were assessed comparing healthy horses, horses with mild and severe GI disease with both CAT and plasma-TEG. Results For CAT, intra- and inter-assay CVs were established for lag-time (1.7, 4.7%), endogenous thrombin potential (1.6, 4.6%), peak (2.6, 3.9%) and time to peak (ttPeak) (1.9, 3.4%). Increasing heparin concentrations led to the expected decrease in thrombin generation. In the group comparison analysis, CAT showed significant higher peak (p = 0.04) and ttPeak (p = 0.008) in the severe GI disease group compared to horses with mild GI disease and healthy horses, respectively. Plasma-TEG showed an increased angle (p = 0.032), maximum amplitude (p = 0.017) and shear elastic force (G) (p = 0.017) in the severe GI disease group compared to healthy horses. Conclusions CAT performed well in horses. Both CAT and plasma-TEG identified hemostatic aberrations in horses with severe GI disease compared to healthy horses. Further studies including more horses, are needed to fully appreciate the use of CAT and plasma-TEG in this species. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-03058-7.
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12
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Sakamoto Y, Sato K, Ishikawa C, Kagawa Y, Nakayama T, Sakai M. Long-term follow-up of portal vein thrombosis in an American Cocker Spaniel with lobular dissecting hepatitis: a case report. BMC Vet Res 2021; 17:319. [PMID: 34592989 PMCID: PMC8482575 DOI: 10.1186/s12917-021-03017-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lobular dissecting hepatitis (LDH) is a rare form of canine liver cirrhosis that may be accompanied by portal hypertension in American Cocker Spaniels. In human patients with liver cirrhosis, portal vein thrombosis (PVT) is a common complication. However, PVT has not been reported in dogs with LDH. Herein, we describe the long-term follow-up of PVT in an American Cocker Spaniel with LDH. CASE PRESENTATION An 8-year-old neutered male American Cocker Spaniel presented with a 1-month history of severe abdominal effusion. The dog was histopathologically diagnosed with LDH and treated with low-dose prednisolone on day 14. On day 115, computed tomography angiography (CTA) confirmed the presence of a thrombus in the portal vein. Therefore, the dog was subcutaneously administered with the anticoagulant dalteparin, and low-dose prednisolone was continued. As a follow-up for PVT, CTA examinations were performed on days 207, 515, 886, and 1168, and the dog's antithrombin and D-dimer levels were measured. Following anticoagulant therapy, the dog was confirmed to have gradually increased antithrombin activity and decreased D-dimer concentrations. In addition, although the thrombus was confirmed to be in the same area of the portal vein system by CTA, atrophy and increased CT values due to organization were observed during the follow-up period. The dog's condition remained stable without clinical signs until day 1112 when it developed hepatic encephalopathy. The dog died on day 1208. On postmortem examination, histopathologically, the liver showed marked bile duct hyperplasia and fibrosis with chronic thrombus in the portal vein. CONCLUSIONS This case demonstrated that low-dose glucocorticoid combined with dalteparin allowed long-term follow-up of PVT in an American Cocker Spaniel with LDH.
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Affiliation(s)
- Yumi Sakamoto
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, 252-0880, Kanagawa, Japan
| | - Keita Sato
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, 252-0880, Kanagawa, Japan
| | - Chieko Ishikawa
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, 252-0880, Kanagawa, Japan
| | - Yumiko Kagawa
- North Lab, 8-35 Kita, 2-chome Hondori, Shiroishi-ku, Sapporo, 003-0027, Hokkaido, Japan
| | - Tomohiro Nakayama
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, 252-0880, Kanagawa, Japan
| | - Manabu Sakai
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, 252-0880, Kanagawa, Japan.
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Rastoder E, Sivapalan P, Eklöf J, Saeed MI, Jordan AS, Meteran H, Tønnesen L, Biering-Sørensen T, Løkke A, Seersholm N, Lynghøj Nielsen T, Carlsen J, Janner J, Godtfredsen N, Bodtger U, Laursen CB, Hilberg O, Knop FK, Priemé H, Ingebrigtsen TS, Gottlieb V, Wilcke JT, Stæhr Jensen JU. Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients. Biomedicines 2021; 9:biomedicines9080874. [PMID: 34440079 PMCID: PMC8389624 DOI: 10.3390/biomedicines9080874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
Due to frequent exacerbations, many patients with chronic obstructive pulmonary disease (COPD) are exposed to oral corticosteroids (OCS), which may be thrombogenic. We evaluated the risk of hospitalisation with venous thromboembolism (VTE) and death in patients with acute exacerbation of COPD (AECOPD) treated with long and short OCS regimens. In this nationwide cohort study of 30,473 COPD outpatients treated for AECOPD, we compared the risk of VTE hospitalisation and all-cause mortality within 6 months in OCS dose of >250 mg vs. ≤250 mg. A multivariable Cox proportional hazard regression was used to estimate the risk. The incidence of VTE hospitalisations was 0.23%. A long OCS treatment course was associated with an increased risk of VTE compared to a short course (hazard ratio (HR) 1.69, [95% confidence interval (CI) 1.05 to 2.72], p < 0.031). A higher risk of all-cause mortality was seen in the group of COPD patients treated with a long OCS course (HR 1.71, [95% CI 1.63 to 1.79], p < 0.0001). The risk of reported VTE hospitalisation was higher among AECOPD patients treated with long courses of OCS, but the absolute risk was low, suggesting under-reporting of the condition.
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Affiliation(s)
- Ema Rastoder
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
- Correspondence:
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Josefin Eklöf
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Mohamad Isam Saeed
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Alexander Svorre Jordan
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Howraman Meteran
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Louise Tønnesen
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Tor Biering-Sørensen
- Section of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark;
| | - Anders Løkke
- Department of Medicine, Hospital Lillebælt, 7100 Vejle, Denmark; (A.L.); (O.H.)
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Niels Seersholm
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Thyge Lynghøj Nielsen
- Section of Respiratory Medicine and Infectious Disease, Nordsjællands Hospital, 3400 Hillerød, Denmark;
| | - Jørn Carlsen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark;
| | - Julie Janner
- Section of Respiratory Medicine, Amager and Hvidovre Hospital, 2650 Hvidovre, Denmark; (J.J.); (N.G.)
| | - Nina Godtfredsen
- Section of Respiratory Medicine, Amager and Hvidovre Hospital, 2650 Hvidovre, Denmark; (J.J.); (N.G.)
| | - Uffe Bodtger
- Section of Respiratory Medicine, Næstved Hospital, 4700 Næstved, Denmark;
| | - Christian B. Laursen
- Department of Respiratory Medicine, Odense University Hospital, Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of South Denmark, 5000 Odense, Denmark;
| | - Ole Hilberg
- Department of Medicine, Hospital Lillebælt, 7100 Vejle, Denmark; (A.L.); (O.H.)
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Filip K. Knop
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark;
- Steno Diabetes Center Copenhagen, Gentofte Hospital, 2900 Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Helene Priemé
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2730 Herlev, Denmark;
| | | | - Vibeke Gottlieb
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Jon Torgny Wilcke
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
| | - Jens Ulrik Stæhr Jensen
- Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.E.); (M.I.S.); (A.S.J.); (H.M.); (L.T.); (N.S.); (V.G.); (J.T.W.); (J.U.S.J.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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14
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Nagahara T, Ohno K, Nagao I, Nakagawa T, Yokoyama N, Ohmi A, Goto-Koshino Y, Chambers JK, Uchida K, Tomiyasu H, Tsujimoto H. Changes in the coagulation parameters in dogs with protein-losing enteropathy between before and after treatment. J Vet Med Sci 2021; 83:1295-1302. [PMID: 34176824 PMCID: PMC8437731 DOI: 10.1292/jvms.21-0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Protein-losing enteropathy (PLE) is known to induce hypercoagulability and resultant
thromboembolism in dogs. We hypothesized that hypercoagulability would improve if
remission was obtained in dogs with PLE after treatment. This study aimed to evaluate the
changes in the coagulation parameters after treatment in dogs diagnosed with PLE. As
coagulation parameters, prothrombin time (PT), activated partial thromboplastin time
(aPTT), fibrinogen, thrombin-antithrombin complex (TAT), D-dimer, and antithrombin (AT)
were measured. In addition to these parameters, rotational thromboelastometry (ROTEM),
which evaluates the comprehensive coagulation and fibrinolysis reactions of whole blood,
was conducted and the data of clotting time (CT), clot formation time (CFT), α angle (α),
maximum clot firmness (MCF) and lysis index at 60 min (LI60) were obtained. Eleven of the
14 dogs diagnosed with PLE were classified as responders to the treatment based on the
changes in their plasma albumin (ALB) concentration after treatment. Significant increase
in CFT and decrease of α and MCF indicating the resolution of hypercoagulability were
found after treatment in responder dogs; however, there was no significant change in the
coagulation and fibrinolysis parameters other than those measured by ROTEM. This study
demonstrated that the hypercoagulability detected by ROTEM was significantly improved
after treatment in dogs with PLE.
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Affiliation(s)
- Takuro Nagahara
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Koichi Ohno
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Itsuma Nagao
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Taisuke Nakagawa
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Nozomu Yokoyama
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
| | - Aki Ohmi
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Yuko Goto-Koshino
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - James K Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Hirotaka Tomiyasu
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Hajime Tsujimoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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15
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Gorenstein T, Portilho F, Calobrizi N, Gonçalves D, Paes A, Takahira R. Thromboelastometry assessment of mycophenolate mofetil effect on thrombotic risk in dogs with primary and secondary immune-mediated hemolytic anemia and by Erhlichia canis infection. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-11465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT This study aimed to identify, by means of thromboelastometry assessment, altered thrombotic risk in dogs with primary and secondary IMHA by E. canis infection after initiating the immunosuppressive therapy with mycophenolate mofetil. The animals’ screening was based on complete blood count (CBC), biochemical and urine tests. Dogs with moderate to severe anemia (hematocrit ≤ 25%) which showed symptoms of immune-mediated hemolysis, such as spherocytosis, positive saline agglutination, bilirubinuria and/or hemoglobinuria, were included. Blood and urine samples were collected at two different moments. The first sample (M1) was collected at the time of diagnosis, when hematocrit was lower or equal to 25% before treatment with mycophenolate mofetil (Accord ®); the second sample (M2) was collected after treatment with mycophenolate mofetil, when hematocrit was greater or equal to 30%. Five out of the twelve animals selected died before the end of the study. No reduction in thrombotic risk was observed in the animals treated with mycophenolate mofetil. The animals that presented hypocoagulation at the time of diagnosis showed the worst prognosis, and their reticulocyte count displayed a better prognostic value than their erythrocytes count at the time of diagnosis.
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Affiliation(s)
| | | | | | | | - A.C. Paes
- Universidade Estadual Paulista, Brazil
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16
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Dixon A, Hall EJ, Adamantos S, Kathrani A, McGrath C, Black V. Hypercoagulability in dogs with chronic enteropathy and association with serum albumin concentration. J Vet Intern Med 2021; 35:860-866. [PMID: 33527508 PMCID: PMC7995358 DOI: 10.1111/jvim.16044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/23/2020] [Accepted: 01/14/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Dogs with protein-losing enteropathy (PLE) are at risk of developing a hypercoagulable state, but the prevalence of hypercoagulability in dogs with chronic enteropathies (CE) and normal serum albumin concentration is unknown. HYPOTHESIS Dogs with CE are predisposed to a hypercoagulable state as assessed by thromboelastography (TEG) independent of serum albumin concentration. METHODS Dogs with chronic gastrointestinal signs from suspected inflammatory CE between 2017 and 2019 were included. Thirty-eight were evaluated; every dog had a CBC, serum biochemistry panel, and abdominal imaging performed. The Canine Inflammatory Bowel Disease Activity Index (CIBDAI) was calculated. Thromboelastography was performed at presentation, and reaction time (R), kinetic time (K), α-angle, maximal amplitude (MA), and global clot strength (G) were recorded. Dogs were considered hypercoagulable if the G value was ≥25% above the reference interval. RESULTS Seventeen of 38 (44.7%; 95% confidence interval [CI], 28.6-61.7%) dogs with CE were hypercoagulable. The G value did not differ between the 19 dogs with normal (≥28 g/L) serum albumin concentrations (9.05 kdyn/cm2 ; 95% CI, 7.26-10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm2 ; 95% CI, 9.04-13.6, SD; 4.7; P = .11). The G value was negatively correlated with hematocrit, serum albumin concentration, and duration of signs and positively correlated with age. CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with CE and normal serum albumin concentration can be hypercoagulable as measured by TEG.
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Affiliation(s)
- Amy Dixon
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, United Kingdom
| | - Edward J Hall
- Small Animal Referral Hospital, Langford Vets, Langford House, Langford, BS40 5DU, United Kingdom
| | - Sophie Adamantos
- Paragon Veterinary Referrals, Paragon Business Village, Red Hall Crescent, Wakefield, West Yorkshire, WF1 2DF, United Kingdom
| | - Aarti Kathrani
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - Ciara McGrath
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, United Kingdom
| | - Vicki Black
- Small Animal Referral Hospital, Langford Vets, Langford House, Langford, BS40 5DU, United Kingdom
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17
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Rosen S, Benedicenti L, Petesch S, Reetz J, Galban EM. Case Report: Mineralized Pulmonary Artery Thrombi in Two Dogs Treated for Meningoencephalitis of Unknown Origin. Front Vet Sci 2021; 7:569597. [PMID: 33392278 PMCID: PMC7773639 DOI: 10.3389/fvets.2020.569597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
Meningoencephalitis of unknown origin (MUO) is a relatively common and very serious canine neurologic condition, which is typically associated with a poor long term prognosis despite treatment. This case series chronicles two dogs diagnosed with MUO who were treated with long term corticosteroids and cytosine arabinoside and lived well-beyond the typical survival time for this condition. Both eventually succumbed to respiratory signs associated with mineralized thrombi in their pulmonary arteries. Adverse effects from the two drugs used for treatment are reviewed in order to propose a possible mechanism to explain how long term use of these medications could result in such a phenomenon.
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Affiliation(s)
- Suzanne Rosen
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Leontine Benedicenti
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Scott Petesch
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer Reetz
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Evelyn Marie Galban
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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18
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Sebbag L, Mochel JP. Pharmacokinetics of Oral Prednisone at Various Doses in Dogs: Preliminary Findings Using a Naïve Pooled-Data Approach. Front Vet Sci 2020; 7:571457. [PMID: 33195563 PMCID: PMC7604266 DOI: 10.3389/fvets.2020.571457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/09/2020] [Indexed: 12/17/2022] Open
Abstract
This pilot study aimed to determine the plasma pharmacokinetics of prednisone and its active metabolite prednisolone following oral prednisone administration in dogs-using dosing regimens that cover anti-inflammatory to immuno-suppressive biological effects. Six healthy Beagle dogs were given 0.5, 1, 2, and 4 mg/kg prednisone orally once daily for 5 days, each successive course separated by a washout period of 9 days. At steady-state (Day 4), a sparse sampling design allowed for collection of blood from 2/6 individuals for each of the following time points: 0, 15, 30, 60, 90, 120, 240, 480, and 720 min. Prednisone and prednisolone were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Oral prednisone was rapidly converted to prednisolone in dogs (≤ 30 min), with plasma prednisolone reaching ~6-fold greater levels (0-656.1 ng/mL) than prednisone (0-98.8 ng/mL) overall. The ratio of plasma prednisolone/prednisone was constant across the dosing regimens, indicating a non-saturation of the hepatic 11-β-hydroxysteroid dehydrogenase that converts the prodrug to the active metabolite in dogs. The level of both corticosteroids increased with increasing dosing regimens, albeit in a non-linear manner. Non-compartmental pharmacokinetic parameters are described, including peak concentration (Cmax), time of peak concentration (Tmax), area under the concentration-time curve (AUClast), and the elimination half-life (t 1/2) for both corticosteroids, as well as clearance and volume of distribution during the terminal phase (Vz) for the administered drug (prednisone). In sum, the present study utilizes a sparse sampling and naïve pooled-data approach to estimate pharmacokinetic parameters for prednisone and prednisolone, providing supporting preliminary knowledge that can be used to optimize corticosteroid efficacy and minimize toxicity in canine patients.
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Affiliation(s)
- Lionel Sebbag
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Jonathan P Mochel
- Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
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19
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Waller AP, Agrawal S, Wolfgang KJ, Kino J, Chanley MA, Smoyer WE, Kerlin BA. Nephrotic syndrome-associated hypercoagulopathy is alleviated by both pioglitazone and glucocorticoid which target two different nuclear receptors. Physiol Rep 2020; 8:e14515. [PMID: 32776495 PMCID: PMC7415912 DOI: 10.14814/phy2.14515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Thrombosis is a potentially life-threatening nephrotic syndrome (NS) complication. We have previously demonstrated that hypercoagulopathy is proportional to NS severity in rat models and that pioglitazone (Pio) reduces proteinuria both independently and in combination with methylprednisolone (MP), a glucocorticoid (GC). However, the effect of these treatments on NS-associated hypercoagulopathy remains unknown. We thus sought to determine the ability of Pio and GC to alleviate NS-associated hypercoagulopathy. METHODS Puromycin aminonucleoside-induced rat NS was treated with sham, Low- or High-dose MP, Pio, or combination (Pio + Low-MP) and plasma was collected at day 11. Plasma samples were collected from children with steroid-sensitive NS (SSNS) and steroid-resistant NS (SRNS) upon presentation and after 7 weeks of GC therapy. Plasma endogenous thrombin potential (ETP), antithrombin (AT) activity, and albumin (Alb) were measured using thrombin generation, amidolytic, and colorimetric assays, respectively. RESULTS In a rat model of NS, both High-MP and Pio improved proteinuria and corrected hypoalbuminemia, ETP and AT activity (p < .05). Proteinuria (p = .005) and hypoalbuminemia (p < .001) were correlated with ETP. In childhood NS, while ETP was not different at presentation, GC therapy improved proteinuria, hypoalbuminemia, and ETP in children with SSNS (p < .001) but not SRNS (p = .330). CONCLUSIONS Both Pio and GC diminish proteinuria and significantly alleviate hypercoagulopathy. Both Pio and MP improved hypercoagulopathy in rats, and successful GC therapy (SSNS) also improved hypercoagulopathy in childhood NS. These data suggest that even a partial reduction in proteinuria may reduce NS-associated thrombotic risk.
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Affiliation(s)
- Amanda P. Waller
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
| | - Shipra Agrawal
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
- Department of PediatricsThe Ohio State University College of MedicineColumbusOHUSA
| | - Katelyn J. Wolfgang
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
| | - Jiro Kino
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
| | - Melinda A. Chanley
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
| | - William E. Smoyer
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
- Department of PediatricsThe Ohio State University College of MedicineColumbusOHUSA
| | - Bryce A. Kerlin
- Center for Clinical & Translational ResearchThe Abigail Wexner Research Institute at Nationwide Children'sColumbusOHUSA
- Department of PediatricsThe Ohio State University College of MedicineColumbusOHUSA
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20
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Gant P, McBride D, Humm K. Abnormal platelet activity in dogs and cats - impact and measurement. J Small Anim Pract 2020; 61:3-18. [PMID: 31919851 DOI: 10.1111/jsap.13092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/06/2019] [Accepted: 10/28/2019] [Indexed: 01/08/2023]
Abstract
Abnormal platelet activity can either lead to bleeding tendencies or inappropriate thrombus formation and can occur secondarily to a wide variety of disease processes, with a range of clinical consequences and severity. This article will discuss the pathophysiology of platelet function abnormalities and consider a logical diagnostic approach applicable to veterinary practice. Recent advances in platelet function testing will then be discussed, with regards to detection of platelet dysfunction and tailoring of pharmacological manipulation. Although many of these tests are still confined to research or academic institutions, techniques for indirectly assessing platelet function are starting to become more widely available. Although we still require further research to develop guidelines for the use of these tests in clinical decision-making, the recent advances in this field are an exciting step forward in being able to detect and manage platelet dysfunction in both primary care and referral practice.
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Affiliation(s)
- P Gant
- Queen Mother Hospital for Animals (QMHA), The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - D McBride
- Queen Mother Hospital for Animals (QMHA), The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - K Humm
- Queen Mother Hospital for Animals (QMHA), The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
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21
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Phipps WE, de Laforcade AM, Barton BA, Berg J. Postoperative thrombocytosis and thromboelastographic evidence of hypercoagulability in dogs undergoing splenectomy for splenic masses. J Am Vet Med Assoc 2020; 256:85-92. [PMID: 31841092 DOI: 10.2460/javma.256.1.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the frequency and severity of thrombocytosis and thromboelastographic evidence of hypercoagulability during the first 2 weeks after splenectomy in dogs with splenic masses and to investigate relationships between platelet counts and thromboelastography values. ANIMALS 34 dogs undergoing splenectomy for splenic masses. PROCEDURES Blood samples for platelet counts and thromboelastography were obtained at induction of anesthesia (day 0) prior to splenectomy and on days 2, 7, and 14. RESULTS Mean platelet counts were 167.9 × 103/μL, 260.4 × 103 μ/L, 715.9 × 103/μL, and 582.2 × 103/μL on days 0, 2, 7, and 14, respectively, and were significantly higher at all postoperative assessment points than on day 0. Thrombocytosis was observed in 3% (1/34), 6% (2/33), 81% (21/26), and 69% (18/26) of dogs on days 0, 2, 7, and 14. Platelet counts > 1,000 × 103/μL were observed in 1 dog on day 2 and in 5 dogs on day 7. One or more thromboelastography values suggestive of hypercoagulability were observed in 45% (15/33), 84% (26/31), 89% (24/27), and 84% (21/25) of dogs on days 0, 2, 7, and 14. At each assessment point, higher platelet counts were correlated with thromboelastography values suggestive of hypercoagulability. CONCLUSIONS AND CLINICAL RELEVANCE Marked thrombocytosis and thromboelastography values suggestive of hypercoagulability were common during the first 2 weeks after splenectomy for the dogs of this study. If present, hypercoagulability could increase the risk for development of postsplenectomy thrombotic conditions such as portal system thrombosis and pulmonary thromboembolism.
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22
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Ames MK, Atkins CE. Treatment of dogs with severe heartworm disease. Vet Parasitol 2020; 283:109131. [PMID: 32521392 DOI: 10.1016/j.vetpar.2020.109131] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 12/11/2022]
Abstract
Fortunately, the majority of dogs diagnosed with heartworm infection are asymptomatic (or have only mild symptoms such as intermittent cough) and go through adulticide therapy without complication. Complications occurring with heartworm infection and during its treatment most often directly reflect the pulmonary vascular and parenchymal injury inflicted by Dirofilaria immitis. Clinical signs may include exercise intolerance, frequent cough, hemoptysis, tachypnea, and dyspnea. Severe manifestations such as heart failure and caval syndrome may prove fatal. Acute hypersensitivity reactions after initiation of macrocyclic lactone preventive therapy in microfilaremic dogs or after melarsomine injection during adulticide therapy do occur, but are uncommon. This article reviews complications associated with heartworm infection.
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Affiliation(s)
- Marisa K Ames
- Colorado State University College of Veterinary Medicine and Biomedical Sciences, 1678 Campus Delivery, Fort Collins, CO, 80523, United States.
| | - Clarke E Atkins
- North Carolina State University College of Veterinary Medicine, 1052 William Moore Dr, Raleigh, NC, 27606, United States
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Thomason J, Mooney AP, Price JM, Whittemore JC. Effects of clopidogrel and prednisone on platelet function in healthy dogs. J Vet Intern Med 2020; 34:1198-1205. [PMID: 32246893 PMCID: PMC7255683 DOI: 10.1111/jvim.15759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/12/2020] [Indexed: 12/27/2022] Open
Abstract
Background Glucocorticoids cause hypercoagulability, but it is unknown if they counteract clopidogrel's antiplatelet effects. Hypothesis/Objectives Determine the effects of clopidogrel and prednisone on platelet function. Animals Twenty‐four healthy dogs. Methods Double‐blinded, placebo‐controlled randomized trial. Platelet function was evaluated using a platelet function analyzer and impedance aggregometry (days 0, 14, and 28) for dogs treated with placebo, clopidogrel (2‐3 mg/kg/d), prednisone (2 mg/kg/d), or prednisone with clopidogrel PO for 28 days. Results were categorized as nonresponder versus responder (platelet function analyzer), and inadequate, ideal, or excessive response (aggregometry). Results were compared using mixed model, split‐plot repeated measures analysis of variance and generalized estimating equation proportional odds models. P < .05 was considered significant. Results Closure times differed by treatment (F [3, 20] = 10.5; P < .001), time (F [2, 40] = 14.3; P < .001), and treatment‐by‐time (F [6, 40] = 3.4; P = .01). Area under the curve (AUC) differed by treatment (F [3, 20] = 19.6; P < .001), time (F [2, 40] = 35.4; P < .001), and treatment‐by‐time (F [6, 40] = 13.5; P < .001). Based on closure times, 5/6 dogs each in the clopidogrel and prednisone/clopidogrel groups were responders. All dogs in the prednisone/clopidogrel group were overcontrolled based on AUC (days 14 and 28), whereas 5/6 (day 14) and 2/6 (day 28) dogs treated with clopidogrel were overcontrolled. Compared to clopidogrel, dogs receiving prednisone/clopidogrel were 11 times (P = .03) more likely to have an excessive response. Conclusions and Clinical Importance Administration of clopidogrel/prednisone increases platelet dysfunction in healthy dogs.
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Affiliation(s)
- John Thomason
- The Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Allison P Mooney
- The Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Joshua M Price
- The Office of Information Technology, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Jacqueline C Whittemore
- The Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
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Thomason JM, Mooney AP, Price JM, Whittemore JC. Effects of Aspirin and Prednisone on Platelet Function and Thromboxane Synthesis in Healthy Dogs. Front Vet Sci 2019; 6:393. [PMID: 31803764 PMCID: PMC6872492 DOI: 10.3389/fvets.2019.00393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/24/2019] [Indexed: 12/15/2022] Open
Abstract
Glucocorticoid administration is a risk factor for thromboembolism in hypercoagulable dogs, and it is unknown if aspirin counteracts glucocorticoid-induced hypercoagulability. The objective was to determine the effects of sustained aspirin and prednisone administration on platelet function and thromboxane synthesis. Our hypothesis was that aspirin would consistently inhibit platelet function and thromboxane synthesis when administered with or without prednisone. In 24 healthy dogs, platelet aggregometry and urine 11-dehydro-thromboxane-B2 (11-dTXB2)-to-creatinine ratios were measured on days 0, 14, and 28. Dogs were administered placebos, aspirin (2 mg/kg/d), prednisone (2 mg/kg/d), or prednisone/aspirin combination therapy PO for 28 days in a randomized double-blinded study. Aspirin response was based on a >25% reduction in platelet aggregation compared to pre-treatment values. Results were compared using mixed model, split-plot repeated measures ANOVAs. P < 0.05 was considered significant. AUC differed significantly by time [F(2,40) = 10.2, P < 0.001] but not treatment or treatment-by-time. On day 14, 2 dogs were aspirin responders (aspirin, 1; placebo, 1). On day 28, 3 dogs were aspirin responders (aspirin, 2; prednisone/aspirin, 1). Urine 11-dTXB2-to-creatinine ratios differed significantly by group [F(3,20) = 3.9, P = 0.024] and time [F(2,40) = 8.7, P < 0.001), but not treatment-by-time. Post-hoc analysis revealed significant differences between aspirin and placebo groups (P=0.008), aspirin and prednisone/aspirin groups (P = 0.030), and placebo and prednisone groups (P = 0.030). In healthy dogs, sustained aspirin, prednisone, and combination therapy do not inhibit platelet aggregation, and when used as individual therapies, aspirin and prednisone decreased thromboxane synthesis. Additional studies using varied platelet function methodologies in hypercoagulable dogs are necessary.
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Affiliation(s)
- John M Thomason
- The Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, United States
| | - Allison P Mooney
- The Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Joshua M Price
- The Office of Information Technology, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Jacqueline C Whittemore
- The Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
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25
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deLaforcade A, Bacek L, Blais MC, Goggs R, Lynch A, Rozanski E. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 1-Defining populations at risk. J Vet Emerg Crit Care (San Antonio) 2019; 29:37-48. [PMID: 30654424 DOI: 10.1111/vec.12797] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Thrombosis is a well-recognized phenomenon in dogs and cats with a significant impact on morbidity and mortality. Despite growing awareness of thrombosis and increased use of antithrombotic therapy, there is little information in the veterinary literature to guide the use of anticoagulant and antiplatelet medications. The goal of Domain 1 was to explore the association between disease and thrombosis in a number of conditions identified as potential risk factors in the current veterinary literature, to provide the basis for prescribing recommendations. DESIGN A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs. Revised guidelines then underwent the Delphi survey process to reach consensus on the final guidelines. Diseases evaluated included immune-mediated hemolytic anemia, protein-losing nephropathy, pancreatitis, glucocorticoid therapy, hyperadrenocorticism, neoplasia, sepsis, cerebrovascular disease, and cardiac disease. SETTINGS Academic and referral veterinary medical centers. RESULTS Of the diseases evaluated, a high risk for thrombosis was defined as dogs with immune-mediated hemolytic anemia or protein-losing nephropathy, cats with cardiomyopathy and associated risk factors, or dogs/cats with >1 disease or risk factor for thrombosis. Low or moderate risk for thrombosis was defined as dogs or cats with a single risk factor or disease, or dogs or cats with known risk factor conditions that are likely to resolve in days to weeks following treatment. CONCLUSIONS Documented disease associations with thrombosis provide the basis for recommendations on prescribing provided in subsequent domains. Numerous knowledge gaps were identified that represent opportunities for future study.
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Affiliation(s)
- Armelle deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Lenore Bacek
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Marie-Claude Blais
- Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY
| | - Alex Lynch
- Department of Clinical Sciences, NC State College of Veterinary Medicine, Raleigh, NC
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
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26
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Craven MD, Washabau RJ. Comparative pathophysiology and management of protein-losing enteropathy. J Vet Intern Med 2019; 33:383-402. [PMID: 30762910 PMCID: PMC6430879 DOI: 10.1111/jvim.15406] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 11/30/2018] [Indexed: 12/17/2022] Open
Abstract
Protein‐losing enteropathy, or PLE, is not a disease but a syndrome that develops in numerous disease states of differing etiologies and often involving the lymphatic system, such as lymphangiectasia and lymphangitis in dogs. The pathophysiology of lymphatic disease is incompletely understood, and the disease is challenging to manage. Understanding of PLE mechanisms requires knowledge of lymphatic system structure and function, which are reviewed here. The mechanisms of enteric protein loss in PLE are identical in dogs and people, irrespective of the underlying cause. In people, PLE is usually associated with primary intestinal lymphangiectasia, suspected to arise from genetic susceptibility, or “idiopathic” lymphatic vascular obstruction. In dogs, PLE is most often a feature of inflammatory bowel disease (IBD), and less frequently intestinal lymphangiectasia, although it is not proven which process is the true driving defect. In cats, PLE is relatively rare. Review of the veterinary literature (1977‐2018) reveals that PLE was life‐ending in 54.2% of dogs compared to published disease‐associated deaths in IBD of <20%, implying that PLE is not merely a continuum of IBD spectrum pathophysiology. In people, diet is the cornerstone of management, whereas dogs are often treated with immunosuppression for causes of PLE including lymphangiectasia, lymphangitis, and crypt disease. Currently, however, there is no scientific, extrapolated, or evidence‐based support for an autoimmune or immune‐mediated mechanism. Moreover, people with PLE have disease‐associated loss of immune function, including lymphopenia, severe CD4+ T‐cell depletion, and negative vaccinal titers. Comparison of PLE in people and dogs is undertaken here, and theories in treatment of PLE are presented.
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Affiliation(s)
- Melanie D Craven
- Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Robert J Washabau
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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27
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Castejon-Gonzalez AC, Soltero-Rivera M, Brown DC, Reiter AM. Treatment Outcome of 22 Dogs With Masticatory Muscle Myositis (1999-2015). J Vet Dent 2018. [DOI: 10.1177/0898756418813536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Medical records of dogs diagnosed with masticatory muscle myositis (MMM) at Ryan Veterinary Hospital of the University of Pennsylvania during a period of 17 years (from 1999 to 2015) were reviewed. Twenty-two dogs were included in this retrospective case series study. Immunosuppressive doses of prednisone were prescribed to all dogs. Twenty dogs had full recovery of masticatory function. The mean (SD) improvement in the vertical mandibular range of motion (vmROM) was 5.3 (3.1) cm during the first 4 weeks of treatment (weeks 1-4) and 2.8 (2.2) cm during the subsequent 8 weeks (weeks 5-12). The vmROM continued to improve for several more months. Six dogs had a relapse, but the clinical signs were more severe in dogs when no longer receiving prednisone compared to dogs still on prednisone at the time of relapse. When diagnosed and treated appropriately, MMM has a good prognosis with relatively quick return to masticatory function. Early discontinuation of prednisone therapy should be avoided. Approximately 1 year of therapy is recommended prior to discontinuing the medication. Educating the client about how to perform muscle palpation, determine vmROM at home, recognize signs of pain, and notice behavioral changes may help in the early detection of relapses.
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Affiliation(s)
- Ana C. Castejon-Gonzalez
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Maria Soltero-Rivera
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Alexander M. Reiter
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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28
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Thomason JM, Archer TM, Wills RW, Mackin AJ. Effects of immunosuppressive agents on the hemostatic system in normal dogs. J Vet Intern Med 2018; 32:1325-1333. [PMID: 29749651 PMCID: PMC6060322 DOI: 10.1111/jvim.15132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/13/2017] [Accepted: 03/08/2018] [Indexed: 01/14/2023] Open
Abstract
Background In dogs, the effects of immunosuppressive medications on hemostasis are not well known. Hypothesis/Objectives The objective was to determine the effects of immunosuppressive medications on primary and secondary hemostasis. Our hypothesis was that cyclosporine and prednisone would increase markers of hypercoagulability and thromboxane synthesis, while azathioprine, mycophenolate mofetil, and leflunomide would have minimal effects on hemostasis. Animals Eight healthy dogs. Methods A randomized, cross‐over study used aggregometry, the PFA‐100 platelet function analyzer, viscoelastometry, platelet count, and prothrombin and activated partial thromboplastin times to evaluate hemostasis during the administration of prednisone, azathioprine, cyclosporine, mycophenolate mofetil, and leflunomide for 1 week each at standard oral doses. Urine 11‐dehydro‐thromboxane‐B2 (11‐dTXB2) and 6‐keto‐prostaglandin‐F1α (6‐keto‐PGF1α) concentrations, normalized to urine creatinine concentration, were measured. Results The aggregometry amplitude decreased from 51 ± 21 to 27 ± 14 (P = .002) during leflunomide treatment (ADP activation), but there were no differences in amplitude (P = .240) for any medications when platelets were activated with collagen. For all medications, there were no significant differences in viscoelastometry indices (ACT, P = .666; ClotRate, P = .340; and platelet function, P = .411) and platelet count (P = .552). Compared with pretreatment values, urinary 11‐dTXB2‐to‐creatinine ratio increased (P = .001) after drug administration (from 3.7 ± 0.6 to 5.6 ± 1.1). Cyclosporine was associated with an increase (P < .001) in the 6‐keto‐PGF1α‐to‐creatinine ratio (from 10.3 ± 4.6 to 22.1 ± 5.3). Conclusions and Clinical Importance Most immunosuppressive drugs do not enhance platelet function or coagulation in healthy dogs, suggesting that these medications might not predispose hypercoagulable dogs to thromboembolism. The results of our study need to be correlated with the clinical outcomes of hypercoagulable dogs.
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Affiliation(s)
- John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Todd M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Robert W Wills
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
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29
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Cuq B, Blois SL, Wood RD, Monteith G, Abrams-Ogg AC, Bédard C, Wood GA. Reproducibility, stability, and biological variability of thrombin generation using calibrated automated thrombography in healthy dogs. Vet Clin Pathol 2018; 47:218-226. [DOI: 10.1111/vcp.12602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Benoît Cuq
- Department of Pathobiology; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Shauna L. Blois
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - R. Darren Wood
- Department of Pathobiology; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Gabrielle Monteith
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Anthony C. Abrams-Ogg
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Christian Bédard
- Département de Pathologie et Microbiologie; Faculté de Médecine Vétérinaire; Université de Montréal; Montreal QC Canada
| | - Geoffrey A. Wood
- Department of Pathobiology; Ontario Veterinary College; University of Guelph; Guelph ON Canada
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30
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Rhue KE, Taylor AR, Cole RC, Winter RL. Bilateral Vertebral Venous Sinus Thrombosis Causing Cervical Spinal Cord Compression in a Dog. Front Vet Sci 2017; 4:8. [PMID: 28229071 PMCID: PMC5296347 DOI: 10.3389/fvets.2017.00008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 01/23/2017] [Indexed: 11/13/2022] Open
Abstract
A 10-year-old male neutered mixed breed dog was evaluated for cervical hyperesthesia and tetraparesis. Magnetic resonance imaging of the brain and cervical spinal cord identified an extradural compressive lesion over the body of C2 caused by marked dilation of the vertebral venous sinuses. Following intravenous contrast administration both vertebral sinuses had heterogeneous contrast enhancement consistent with incomplete thrombi formation. An abdominal ultrasound also showed a distal aortic thrombus. A definitive cause for the thrombi formation was not identified, but the patient had several predisposing factors which may have contributed. The patient was treated with a combination of warfarin, clopidogrel, and enoxaparin as well as analgesics. Within 48 h of initiation of warfarin therapy, the tetraparesis and hyperesthesia were markedly improved. Repeat abdominal ultrasound 3 weeks after discharge showed reduction in size of aortic thrombus. Neurologic function remained normal for 6 weeks following initiation of treatment. Seventy-four days following initial diagnosis the patient rapidly declined and passed away at home. Necropsy was declined. This is the first report of vertebral venous sinus enlargement leading to spinal cord compression and tetraparesis in a dog. Additionally, warfarin in combination with clopidogrel and enoxaparin appeared to be a safe and effective treatment for the suspected thrombi reported in this case. Vertebral sinus enlargement secondary to thrombi should be considered as a differential diagnosis in patients presenting with tetraparesis and cervical hyperesthesia.
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Affiliation(s)
- Kathryn E Rhue
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University , Auburn, AL , USA
| | - Amanda R Taylor
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University , Auburn, AL , USA
| | - Robert C Cole
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University , Auburn, AL , USA
| | - Randolph L Winter
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University , Auburn, AL , USA
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31
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Jacinto AML, Ridyard AE, Aroch I, Watson PJ, Morrison LR, Chandler ML, Kuzi S. Thromboembolism in Dogs with Protein-Losing Enteropathy with Non-Neoplastic Chronic Small Intestinal Disease. J Am Anim Hosp Assoc 2016; 53:185-192. [PMID: 27841681 DOI: 10.5326/jaaha-ms-6328] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dogs with protein-losing enteropathy (PLE) are suggested to be at increased risk of developing thromboembolic events. However, with some exceptions, there are very few reports of thromboembolism in such dogs. This multicentre retrospective observational study describes a case series of thromboembolism (TE) in eight dogs with PLE secondary to non-neoplastic, chronic small intestinal disease. Seven dogs had poorly controlled PLE when the thromboembolic event occurred. Pulmonary thromboembolism (PTE) occurred in six dogs, while one dog developed splenic vein thrombosis and another had concurrent splenic vein and aortic TE. Six dogs died, all with PTE. Antithrombin activity was decreased in one of two dogs in which it was measured. Serum cobalamin and folate concentrations were measured in three dogs and cobalamin was subnormal in all three. Serum magnesium, measured in two dogs, was low in both. Dogs with uncontrolled chronic small intestinal disease and PLE are at risk for developing serious life-threatening TE, mostly PTE.
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Affiliation(s)
| | - Alison E Ridyard
- From the Division of Veterinary Clinical Sciences (A.M.L.J., A.E.R., M.L.C.) and Easter Bush Pathology (L.R.M.), Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom; Koret School of Veterinary Medicine, the Robert H. Smith Faculty of Agricultural, the Hebrew University of Jerusalem, Rehovot, Israel (S.K., I.A.); and the Queen's Veterinary School Hospital, University of Cambridge, Cambridge, England, United Kingdom (P.J.W.)
| | | | - Penny J Watson
- From the Division of Veterinary Clinical Sciences (A.M.L.J., A.E.R., M.L.C.) and Easter Bush Pathology (L.R.M.), Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom; Koret School of Veterinary Medicine, the Robert H. Smith Faculty of Agricultural, the Hebrew University of Jerusalem, Rehovot, Israel (S.K., I.A.); and the Queen's Veterinary School Hospital, University of Cambridge, Cambridge, England, United Kingdom (P.J.W.)
| | - Linda R Morrison
- From the Division of Veterinary Clinical Sciences (A.M.L.J., A.E.R., M.L.C.) and Easter Bush Pathology (L.R.M.), Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom; Koret School of Veterinary Medicine, the Robert H. Smith Faculty of Agricultural, the Hebrew University of Jerusalem, Rehovot, Israel (S.K., I.A.); and the Queen's Veterinary School Hospital, University of Cambridge, Cambridge, England, United Kingdom (P.J.W.)
| | - Marge L Chandler
- From the Division of Veterinary Clinical Sciences (A.M.L.J., A.E.R., M.L.C.) and Easter Bush Pathology (L.R.M.), Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom; Koret School of Veterinary Medicine, the Robert H. Smith Faculty of Agricultural, the Hebrew University of Jerusalem, Rehovot, Israel (S.K., I.A.); and the Queen's Veterinary School Hospital, University of Cambridge, Cambridge, England, United Kingdom (P.J.W.)
| | - Sharon Kuzi
- From the Division of Veterinary Clinical Sciences (A.M.L.J., A.E.R., M.L.C.) and Easter Bush Pathology (L.R.M.), Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom; Koret School of Veterinary Medicine, the Robert H. Smith Faculty of Agricultural, the Hebrew University of Jerusalem, Rehovot, Israel (S.K., I.A.); and the Queen's Veterinary School Hospital, University of Cambridge, Cambridge, England, United Kingdom (P.J.W.)
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32
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Williams TP, Shaw S, Porter A, Berkwitt L. Aortic thrombosis in dogs. J Vet Emerg Crit Care (San Antonio) 2016; 27:9-22. [DOI: 10.1111/vec.12527] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 02/10/2016] [Accepted: 03/23/2016] [Indexed: 12/20/2022]
Affiliation(s)
| | - Scott Shaw
- VCA Veterinary Referral Associates; Gaithersburg MD 20877
| | - Adam Porter
- VCA Veterinary Referral Associates; Gaithersburg MD 20877
| | - Larry Berkwitt
- VCA Veterinary Referral Associates; Gaithersburg MD 20877
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33
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Tomasiak-Lozowska MM, Rusak T, Misztal T, Bodzenta-Lukaszyk A, Tomasiak M. Reduced clot retraction rate and altered platelet energy production in patients with asthma. J Asthma 2016; 53:589-98. [PMID: 27145190 DOI: 10.3109/02770903.2015.1130151] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Asthma enhances the risk of pulmonary embolism. The mechanism of this phenomenon is unclear. METHODS We evaluated the kinetics of clot formation, clot retraction rate (CRR), clot volume at 40 min, the rate of lactate production (a marker of aerobic glycolysis in platelets in contracting clots), blood eosinophil count (EOS), nitric oxide in exhaled breath (FENO), and spirometry (FEV1) in 50 healthy controls and in 81 allergic asthmatics (41 subjects with steroid-naïve asthma and 40 with steroid-treated asthma). RESULTS Thromboelastometry revealed that only steroid-treated asthmatics had slightly activated coagulation. Compared with healthy controls, whole asthmatics demonstrated (p < 0.05) reduced CRR, higher clot volume at 40 minutes, higher FENO, decreased FEV1, elevated EOS, and augmented lactate production in retracting clots. Reduced CRR was observed also in the absence of native plasma. In whole study population (asthmatics and healthy controls), CRR positively correlated with spirometry (rS = 0.668, p = <0.001) and negatively with FENO (rS = -0.543; p < 0.001), EOS (rS = -0.367, p < 0.002), and lactate production (rS = -0.791; p < 0.001). However, in steroid-treated asthmatics, the CRR did not correlate with FENO and EOS. In all study patients lactate production negatively correlated with FEV1 and positively with FENO. CONCLUSION Collectively, this data is consistent with the hypothesis that, in asthmatics, reactive nitrogen species produced in the lungs may reduce platelet contractility (and CRR) through the diminution of platelet energy production. CRR inhibition would predispose asthmatics to pulmonary embolism.
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Affiliation(s)
| | - Tomasz Rusak
- b Department of Physical Chemistry , Medical University of Bialystok , Bialystok , Poland
| | - Tomasz Misztal
- b Department of Physical Chemistry , Medical University of Bialystok , Bialystok , Poland
| | - Anna Bodzenta-Lukaszyk
- a Department of Allergology and Internal Diseases , Medical University of Bialystok , Bialystok , Poland
| | - Marian Tomasiak
- b Department of Physical Chemistry , Medical University of Bialystok , Bialystok , Poland
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34
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Dengate AL, Morel-Kopp MC, Beatty JA, Barrs V, Braddock JA, Churcher RK, Wilson BJ, Ward CM. Differentiation between dogs with thrombosis and normal dogs using the overall hemostasis potential assay. J Vet Emerg Crit Care (San Antonio) 2016; 26:446-52. [PMID: 26808263 DOI: 10.1111/vec.12442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 08/03/2014] [Accepted: 08/29/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine whether the overall hemostasis potential (OHP) and calibrated automated thrombogram (CAT) were significantly different between dogs with thrombosis and normal dogs. ANIMALS Ten dogs with clinical evidence of thromboembolic disease had both OHP and CAT performed. Forty healthy control dogs had OHP performed, and 23 of these also had CAT performed. MEASUREMENTS AND MAIN RESULTS Dogs with thrombosis had significantly higher OHP (P = 0.003), overall coagulation potential (P = 0.0001), and maximum optical density (Max OD, P < 0.0001) than normal dogs, and a significantly longer delay in the start of clot formation (P = 0.01). Max OD was higher than established reference intervals in 80% of the dogs with thrombosis. Using the CAT assay, dogs with thrombosis had a significantly longer lag time than normal dogs (P < 0.001). Plasma fibrinogen concentration correlated positively with overall coagulation potential, OHP, Max OD, and the slope of the OHP curve (P < 0.05), and was increased in 90% of dogs with thrombosis. CONCLUSIONS The OHP assay findings were significantly different between normal dogs and those with thrombosis. CAT did not detect any significant differences between these populations of dogs, other than the lag time of the assay.
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Affiliation(s)
- Anna L Dengate
- Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, 2065, Australia.,Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia.,North Shore Veterinary Specialist Centre, Crows Nest, NSW, 2065, Australia
| | - Marie-Christine Morel-Kopp
- Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Julia A Beatty
- Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia
| | - Vanessa Barrs
- Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia
| | - Jody A Braddock
- North Shore Veterinary Specialist Centre, Crows Nest, NSW, 2065, Australia
| | - Richard K Churcher
- North Shore Veterinary Specialist Centre, Crows Nest, NSW, 2065, Australia
| | - Bethany J Wilson
- Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia
| | - Christopher M Ward
- Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
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Swann JW, Garden OA. Novel immunotherapies for immune-mediated haemolytic anaemia in dogs and people. Vet J 2016; 207:13-9. [DOI: 10.1016/j.tvjl.2015.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Hamzianpour N, Chan DL. Thromboelastographic assessment of the contribution of platelets and clotting proteases to the hypercoagulable state of dogs with immune-mediated hemolytic anemia. J Vet Emerg Crit Care (San Antonio) 2015; 26:295-9. [DOI: 10.1111/vec.12315] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 03/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Negar Hamzianpour
- Department of Clinical Science and Services, The Royal Veterinary College; University of London; North Mymms Hatfield UK
| | - Daniel L. Chan
- Department of Clinical Science and Services, The Royal Veterinary College; University of London; North Mymms Hatfield UK
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Kuy S, Dua A, Chappidi R, Seabrook G, Brown KR, Lewis B, Rossi PJ, Lee CJ. The increasing incidence of thromboembolic events among hospitalized patients with inflammatory bowel disease. Vascular 2014; 23:260-4. [PMID: 24986868 DOI: 10.1177/1708538114541799] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND We performed a national population-based study examining the incidence of both venous and arterial thromboembolic events in patients hospitalized with inflammatory bowel disease over the past decade. METHODS A retrospective cross-sectional analysis using the Nationwide Inpatient Sample Database was performed. Patients hospitalized with Crohn's disease and ulcerative colitis were identified using ICD-9 codes. The incidence of clinically relevant venous thromboembolic events and arterial thromboembolic events including myocardial infarction, visceral ischemia, cerebrovascular accidents, and peripheral arterial events was examined. RESULTS During the study period, 461,415 hospitalized inflammatory bowel disease patients were identified. Among these patients, 28,820 had a diagnosis of a thromboembolic event (overall prevalence of 6%). The incidence of thromboembolic events in patients with inflammatory bowel disease rose from 5.65% in 2000 to 7.17% by 2009. There were 18,270 (3.96%) patients who had an arterial thrombotic event, the most common being myocardial infarction (50%), followed by visceral ischemia (25%), and cerebrovascular incidents (22%). There were 11,083 (2.4%) patients identified to have had a venous thrombotic event, with the most common manifestation being deep vein thrombosis (77%), pulmonary embolism (32%), and portal vein thrombosis (3.9%). CONCLUSION An increasing incidence of thromboembolic event in patients with inflammatory bowel disease was observed over the past decade. Interestingly, there were more arterial thrombotic events in comparison to venous thrombotic events.
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Affiliation(s)
- SreyRam Kuy
- Overton Brooks Veterans Affairs Medical Center and Louisiana State University at Shreveport, USA
| | - Anahita Dua
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA Center for Translational Injury Research (CeTIR), Department of Surgery, University of Texas-Houston, Houston, TX, USA
| | - Rohit Chappidi
- Department of Internal Medicine, Loyola University, Chicago, IL, USA
| | - Gary Seabrook
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kellie R Brown
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian Lewis
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Peter J Rossi
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Cheong J Lee
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
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de Laforcade A, Goggs R, Wiinberg B. Systematic evaluation of evidence on veterinary viscoelastic testing Part 3: Assay activation and test protocol. J Vet Emerg Crit Care (San Antonio) 2014; 24:37-46. [DOI: 10.1111/vec.12147] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 11/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Armelle de Laforcade
- From the Department of Clinical Sciences; Cummings School of Veterinary Medicine; Tufts University; North Grafton MA
| | - Robert Goggs
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY, 14853
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Romão FG, Campos EF, Mattoso CRS, Takahira RK. Hemostatic profile and thromboembolic risk in healthy dogs treated with prednisone: a randomized controlled trial. BMC Vet Res 2013; 9:268. [PMID: 24380388 PMCID: PMC3892056 DOI: 10.1186/1746-6148-9-268] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 12/18/2013] [Indexed: 11/10/2022] Open
Abstract
Background Thrombosis has been associated to some diseases like hyperadrenocorticism (HAC). Several drugs can alter the balance, such as the corticosteroid prednisone, used mainly for its anti-inflammatory and immunosuppressive effects. It is known that hypercortisolism can stimulate thrombi formation by increasing coagulation factors and decreasing fibrinolysis. However it is not known how prednisone administration affects hemostasis in dogs and if it is dose dependent. The aim of this study, therefore, was to demonstrate the effects of prednisone administration on dogs’ hemostatic profile. Results Significant decrease of antithrombin levels was observed in both groups (anti-inflammatory and immunosuppressive doses) after 15 days of treatment. An increase of platelet aggregation was observed in dogs receiving immunosuppressive doses of prednisone (Group II). Conclusions From the results obtained in our study, it is not possible to infer that hypercortisolism can increase the thromboembolic risk, despite the decreased anticoagulant factors (antithrombin levels).
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Affiliation(s)
- Felipe Gazza Romão
- Department of Veterinary Clinics, Botucatu Veterinary Medicine School, University Estadual Paulista - UNESP, Botucatu, Brazil.
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Kol A, Nelson R, Gosselin R, Borjesson D. Characterization of thrombelastography over time in dogs with hyperadrenocorticism. Vet J 2013; 197:675-81. [DOI: 10.1016/j.tvjl.2013.05.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 04/13/2013] [Accepted: 05/27/2013] [Indexed: 12/25/2022]
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Pace S, Creevy K, Krimer P, Brainard B. Assessment of Coagulation and Potential Biochemical Markers for Hypercoagulability in Canine Hyperadrenocorticism. J Vet Intern Med 2013; 27:1113-20. [DOI: 10.1111/jvim.12159] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 05/10/2013] [Accepted: 07/11/2013] [Indexed: 12/19/2022] Open
Affiliation(s)
- S.L. Pace
- Department of Small Animal Medicine and Surgery; College of Veterinary Medicine; University of Georgia; Athens GA
| | - K.E. Creevy
- Department of Small Animal Medicine and Surgery; College of Veterinary Medicine; University of Georgia; Athens GA
| | - P.M. Krimer
- Department of Pathology (Krimer); College of Veterinary Medicine; University of Georgia; Athens GA
| | - B.M. Brainard
- Department of Small Animal Medicine and Surgery; College of Veterinary Medicine; University of Georgia; Athens GA
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Kol A, Marks SL, Skorupski KA, Kass PH, Guerrero T, Gosselin RC, Borjesson DL. Serial haemostatic monitoring of dogs with multicentric lymphoma. Vet Comp Oncol 2013; 13:255-66. [DOI: 10.1111/vco.12041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 04/16/2013] [Accepted: 04/23/2013] [Indexed: 12/24/2022]
Affiliation(s)
- A. Kol
- Department of Pathology, Microbiology and Immunology; University of California; Davis CA 95616 USA
| | - S. L. Marks
- Department of Medicine and Epidemiology; University of California; Davis CA 95616 USA
| | - K. A. Skorupski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California; Davis CA 95616 USA
| | - P. H. Kass
- Department of population, health & reproduction; University of California; Davis CA 95616 USA
| | - T. Guerrero
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California; Davis CA 95616 USA
| | - R. C. Gosselin
- Department of Medical Pathology and Laboratory Medicine; University of California Davis Medical Center; Sacramento CA 95817 USA
| | - D. L. Borjesson
- Department of Pathology, Microbiology and Immunology; University of California; Davis CA 95616 USA
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43
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Bauer N, Moritz A. Characterisation of changes in the haemostasis system in dogs with thrombosis. J Small Anim Pract 2013; 54:129-36. [DOI: 10.1111/jsap.12037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- N. Bauer
- From the Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology; Justus-Liebig University Giessen; Giessen Germany
| | - A. Moritz
- From the Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology; Justus-Liebig University Giessen; Giessen Germany
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Bauer N, Moritz A. Coagulation response in dogs with and without systemic inflammatory response syndrome – Preliminary results. Res Vet Sci 2013; 94:122-31. [DOI: 10.1016/j.rvsc.2012.07.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 07/10/2012] [Accepted: 07/28/2012] [Indexed: 10/27/2022]
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Rose L, Dunn ME, Bédard C. Effect of canine hyperadrenocorticism on coagulation parameters. J Vet Intern Med 2012; 27:207-11. [PMID: 23278831 DOI: 10.1111/jvim.12005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 07/30/2012] [Accepted: 09/24/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hyperadrenocorticism (HAC) has been associated with thrombotic disease in dogs. HYPOTHESIS The purpose of this study was to use thromboelastography (TEG) and measurement of thrombin generation (TG) to characterize the hypercoagulable state in dogs with HAC. We hypothesized that dogs with HAC would have a hypercoagulable profile on TEG tracings and an increase in thrombin generation as measured by endogenous thrombin potential (ETP). ANIMALS Sixteen dogs with HAC. Dogs were compared with a population of normal dogs used to obtain reference intervals. METHODS TEG tracings on citrated whole blood were obtained from 15 dogs, and TG measurements on frozen-thawed platelet-poor plasma (PPP) were obtained from 15 dogs. RESULTS For the TEG analysis, when results of individual dogs were compared with the reference interval, 12/15 dogs had at least 1 parameter associated with hypercoagulability. When the population of HAC dogs was compared with a population of healthy dogs, HAC dogs had decreases in R and K and increases in α and MA values. The ETP was increased when the HAC group was compared with a population of normal dogs. However, only 3/15 dogs had an ETP above reference interval, and 1/15 had a decreased lag time. CONCLUSION AND CLINICAL IMPORTANCE Of 16 dogs with HAC, 12/15 had evidence of hypercoagulability when evaluated by TEG, 4/15 when evaluated by TG, and 2 dogs had increases in ETP and MA.
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Affiliation(s)
- L Rose
- Université de Montréal, Montreal, Quebec, Canada.
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