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Davis S, Fletcher DJ, Newman A, Brooks MB. Comparison of coagulation and fibrinolysis in Irish Wolfhounds and age-matched control dogs using tissue plasminogen activator-augmented viscoelastic testing. J Vet Emerg Crit Care (San Antonio) 2024; 34:222-230. [PMID: 38775137 DOI: 10.1111/vec.13385] [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: 10/31/2022] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 06/15/2024]
Abstract
OBJECTIVE To determine if Irish Wolfhounds (IWs), like other sighthounds, are hyperfibrinolytic compared with nonsighthound dogs using 2 native and tissue plasminogen activator (tPA)-enhanced viscoelastic assays, one that is whole blood-based (viscoelastic coagulation monitor [VCM]) and the other that is plasma-based thromboelastography (TEG). DESIGN Cohort study. SETTING University teaching hospital. ANIMALS A convenience sample of 27 IWs recruited from the Irish Wolfhound Association of New England Specialty and the local community, and 27 healthy, age-matched, large-breed control dogs. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Blood samples including CBC, biochemistry, traditional coagulation, and viscoelastic testing were collected from IWs and control dogs. Twelve IWs had viscoelastic testing. IWs had lower fibrinogen concentrations (215.5 ± 57.8 vs 251.4 ± 64.5 mg/dL, P = 0.034) and formed weaker clots on both whole-blood VCM and plasma TEG assays (maximum clot firmness [VCM-MCF] = 39.4 [25.1-48.8] vs 48.5 [34.6-57.3], P = 0.0042; maximum amplitude [TEG-MA] = 22.7 [14.7-33.6] vs 32.2 [26.9-42.0], P < 0.0001). IWs were hyperfibrinolytic compared with control dogs on VCM whole-blood assays, with 25 U/mL tPA (lysis at 30 min [VCM-LI30] = 68.1 [0-100] vs\ 99.9 [63.3-100], P = 0.0009; lysis at 45 min [VCM-LI45] = 31.0 [0-100] vs 98.1 [38.4-100], P = 0.0002) but hypofibrinolytic compared with controls on TEG plasma assays with 50 U/mL tPA (lysis at 30 min [TEG-LY30] = 45.7 [4.6-94.6] vs 93.7 [12.3-96.5], P = 0.0004; lysis at 60 min [TEG-LY60] = 68.7 [29.7-96.8] vs 95.7 [34.4-97.6], P = 0.0003). Minimal fibrinolysis was measured on whole-blood VCM or plasma TEG assays without the addition of tPA, and there were no differences between the 2 groups. CONCLUSIONS Weaker clots were found in IWs than control dogs. With the addition of tPA, IWs had evidence of hyperfibrinolysis on whole-blood VCM assays and hypofibrinolysis on plasma TEG assays compared with control dogs. Without the addition of tPA, however, both groups of dogs showed minimal fibrinolysis on viscoelastic testing.
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Affiliation(s)
- Samantha Davis
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Daniel J Fletcher
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | | | - Marjory B Brooks
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
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Williams M, Shropshire S, Chornarm N, Brewer M, Hawley J, Khorsand M, Lappin M. Effects of canine influenza infection and DA2PP vaccination on the development of platelet-associated immunoglobulins and platelet counts in dogs. Vet Clin Pathol 2024; 53:47-56. [PMID: 38433107 DOI: 10.1111/vcp.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Immune thrombocytopenia (ITP) is commonly associated with platelet-associated immunoglobulins (PAIg). Demonstration of PAIg can help determine etiologies for thrombocytopenia. In humans, ITP and thrombocytopenia have been associated with various vaccinations and influenza infections, respectively. OBJECTIVES We aimed to evaluate platelet counts and PAIg in research dogs with H3N2 and in research and client-owned dogs routinely vaccinated for distemper, adenovirus-2, parainfluenza, and parvovirus (DA2PP). The hypotheses were that H3N2 infection but not DA2PP vaccination would decrease platelet counts, and neither would result in the detection of PAIg. METHODS Three pilot studies. Platelet counts and PAIg, measured by direct flow cytometry as %IgG, were evaluated in eight research Beagles following experimental infection with H3N2 (experiment 1), nine research Beagles vaccinated for DA2PP (experiment 2), and thirty client-owned dogs vaccinated for DA2PP (experiment 3). All animals were considered healthy at the start of the experiments. RESULTS Transient, self-resolving decreases in platelet counts and increases in %IgG occurred following H3N2 infection, and one dog became thrombocytopenic and positive for PAIg. Following DA2PP vaccination, %IgG increased in research and client-owned dogs, but only one dog was considered positive for PAIg with a concurrent increase in platelet count. Mean PAIg increased from baseline in client-owned dogs following vaccination. CONCLUSIONS Transient PAIg and thrombocytopenia can occur following H3N2 infection, while routine vaccination for DA2PP in this group of dogs was not associated with the development of thrombocytopenia or clinically relevant formation of PAIg.
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Affiliation(s)
- Maggie Williams
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah Shropshire
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Nida Chornarm
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Melissa Brewer
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Jennifer Hawley
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Matthew Khorsand
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Michael Lappin
- Department of Clinical Sciences, Center for Companion Animal Studies, Colorado State University, Fort Collins, Colorado, USA
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Cardoso SP, Honorio-França AC, França DCH, Silva LPS, Fagundes-Triches DLG, Neves MCB, Cotrim ACDM, de Almeida ADBPF, França EL, Sousa VRF. Effects of Doxycycline Treatment on Hematological Parameters, Viscosity, and Cytokines in Canine Monocytic Ehrlichiosis. BIOLOGY 2023; 12:1137. [PMID: 37627021 PMCID: PMC10452297 DOI: 10.3390/biology12081137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
This study aimed to analyze the hematological parameters, blood viscosity, and cytokines of dogs infected by Ehrlichia canis untreated and treated with doxycycline. Initially, 47 dogs were examined, and 36 were suspected to have canine monocytic ehrlichiosis, which was confirmed through molecular polymerase chain reaction tests. This study consisted of 25 dogs, with 11 being healthy and 14 testing positive for E. canis. The dogs were divided into experimental groups based on their test results, including a control group of healthy dogs (N = 11), a group of infected dogs without treatment (N = 7), and a group of infected dogs treated with doxycycline (N = 7) at a 10 mg/kg dose every 12 h for 28 days. Blood samples were taken to determine hematological parameters, viscosity, and cytokine levels. It was observed that, regardless of doxycycline treatment, there was a reduction in total leukocytes and lymphocytes in infected dogs with Ehrlichia canis. The eosinophils and platelets decreased in dogs with Ehrlichia canis infections without treatment. Monocytes, eosinophils, and platelets increased when the dogs were treated with doxycycline. Regardless of treatment, infected dogs' blood viscosity was lower than uninfected dogs. Infected dogs showed lower TNF-α and increased IL-1β. There was a correlation between the blood viscosity with the cytokines IL-10 and IL-12 in the infected dogs. The eosinophil count correlated with TNF-α in the group of infected and untreated dogs. In conclusion, treating dogs with monocytic ehrlichiosis using doxycycline can increase platelet and eosinophil levels but may also increase IL-1β and monocyte levels, exacerbating inflammation. Therefore, evaluating viscosity and cytokine levels is important when treating dogs with this condition.
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Affiliation(s)
- Saulo Pereira Cardoso
- Instituto Federal de Educação, Ciência e Tecnologia de Mato Grosso, Barra do Garças 78607-899, MT, Brazil;
- Programa de Pós-Graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária (FAVET), Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, MT, Brazil; (M.C.B.N.)
| | - Adenilda Cristina Honorio-França
- Programa de Pós-Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), Universidade Federal de Mato Grosso (UFMT), Barra do Garças 78605-091, MT, Brazil (L.P.S.S.); (D.L.G.F.-T.); (A.C.d.M.C.); (E.L.F.)
| | - Danielle Cristina Honorio França
- Programa de Pós-Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), Universidade Federal de Mato Grosso (UFMT), Barra do Garças 78605-091, MT, Brazil (L.P.S.S.); (D.L.G.F.-T.); (A.C.d.M.C.); (E.L.F.)
| | - Luana Paula Sales Silva
- Programa de Pós-Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), Universidade Federal de Mato Grosso (UFMT), Barra do Garças 78605-091, MT, Brazil (L.P.S.S.); (D.L.G.F.-T.); (A.C.d.M.C.); (E.L.F.)
| | - Danny Laura Gomes Fagundes-Triches
- Programa de Pós-Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), Universidade Federal de Mato Grosso (UFMT), Barra do Garças 78605-091, MT, Brazil (L.P.S.S.); (D.L.G.F.-T.); (A.C.d.M.C.); (E.L.F.)
| | - Maria Clara Bianchini Neves
- Programa de Pós-Graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária (FAVET), Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, MT, Brazil; (M.C.B.N.)
| | - Aron Carlos de Melo Cotrim
- Programa de Pós-Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), Universidade Federal de Mato Grosso (UFMT), Barra do Garças 78605-091, MT, Brazil (L.P.S.S.); (D.L.G.F.-T.); (A.C.d.M.C.); (E.L.F.)
| | - Arleana do Bom Parto Ferreira de Almeida
- Programa de Pós-Graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária (FAVET), Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, MT, Brazil; (M.C.B.N.)
| | - Eduardo Luzía França
- Programa de Pós-Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), Universidade Federal de Mato Grosso (UFMT), Barra do Garças 78605-091, MT, Brazil (L.P.S.S.); (D.L.G.F.-T.); (A.C.d.M.C.); (E.L.F.)
| | - Valéria Régia Franco Sousa
- Programa de Pós-Graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária (FAVET), Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, MT, Brazil; (M.C.B.N.)
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Christodoulou V, Meletis E, Kostoulas P, Theodorou K, Saridomichelakis EN, Koutinas C, Mylonakis ME. Clinical and Clinicopathologic Discriminators Between Canine Acute Monocytic Ehrlichiosis and Primary Immune Thrombocytopenia. Top Companion Anim Med 2023; 52:100750. [PMID: 36574587 DOI: 10.1016/j.tcam.2022.100750] [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: 03/09/2022] [Revised: 09/08/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
Acute canine monocytic ehrlichiosis due to Ehrlichia canis (aCME), and primary immune thrombocytopenia (pITP) are major differentials for dogs presented with thrombocytopenia, and the two diseases may clinically overlap. The aim of this study was to compare dogs diagnosed with naturally occurring aCME and pITP, to establish potentially useful clinical and clinicopathologic discriminators. A clinical record-based retrospective study was performed in 35 dogs diagnosed with aCME and 29 dogs with pITP. Dogs with aCME were significantly younger, and were more likely to experience depression or lethargy, anorexia, body weight loss, fever, lymphadenomegaly, tick infestation, and ocular discharge on admission, compared to dogs with pITP. In contrast, dogs with pITP presented more frequently with overt bleeding and had a significantly higher bleeding score compared to dogs with aCME. Dogs with aCME were more likely to be anemic and hypoalbuminemic on presentation compared to dogs with pITP. Dogs with pITP had higher white blood cell and neutrophil counts as well as lower platelet counts than dogs with aCME and were more likely to present with leukocytosis, neutrophilia and monocytosis. These clinical, hematological, and biochemical findings may be helpful discriminators between aCME and pITP, on the understanding that they will be interpreted in the context of disease-specific testing.
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Affiliation(s)
- Vasilios Christodoulou
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (CAC-AUTh), Thessaloniki, Greece
| | - Eleftherios Meletis
- Laboratory of Epidemiology, School of Public and One (Integrated) Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - Polychronis Kostoulas
- Laboratory of Epidemiology, School of Public and One (Integrated) Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | | | | | - Christos Koutinas
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (CAC-AUTh), Thessaloniki, Greece
| | - Mathios E Mylonakis
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (CAC-AUTh), Thessaloniki, Greece.
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Mylonakis ME, Harrus S, Breitschwerdt EB. An update on the treatment of canine monocytic ehrlichiosis (Ehrlichia canis). Vet J 2019; 246:45-53. [PMID: 30902188 DOI: 10.1016/j.tvjl.2019.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/26/2019] [Accepted: 01/30/2019] [Indexed: 12/14/2022]
Abstract
Canine monocytic ehrlichiosis (CME), caused by Ehrlichia canis, a gram-negative, obligate intracellular bacterium, is a tick-borne disease of worldwide distribution. Experimentally, the course of E. canis infection can be sequentially divided into acute, subclinical and chronic phases, although distinction of these phases is challenging in the clinical setting. Spontaneous clinical recovery of acutely infected dogs is common; however, dogs at this stage require medical treatment in order to hasten their clinical recovery, and to prevent clinical exacerbation or death. An unpredictable proportion of subclinically infected dogs will eventually develop the chronic, severe form of ehrlichiosis, characterized by aplastic pancytopenia and high mortality. The aims of antimicrobial treatment in CME include the achievement of clinical remission, resolution of the clinicopathologic abnormalities, and eradication of the infection, although the latter is not always feasible or diagnostically confirmable. Treatment of dogs with aplastic pancytopenia should be undertaken with the clear understanding that medical management will require long-term care, will be expensive, and may eventually prove ineffective. This manuscript reviews the current state of knowledge regarding treatment of ehrlichiosis, caused by E. canis infection in dogs, provides expert opinion guidelines for the management of the CME-associated aplastic pancytopenia, and outlines methods for evaluation of treatment outcomes.
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Affiliation(s)
- Mathios E Mylonakis
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 11 Stavrou Voutyra st., Thessaloniki 54627, Greece.
| | - Shimon Harrus
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel
| | - Edward B Breitschwerdt
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University (NCSU-CVM),1060 William Moore Drive, Raleigh, NC 27607 USA
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Shropshire S, Olver C, Lappin M. Characteristics of hemostasis during experimental Ehrlichia canis infection. J Vet Intern Med 2018; 32:1334-1342. [PMID: 29704268 PMCID: PMC6060328 DOI: 10.1111/jvim.15130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/09/2018] [Accepted: 03/07/2018] [Indexed: 12/20/2022] Open
Abstract
Background Ehrlichia canis infection in dogs can cause thrombocytopenia and clinical evidence of bleeding. It is unknown why some dogs show signs of bleeding whereas others do not despite clinically relevant thrombocytopenia. Hypothesis/Objectives Activated platelets, decreased fibrinolysis or both mitigate bleeding tendency. Assess standard hemostatic variables, platelet dynamics, and specialized coagulation testing in dogs experimentally infected with E. canis to evaluate this clinical discrepancy. Animals Four healthy laboratory beagles. Methods Dogs were given blood infected with E. canis IV. Platelet indices of activation, platelet aggregometry, antiplatelet antibodies (percent IgG), complete coagulation panel, and thromboelastography (TEG) were measured before inoculation and on weeks 1‐8. Dogs were treated with doxycycline at approximately 5 mg/kg PO q12h between weeks 3 and 4 (day 24). For each variable, 1‐way repeated measures analysis (1‐way ANOVA) with post‐hoc analysis was performed with statistical significance set at P < .05. Results Dogs had significantly lower platelet counts, evidence of activated platelets, and antiplatelet antibodies during E. canis infection. Dogs also appeared hypercoagulable and hypofibrinolytic using TEG as compared with baseline, changes that persisted for variable amounts of time after doxycycline administration. No overt signs of bleeding were noted during the study. Conclusions and Clinical Importance Activated platelets and a hypercoagulable, hypofibrinolytic state could explain the lack of a bleeding phenotype in some dogs despite clinically relevant thrombocytopenia. Findings from our pilot study indicate that additional studies are warranted.
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Affiliation(s)
- Sarah Shropshire
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, CO
| | - Christine Olver
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, CO
| | - Michael Lappin
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, CO
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