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Evaluation of hemostatic and fibrinolytic markers in dogs with ascites attributable to right-sided congestive heart failure

Andrea Zoia DVM1, Monica Augusto DVM2, Michele Drigo DVM, PhD3, and Marco Caldin DVM, PhD4
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  • 1 Department of Small Animal Clinical Study, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
  • | 2 Division of Companion Animal Science, School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow, G61 1GH, Scotland.
  • | 3 Sanità Pubblica, Patologia Comparata e Igiene Veterinaria, Padua University, 35020 Legnaro, Italy.
  • | 4 San Marco Veterinary Clinic, via Sorio 114/c, 35141 Padua, Italy.

Abstract

Objective—To determine whether dogs with ascites secondary to right-sided congestive heart failure (CHF) have bleeding disorders associated with hypofibrinogenemia and discordant plasma fibrin-fibrinogen degradation products (FDPs) and D-dimer assay results (ie, a circulating concentration of FDPs higher than the reference range and a circulating concentration of D-dimer within the reference range).

Design—Retrospective case-control study.

Animals—80 client-owned dogs.

Procedures—Dogs with ascites secondary to right-sided CHF (group 1; n = 20), unhealthy dogs without cardiac disease (group 2; 40), and dogs with left-sided CHF (group 3; 20) were included in the study. Urine bile acids-to-creatinine concentration ratios were calculated as a marker of liver function. Differences among groups regarding coagulation profile analysis results and prevalence of discordant FDPs and D-dimer assay results were determined.

Results—No significant differences were detected among the 3 groups regarding urine bile acids-to-creatinine concentration ratios. Plasma fibrinogen concentration was significantly lower for group 1 versus groups 2 or 3. Prevalence of discordant FDPs and D-dimer assay results was significantly higher for group 1 versus groups 2 or 3. Eighteen group 1 dogs had discordant FDPs and D-dimer assay results. Ten of these dogs had concurrent hypofibrinogenemia, 2 of which had clinical signs of bleeding. Only 10 dogs in groups 2 or 3 had discordant FDPs and D-dimer assay results; none of these dogs had hypofibrinogenemia or clinical signs of bleeding.

Conclusions and Clinical Relevance—Dogs with right-sided CHF and ascites may be at increased risk for primary hyperfibrinogenolysis (ie, hypofibrinogenemia and discordant FDPs and D-dimer assay results).

Abstract

Objective—To determine whether dogs with ascites secondary to right-sided congestive heart failure (CHF) have bleeding disorders associated with hypofibrinogenemia and discordant plasma fibrin-fibrinogen degradation products (FDPs) and D-dimer assay results (ie, a circulating concentration of FDPs higher than the reference range and a circulating concentration of D-dimer within the reference range).

Design—Retrospective case-control study.

Animals—80 client-owned dogs.

Procedures—Dogs with ascites secondary to right-sided CHF (group 1; n = 20), unhealthy dogs without cardiac disease (group 2; 40), and dogs with left-sided CHF (group 3; 20) were included in the study. Urine bile acids-to-creatinine concentration ratios were calculated as a marker of liver function. Differences among groups regarding coagulation profile analysis results and prevalence of discordant FDPs and D-dimer assay results were determined.

Results—No significant differences were detected among the 3 groups regarding urine bile acids-to-creatinine concentration ratios. Plasma fibrinogen concentration was significantly lower for group 1 versus groups 2 or 3. Prevalence of discordant FDPs and D-dimer assay results was significantly higher for group 1 versus groups 2 or 3. Eighteen group 1 dogs had discordant FDPs and D-dimer assay results. Ten of these dogs had concurrent hypofibrinogenemia, 2 of which had clinical signs of bleeding. Only 10 dogs in groups 2 or 3 had discordant FDPs and D-dimer assay results; none of these dogs had hypofibrinogenemia or clinical signs of bleeding.

Conclusions and Clinical Relevance—Dogs with right-sided CHF and ascites may be at increased risk for primary hyperfibrinogenolysis (ie, hypofibrinogenemia and discordant FDPs and D-dimer assay results).

Contributor Notes

Dr. Zoia's present address is San Marco Veterinary Clinic, via Sorio 114/c, 35141 Padua, Italy.

Dr. Augusto's present address is Anderson Sturgess Veterinary Specialist, The Granary, Bunstead Barns, Poles Ln, Hursley SO21 2LL, Hampshire, England.

Presented as an oral presentation at the European College of Veterinary Internal Medicine Companion Animal Congress, Porto, Portugal, September 2009.

Address correspondence to Dr. Zoia (zoia.andrea06@googlemail.com).