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Published on: May 7, 2015
Haematology and coagulation profiles in cats with congenital portosystemic shunts
Caitlin E Tzounos1, Michael S Tivers2, Sophie E Adamantos3
11 Department of Clinical Sciences and Services, Royal Veterinary College, Hatfield, UK.
Insights
Cats with congenital portosystemic shunts often have microcytosis but rarely anemia. Surgical attenuation improves hematocrit and microcytosis, with no increased bleeding risk despite prolonged coagulation times.
Area of Science:
- Veterinary Medicine
- Comparative Pathology
- Surgical Science
Background:
- Congenital portosystemic shunts (CPSS) are vascular anomalies affecting feline health.
- Understanding CPSS-related hematological and coagulation changes is crucial for surgical management.
Purpose of the Study:
- To document hematological parameters and coagulation times in cats with CPSS.
- To assess the impact of surgical shunt attenuation on these parameters.
- To investigate the link between prolonged coagulation and perioperative bleeding.
Main Methods:
- Retrospective study of client-owned cats with CPSS undergoing surgical treatment.
- Analysis of signalment, shunt type, attenuation degree, hematology, prothrombin time (PT), and activated partial thromboplastin time (aPTT).
- Recording of perioperative bleeding complications.
Main Results:
- Preoperatively, microcytosis (low MCV/MCH) was common; anemia, leukocytosis, or thrombocytopenia were rare.
- Post-surgery, significant increases in hematocrit (HCT), MCV, and MCH were observed.
- Prolonged PT and aPTT were frequent preoperatively, but no clinical bleeding occurred.
Conclusions:
- Cats with CPSS typically exhibit microcytosis, not anemia.
- Surgical attenuation effectively increases HCT and MCV.
- Prolonged coagulation times in CPSS cats do not correlate with increased perioperative bleeding risk.
Abstract:
Objectives The objectives of this study were, first, to report the haematological parameters and coagulation times for cats with a congenital portosystemic shunt (CPSS) and the influence of surgical shunt attenuation on these parameters; and, second, to identify any association between prolongation in coagulation profiles and incidence of perioperative haemorrhage. Methods This was a retrospective clinical study using client-owned cats with a CPSS. Signalment, shunt type (extra- or intrahepatic), degree of shunt attenuation (complete or partial), haematological parameters, prothrombin time (PT) and activated partial thromboplastin time (aPTT) test results, and occurrence of any perioperative clinical bleeding complications were recorded for cats undergoing surgical treatment of a CPSS at the Royal Veterinary College, UK, between 1994 and 2011. Results Forty-two cats were included. Thirty-six (85.7%) had an extrahepatic CPSS and six (14.3%) had an intrahepatic CPSS. Preoperatively, mean cell volume (MCV) and mean cell haemoglobin (MCH) were below the reference interval (RI) in 32 (76.2%) and 31 (73.8%) cats, respectively. Red blood cell count and mean cell haemoglobin concentration (MCHC) were above the RI in 10 (23.8%) and eight (19.1%) cats, respectively. Postoperatively, there were significant increases in haematocrit ( P = 0.044), MCV ( P = 0.008) and MCH ( P = 0.002). Despite the significant increase in MCV postoperatively, the median MCV postoperatively was below the RI, indicating persistence of microcytosis. Preoperatively, PT was above the upper RI in 14 cats (87.5%), and aPTT was above the upper RI in 11 cats (68.8%). No cat demonstrated a perioperative clinical bleeding complication. Conclusions and relevance Cats with a CPSS are likely to present with a microcytosis, but rarely present with anaemia, leukocytosis or thrombocytopenia. Surgical attenuation of the CPSS results in a significant increase in the HCT and MCV. Coagulation profiles in cats with a CPSS are likely to be prolonged, irrespective of shunt type, but do not appear to be associated with an increased risk of clinical bleeding.
