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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Pulmonary hypertension is associated with hypocoagulability in dogs: a retrospective analysis of 66 cases (2013-2021)
Insights
Dogs with pulmonary hypertension (PH) show altered coagulation profiles, indicating a hypocoagulable state. Monitoring coagulation is crucial for canine PH patients, especially before antithrombotic therapy.
Area of Science:
- Veterinary Cardiology
- Hemostasis and Thrombosis
Background:
- Pulmonary hypertension (PH) is a serious cardiovascular condition in dogs.
- Coagulation status in dogs with PH is not well-characterized.
- Understanding coagulation changes is vital for managing PH and preventing complications.
Purpose of the Study:
- To characterize coagulation profiles in dogs with echocardiographically diagnosed PH.
- To compare coagulation parameters between dogs with and without PH.
- To determine the relationship between coagulation status and the probability of PH.
Main Methods:
- Retrospective study of 66 dogs with PH and 86 control dogs.
- Analysis of coagulation panels (traditional and VCM Vet) performed within 7 days of echocardiography.
- Exclusion of dogs on antithrombotics or with pre-existing coagulopathies.
Main Results:
- Dogs with PH were older and lighter than controls.
- PH group showed increased prothrombin time (PT), partial thromboplastin time (PTT), and fibrinogen.
- Antithrombin concentration was lower in dogs with PH.
- Dogs with PH had significantly higher odds of being hypocoagulable based on PT and PTT.
Conclusions:
- A moderate to high probability of PH is associated with a hypocoagulable state in dogs.
- Coagulation monitoring is important for canine patients with PH.
- This highlights the need for careful consideration before initiating antithrombotic medications in dogs with PH.
Objective:
To describe coagulation profiles in dogs with echocardiographic evidence of pulmonary hypertension (PH), to compare them to coagulation profiles in dogs without echocardiographic evidence of PH, and to determine the relationship between coagulation profiles and echocardiographic probability of PH.
Animals:
66 dogs with PH (cases) and 86 dogs without PH (controls).
Methods:
Retrospective evaluation of records between 2013 and 2021 of dogs that had both an echocardiogram and a coagulation panel performed within 7 days. Dogs that received antithrombotics within 7 days of evaluation and dogs diagnosed with congenital or acquired coagulopathy or other severe systemic disease that could lead to coagulopathy were excluded. Dogs with a low echocardiographic probability of PH were also excluded. The dogs were divided into a PH group and non-PH group based on echocardiographic results. Demographic, clinicopathologic, and traditional coagulation parameters and VCM Vet (Entegrion) parameters were compared between the 2 groups.
Results:
Dogs with PH were significantly older (median, 11 years vs 9.5 years, P = .02) and had a significantly lower body weight (median, 7.3 kg vs 19.3 kg, P < .001) than controls. Dogs with PH also had a significantly greater percent increase in prothrombin time (PT; P = .02), partial thromboplastin time (PTT; P < .0001), and fibrinogen (P = .045); however, their antithrombin concentration was lower (P = .005) compared to controls. Eight of 65 dogs (12.3%) in the PH group and 1/86 (1.2%) dogs in the non-PH group had an elevation of PT and/or PTT greater than 50% above the reference interval (P = .005). Dogs with PH had 11.9 times (95% CI, 1.5 to 97.9; P = .02) greater odds of being hypocoagulable than dogs without PH based on PT and PTT.
Clinical Relevance:
This study demonstrated an association between a moderate to high echocardiographic probability of PH and a hypocoagulable state in dogs as determined by traditional coagulation assays. It underscores the importance of monitoring the coagulation status in canine patients with PH, particularly before initiating antithrombotic medications.
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