Hemorrhagic, Hemostatic, and Thromboelastometric Disorders in 35 Dogs with a Clinical Diagnosis of Leptospirosis: A Prospective Study

J Vet Intern Med. 2017 Jan;31(1):69-80. doi: 10.1111/jvim.14626. Epub 2016 Dec 2.

Abstract

Background: Leptospirosis in dogs is occasionally associated with a hemorrhagic syndrome, the pathophysiology of which is not fully understood.

Hypothesis/objectives: To characterize hematologic, hemostatic, and thromboelastometric abnormalities in dogs with leptospirosis and to study their association with hemorrhagic diatheses and outcomes.

Animals: Thirty-five client-owned dogs.

Methods: A prospective observational single cohort study was conducted. Results from the CBC, coagulation tests (prothrombin, activated partial thromboplastin and thrombin times, fibrinogen, fibrin(ogen) degradation products, and D-dimer concentrations), rotational thromboelastometry (TEM), signalment, hemorrhagic diatheses, occurrence of disseminated intravascular coagulation (DIC) at admission, and survival to discharge were recorded.

Results: The most common hematologic and hemostatic abnormalities were anemia (30/35), thrombocytopenia (21/35), and hyperfibrinogenemia (15/35). Eight dogs were diagnosed with DIC. A normal TEM profile was found in 14 dogs, a hypercoagulable profile in 14 dogs, and a hypocoagulable profile in 7 dogs. The 8 dogs with hemorrhagic diatheses at admission had significantly decreased platelet counts (P = .037) and increased D-dimer concentrations (P = .015) compared with other dogs. Dogs with a hypocoagulable profile exhibited more hemorrhagic diatheses compared with the dogs that had normal and hypercoagulable profiles (P = .049). The mortality rate was lower in dogs with a hypercoagulable profile than in those with a hypocoagulable profile (21% vs 57%; P = .043). Disseminated intravascular coagulation was not a significant prognostic factor.

Conclusions and clinical importance: Thromboelastometric parameters were altered in dogs with both hypercoagulable and hypocoagulable profiles. A hypocoagulable profile was significantly correlated with hemorrhagic diathesis and higher mortality rate.

Keywords: DIC; Bleeding; Canine; Coagulation; Leptospirosis; Thrombocytopenia.

MeSH terms

  • Animals
  • Cohort Studies
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / complications
  • Disseminated Intravascular Coagulation / mortality
  • Disseminated Intravascular Coagulation / veterinary*
  • Dog Diseases / blood
  • Dog Diseases / mortality*
  • Dogs
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • France
  • Hemostasis
  • Leptospirosis / blood
  • Leptospirosis / complications
  • Leptospirosis / mortality
  • Leptospirosis / veterinary*
  • Male
  • Partial Thromboplastin Time / veterinary
  • Prospective Studies
  • Survival Analysis

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D