A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma

Abstract Background Knowledge of the prevalence of thromboemboli and the associated hemostatic status in dogs with carcinoma or sarcoma is unknown and might allow earlier intervention. Objectives Estimate prevalence of thromboemboli and their association with hemostatic changes in dogs with carcinom...

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Main Authors: Paolo Pazzi, Geoffrey T. Fosgate, Anouska Rixon, Josef Hanekom, Annemarie T. Kristensen, Amelia Goddard
Format: Article
Language:English
Published: Wiley 2023-09-01
Series:Journal of Veterinary Internal Medicine
Subjects:
Online Access:https://doi.org/10.1111/jvim.16828
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author Paolo Pazzi
Geoffrey T. Fosgate
Anouska Rixon
Josef Hanekom
Annemarie T. Kristensen
Amelia Goddard
author_facet Paolo Pazzi
Geoffrey T. Fosgate
Anouska Rixon
Josef Hanekom
Annemarie T. Kristensen
Amelia Goddard
author_sort Paolo Pazzi
collection DOAJ
description Abstract Background Knowledge of the prevalence of thromboemboli and the associated hemostatic status in dogs with carcinoma or sarcoma is unknown and might allow earlier intervention. Objectives Estimate prevalence of thromboemboli and their association with hemostatic changes in dogs with carcinomas or sarcomas; estimate predictive values of hemostatic variables for thromboembolic disease in tumor‐bearing dogs. Animals Thirty‐two dogs with sarcoma, 30 with carcinoma, 20 healthy age‐controlled dogs. Methods Prospective cross‐sectional study. A hemostasis panel (platelet concentration, thromboelastography, fibrinogen and D‐dimer concentration, factor X, VII and antithrombin activity) was performed in all dogs. Tumor‐bearing dogs underwent complete post mortem and histopathological evaluation. Comparisons between healthy dogs and tumor‐bearing dogs with and without intracavitary hemorrhage; and tumor‐bearing dogs with and without microthrombi were analyzed. Results Thromboembolic disease was identified in 32/62 (52%, 95% CI: 39%‐65%) tumor‐bearing dogs. Microthrombi were identified in 31/62 (50%, 95% CI: 37%‐63%) dogs, 21/31 (68%, 95% CI: 49%‐83%) had exclusively intra‐tumoral microthrombi, 10/31 (32%, 95% CI: 17%‐51%) had distant microthrombi. Macrothrombi were identified in 3 tumor‐bearing dogs. Hemostatic changes potentially consistent with overt and non‐overt disseminated intravascular coagulation were identified in some tumor‐bearing dogs. D‐dimer concentrations were significantly higher (P = .02) and platelet concentration significantly lower (P = .03) in tumor‐bearing dogs with microthrombi compared to tumor‐bearing dogs without microthrombi. D‐dimer concentration above 500 ng/mL was 80% sensitive and 41% specific for the prediction of microthrombi presence. Conclusion The high microthrombi prevalence and concomitant hemostatic dysfunction in dogs with carcinomas or sarcomas has not previously been reported, though the clinical importance is unknown. Increased D‐dimer concentration might increase suspicion of microthrombi.
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spelling doaj.art-41795732665441a09b05c714a53867552023-09-01T14:18:40ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762023-09-013751848186310.1111/jvim.16828A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcomaPaolo Pazzi0Geoffrey T. Fosgate1Anouska Rixon2Josef Hanekom3Annemarie T. Kristensen4Amelia Goddard5Department of Companion Animal Clinical Studies, Faculty of Veterinary Science University of Pretoria Pretoria South AfricaDepartment of Production Animal Studies, Faculty of Veterinary Science University of Pretoria Pretoria South AfricaDepartment of Companion Animal Clinical Studies, Faculty of Veterinary Science University of Pretoria Pretoria South AfricaDepartment of Companion Animal Clinical Studies, Faculty of Veterinary Science University of Pretoria Pretoria South AfricaDepartment of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen DenmarkDepartment of Companion Animal Clinical Studies, Faculty of Veterinary Science University of Pretoria Pretoria South AfricaAbstract Background Knowledge of the prevalence of thromboemboli and the associated hemostatic status in dogs with carcinoma or sarcoma is unknown and might allow earlier intervention. Objectives Estimate prevalence of thromboemboli and their association with hemostatic changes in dogs with carcinomas or sarcomas; estimate predictive values of hemostatic variables for thromboembolic disease in tumor‐bearing dogs. Animals Thirty‐two dogs with sarcoma, 30 with carcinoma, 20 healthy age‐controlled dogs. Methods Prospective cross‐sectional study. A hemostasis panel (platelet concentration, thromboelastography, fibrinogen and D‐dimer concentration, factor X, VII and antithrombin activity) was performed in all dogs. Tumor‐bearing dogs underwent complete post mortem and histopathological evaluation. Comparisons between healthy dogs and tumor‐bearing dogs with and without intracavitary hemorrhage; and tumor‐bearing dogs with and without microthrombi were analyzed. Results Thromboembolic disease was identified in 32/62 (52%, 95% CI: 39%‐65%) tumor‐bearing dogs. Microthrombi were identified in 31/62 (50%, 95% CI: 37%‐63%) dogs, 21/31 (68%, 95% CI: 49%‐83%) had exclusively intra‐tumoral microthrombi, 10/31 (32%, 95% CI: 17%‐51%) had distant microthrombi. Macrothrombi were identified in 3 tumor‐bearing dogs. Hemostatic changes potentially consistent with overt and non‐overt disseminated intravascular coagulation were identified in some tumor‐bearing dogs. D‐dimer concentrations were significantly higher (P = .02) and platelet concentration significantly lower (P = .03) in tumor‐bearing dogs with microthrombi compared to tumor‐bearing dogs without microthrombi. D‐dimer concentration above 500 ng/mL was 80% sensitive and 41% specific for the prediction of microthrombi presence. Conclusion The high microthrombi prevalence and concomitant hemostatic dysfunction in dogs with carcinomas or sarcomas has not previously been reported, though the clinical importance is unknown. Increased D‐dimer concentration might increase suspicion of microthrombi.https://doi.org/10.1111/jvim.16828cancerhemangiosarcomahemostasismacrothrombithromboelastography
spellingShingle Paolo Pazzi
Geoffrey T. Fosgate
Anouska Rixon
Josef Hanekom
Annemarie T. Kristensen
Amelia Goddard
A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
Journal of Veterinary Internal Medicine
cancer
hemangiosarcoma
hemostasis
macrothrombi
thromboelastography
title A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
title_full A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
title_fullStr A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
title_full_unstemmed A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
title_short A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
title_sort prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
topic cancer
hemangiosarcoma
hemostasis
macrothrombi
thromboelastography
url https://doi.org/10.1111/jvim.16828
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