A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs
Abstract Background Primary immune thrombocytopenia (pITP) in dogs presents a diagnostic challenge, and clinical markers of severity are lacking. Objectives Identify clinicopathologic features that differentiate pITP from secondary ITP (sITP) and markers related to bleeding severity, transfusion, an...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-03-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16985 |
| _version_ | 1797263089598464000 |
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| author | Marjory B. Brooks Robert Goggs Amelia H. Frye Jessica Armato Marnin Forman Julia Hertl Michael Koch John P. Loftus John Lucy Brandi Mattison Julia Merriam Sarah Shropshire Laura Van Vertloo Austin Viall Dana N. LeVine |
| author_facet | Marjory B. Brooks Robert Goggs Amelia H. Frye Jessica Armato Marnin Forman Julia Hertl Michael Koch John P. Loftus John Lucy Brandi Mattison Julia Merriam Sarah Shropshire Laura Van Vertloo Austin Viall Dana N. LeVine |
| author_sort | Marjory B. Brooks |
| collection | DOAJ |
| description | Abstract Background Primary immune thrombocytopenia (pITP) in dogs presents a diagnostic challenge, and clinical markers of severity are lacking. Objectives Identify clinicopathologic features that differentiate pITP from secondary ITP (sITP) and markers related to bleeding severity, transfusion, and survival of dogs with pITP. Animals Ninety‐eight thrombocytopenic dogs (58 pITP and 40 sITP). Methods Client‐owned dogs with platelet counts <50 000/μL were enrolled in a prospective, multi‐institution cohort study. History and treatment information, through a maximum of 7 days, was recorded on standard data forms. Bleeding severity was scored daily using a bleeding assessment tool (DOGiBAT). At‐admission blood samples were collected for CBC, biochemistry, C‐reactive protein concentration, and coagulation panels, and to measure platelet surface‐associated immunoglobulin G (PSAIg) and expression of platelet membrane proteins and phospholipids. Dogs with evidence of coincident disease were classified as sITP. Results No definitive pITP diagnostic test was found. However, pITP cases were characterized by lower platelet counts, D dimer concentrations, and platelet membrane protein expression than sITP cases. Differentiation between pITP and sITP was further enhanced using logistic regression modeling combining patient sex, coagulation profile, platelet count, D dimer, and PSAIg. A second model of pITP severity indicated that low hematocrit and high BUN concentration were associated with non‐survival. Low hematocrit at admission, but not platelet count or DOGiBAT score, was associated with transfusion. Conclusions and Clinical Importance Pending validation studies, models constructed from at‐admission clinicopathologic findings may improve differentiation of pITP from sITP and identify the most severe pITP cases at the time of presentation. |
| first_indexed | 2024-04-25T00:07:28Z |
| format | Article |
| id | doaj.art-d6c07a4a9e4143fc87e0e47329d9e34f |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-25T00:07:28Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-d6c07a4a9e4143fc87e0e47329d9e34f2024-03-14T04:25:21ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762024-03-013821022103410.1111/jvim.16985A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogsMarjory B. Brooks0Robert Goggs1Amelia H. Frye2Jessica Armato3Marnin Forman4Julia Hertl5Michael Koch6John P. Loftus7John Lucy8Brandi Mattison9Julia Merriam10Sarah Shropshire11Laura Van Vertloo12Austin Viall13Dana N. LeVine14Population Medicine & Diagnostic Sciences Cornell University, 240 Farrier Road Ithaca, New York 14853 USAClinical Sciences, C3‐502D Clinical Programs Center Cornell University, 930 Campus Road Ithaca, New York 14853‐0001 USAPopulation Medicine & Diagnostic Sciences Cornell University, 240 Farrier Road Ithaca, New York 14853 USAInternal Medicine Cornell University Veterinary Specialists Stamford Connecticut USAInternal Medicine Cornell University Veterinary Specialists Stamford Connecticut USAPopulation Medicine & Diagnostic Sciences Cornell University, 240 Farrier Road Ithaca, New York 14853 USAVeterinary Internal Medicine Consulting Rochester New York USAClinical Sciences College of Veterinary Medicine, Cornell University, 930 Campus Road Ithaca, New York 14853 USAInternal Medicine, Oradell Animal Hospital Paramus New Jersey USAArizona Veterinary Emergency & Critical Care Center Peoria Arizona USABlue Pearl Pet Hospital Northfield Northfield Illinois USAColorado State University Fort Collins Colorado USAVeterinary Clinical Sciences College of Veterinary Medicine, Iowa State University Ames Iowa USADepartment of Pathology, Microbiology and Immunology University of California, Davis Davis California USAVeterinary Clinical Sciences College of Veterinary Medicine, Auburn University, 1600 S 16th St Auburn, Alabama 36849 USAAbstract Background Primary immune thrombocytopenia (pITP) in dogs presents a diagnostic challenge, and clinical markers of severity are lacking. Objectives Identify clinicopathologic features that differentiate pITP from secondary ITP (sITP) and markers related to bleeding severity, transfusion, and survival of dogs with pITP. Animals Ninety‐eight thrombocytopenic dogs (58 pITP and 40 sITP). Methods Client‐owned dogs with platelet counts <50 000/μL were enrolled in a prospective, multi‐institution cohort study. History and treatment information, through a maximum of 7 days, was recorded on standard data forms. Bleeding severity was scored daily using a bleeding assessment tool (DOGiBAT). At‐admission blood samples were collected for CBC, biochemistry, C‐reactive protein concentration, and coagulation panels, and to measure platelet surface‐associated immunoglobulin G (PSAIg) and expression of platelet membrane proteins and phospholipids. Dogs with evidence of coincident disease were classified as sITP. Results No definitive pITP diagnostic test was found. However, pITP cases were characterized by lower platelet counts, D dimer concentrations, and platelet membrane protein expression than sITP cases. Differentiation between pITP and sITP was further enhanced using logistic regression modeling combining patient sex, coagulation profile, platelet count, D dimer, and PSAIg. A second model of pITP severity indicated that low hematocrit and high BUN concentration were associated with non‐survival. Low hematocrit at admission, but not platelet count or DOGiBAT score, was associated with transfusion. Conclusions and Clinical Importance Pending validation studies, models constructed from at‐admission clinicopathologic findings may improve differentiation of pITP from sITP and identify the most severe pITP cases at the time of presentation.https://doi.org/10.1111/jvim.16985dog diseasesidiopathicimmune‐mediated diseasesimmunologypurpurathrombocytopenic |
| spellingShingle | Marjory B. Brooks Robert Goggs Amelia H. Frye Jessica Armato Marnin Forman Julia Hertl Michael Koch John P. Loftus John Lucy Brandi Mattison Julia Merriam Sarah Shropshire Laura Van Vertloo Austin Viall Dana N. LeVine A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs Journal of Veterinary Internal Medicine dog diseases idiopathic immune‐mediated diseases immunology purpura thrombocytopenic |
| title | A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs |
| title_full | A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs |
| title_fullStr | A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs |
| title_full_unstemmed | A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs |
| title_short | A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs |
| title_sort | prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs |
| topic | dog diseases idiopathic immune‐mediated diseases immunology purpura thrombocytopenic |
| url | https://doi.org/10.1111/jvim.16985 |
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