Splenomegaly development and disseminated intravascular coagulation syndrome in acute canine babesiosis

Disseminated intravascular coagulation (DIC) syndrome is the main defining process in the pathogenetic axis of complications in canine babesiosis. The involvement of the spleen with further irreversible changes in the organ largely determines the severity of the animal’s condition after spontaneous babesiosis. The work presented here aimed to determine the role of the DIC syndrome as a triggering factor for lesions of the spleen. Clinical and laboratory studies (haematological, biochemical, hemodynamic) have been carried out. Pathological studies of the removed spleen were carried out by histological methods using universal and specific staining. After suffering acute spontaneous babesiosis, the development of hypersplenism and splenomegaly was found in dogs. The diagnosis was confirmed haematologically by the detected cytopenia, normochromic type anaemia. An additional parameter was a significantly increased erythrocyte sedimentation rate. The biochemical profile indicated the development of bilirubinaemia due to the conjugated fraction, hyperfermentation of transaminases, hypoalbuminemia, which reflected the development of hepatitis and liver failure. Markers of DIC syndrome in laboratory studies are represented by reliable hypofibrinogenemia, increased level of fibrinogen/fibrin degradation products, including D-dimer, and soluble fibrin monomer complexes. The multidirectional indices of coagulation tests (activated partial thromboplastin and prothrombin time) made it possible to classify the stage of “consumption coagulopathy” of the DIC syndrome. The haemodynamic parameters of the sick dogs were characterized by a significant deficit in the circulating blood volume. Together with the indicators of the “consumption coagulopathy” stage of the DIC syndrome, the hemodynamic indexes indicate a moderate degree of shock stage II – the stable reversibility, but the magnitude of the circulating blood volume deficit determines the tendency towards shock irreversibility. Histological studies have established a significant proliferation of the stromal elements of the organ, the formation of specific complexes of vessels with sinuses, clogging with blood clots, and the organ's parenchyma dystrophy. Such changes characterize complete splenomegaly, which is based on the organo-pathology of the DIC syndrome. The deposition of “old” fibrin in the connective tissue structures of the spleen indicates that DIC syndrome continues throughout the entire period of hyperplastic changes in the organ. The presence of hyalinosis in blood vessel walls of the spleen parenchyma determines irreversible changes in them. Thus, DIC syndrome is the basis for splenomegaly development in dogs after acute spontaneous babesiosis. It is confirmed by laboratory blood tests and histologically by the presence of fibrin thrombi in the structures of the organ, which determine the organopathology of the syndrome. The information obtained serves to expand the concepts of the pathogenesis of blood protozoal disease, define the high risk of complications that can become fatal for the health and life of animals.

Download Full-text

Disseminated Intravascular Coagulation Syndrome as a Complication in Acute Spontaneous Canine Babesiosis

Macedonian Veterinary Review ◽

10.2478/macvetrev-2020-0027 ◽

2020 ◽

Vol 43 (2) ◽

pp. 141-149

Author(s):

Oksana A. Dubova ◽

Diana V. Feshchenko ◽

Tetiana I. Bakhur ◽

Oksana A. Zghozinska ◽

Anatoliy A. Antipov ◽

...

Keyword(s):

Blood Pressure ◽

Blood Volume ◽

Disseminated Intravascular Coagulation ◽

Degradation Product ◽

Fibrin Degradation Product ◽

Canine Babesiosis ◽

Circulating Blood Volume ◽

Soluble Fibrin ◽

Intravascular Coagulation ◽

Fibrin Monomer

AbstractThe polyetiological syndrome of disseminated intravascular coagulation (DIC) is characterized by changes in patients’ hemostasis. The aim of the current research was to elucidate the main factors for the development of DIC syndrome during canine babesiosis, and to assess their correlation level. Dogs included in this study were of various breeds and sex, weighing 10-40 kg and aged 2-7 years. They were separated in two groups (n=50) according to their diagnosis to babesiosis. Oscillometry (blood pressure, pulse rate), vascular-platelet hemostasis, coagulogram, hematological, biochemical (fibrinogen, fibrin degradation product, soluble fibrin-monomer complex) and hemodynamic (circulating blood volume) assessment methods were used. The group of dogs positive on Babesia spp., had clear manifestation of DIC with 5-7% of the erythrocyte population being affected. DIC was manifested by a significant increase in soluble fibrin-monomer complex and fibrin degradation product (p<0.001), hypofibrinogenemia (p<0.001), thrombocytopenia (p<0.001), and an increase in indicators of spontaneous aggregation ability of platelets and red blood cells (p<0.001). Significant hemodynamic disorders were observed: a decrease in circulating blood volume, circulating erythrocytes volume (p<0.05), specific circulating blood volume and hematocrit value (p<0.001). The average blood pressure was reduced (p<0.001), and the Allgöwer’s shock index was increased 2 times (p<0.05). A shock of II degree (medium, subcompensated) was confirmed. Therefore, it can be concluded that acute spontaneous dogs’ babesiosis can be characterized by the occurrence of DIC in a consumption coagulopathy form, and shock of II degree. This condition renders the patients for emergency admission.

Download Full-text

ШОК ТА ДВЗ-СИНДРОМ ЯК ПАТОГЕНЕТИЧНА ВІСЬ ЗА БАБЕЗІОЗУ СОБАК

Scientific Messenger of LNU of Veterinary Medicine and Biotechnology ◽

10.15421/nvlvet6615 ◽

2016 ◽

Vol 18 (2(66)) ◽

pp. 70-74

Author(s):

O.A. Dubova

Keyword(s):

Cause Of Death ◽

Disseminated Intravascular Coagulation ◽

Degradation Products ◽

Clinical Signs ◽

Vicious Circle ◽

Consumption Coagulopathy ◽

Soluble Fibrin ◽

Intravascular Coagulation ◽

Determining Factors ◽

Morphological Picture

The article is devoted to research of complication of dogs babesiosis and the elucidation of their pathogenetic mechanisms. Babesiosis of dogs is extremely common in Polissya region of Ukraine, as created ideal conditions for enzootic focus. Agents have considerable virulence, so the disease is often accompanied by extremely severe complications. In our researches it is established that the main pathogenetic axis represent the shock and syndrome of disseminated intravascular coagulation of blood. These two processes are the secondary and create a "vicious circle" mutually causing and utilise each other. They are the determining factors of the death of the body.We studied clinical signs, laboratory indicators and pathological and morphological picture of complication. Clearly the stage of hypercoagulability with the defeat of the shock bodies, of consumption coagulopathy with bleeding on the background of thrombosis, fibrinolysis with ongoing bleeding and further irreversible terminal stage of shock. The main involving laboratory criteria are the concentration of degradation products of fibrinogen/fibrin and the presence of soluble fibrin-monomer complexes defined in the ethanol test, and hematocrit. Other indicators and signs allow you to identify the stage of complications.Thus, when dogs babesiosis main complications are disseminated intravascular coagulation and shock that affect the vital organs and systems and they are the main determining cause of death of animals.

Download Full-text

Plasma Thrombin Assay using a Chromogenic Substrate in Disseminated Intravascular Coagulation due to Snake Bite Envenomation

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646807 ◽

1979 ◽

Vol 41 (03) ◽

pp. 544-552 ◽

Cited By ~ 3

Author(s):

R P Herrmann ◽

P E Bailey

Keyword(s):

Disseminated Intravascular Coagulation ◽

Degradation Products ◽

Snake Bite ◽

Chromogenic Substrate ◽

Coagulation Parameters ◽

Fibrinogen Degradation Products ◽

Intravascular Coagulation

SummaryUsing the chromogenic substrate, Tos-Gly-Pro-Arg-pNA-HCL (Chromozym TH, Boehringer Mannheim) plasma thrombin was estimated in six cases of envenomation by Australian elapid snakes. All patients manifested findings chracteristic of defibrination due to envenomation by these snakes. Fibrin-fibrinogen degradation products were grossly elevated, as was plasma thrombin in all cases.Following treatment with antivenene, all abnormal coagulation parameters returned rapidly towards normal by 24 hours and plasma thrombin disappeared.

Download Full-text

Platelet Function in Experimentally Induced Pancreatitis in the Dog

Thrombosis and Haemostasis ◽

10.1055/s-0038-1661521 ◽

1986 ◽

Vol 55 (02) ◽

pp. 197-200 ◽

Cited By ~ 6

Author(s):

R M Jacobs ◽

R J Murtaugh ◽

R H Fertel

Keyword(s):

Platelet Function ◽

Disseminated Intravascular Coagulation ◽

Degradation Products ◽

Plasma Concentrations ◽

Adenosine Diphosphate ◽

Intravascular Coagulation ◽

Fibrin Degradation Products ◽

Functional Defect ◽

And Function ◽

Experimentally Induced

SummaryEvidence suggests that changes in prostaglandins and disseminated intravascular coagulation accompany pancreatitis. Both may induce changes in platelet function. We wished to determine if experimentally induced pancreatitis in the dog was associated with altered platelet number and function, and whether there were concomitant changes in prostaglandins. Evidence for disseminated intravascular coagulation in the dogs with pancreatitis were red blood cell fragmentation, increased platelet turnover indicated by macro-platelets and the transient presence of fibrin degradation products in urine. There were no significant changes in platelet count. The platelets from dogs with pancreatitis showed a functional defect characterized by significantly decreased aggregation in response to adenosine diphosphate, arachidonic acid, and collagen. Release of adenosine triphosphate from platelets was reduced in collagen-stimulated aggregation. There were no changes in the plasma concentrations of thromboxane B2, 6-Keto-PGF1a, and PGE2. This defect may have been due to the generation of fibrin degradation products and platelet “exhaustion”.

Download Full-text

False-Positive D-Dimer Result in a Patient With Castleman Disease

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-328-fdriap ◽

2004 ◽

Vol 128 (3) ◽

pp. 328-331

Author(s):

Kimberly Mugler ◽

Jerry B. Lefkowitz

Keyword(s):

Western Blot ◽

Disseminated Intravascular Coagulation ◽

False Positive ◽

Degradation Products ◽

False Negative ◽

Castleman Disease ◽

Laboratory Findings ◽

Intravascular Coagulation ◽

Immunodeficiency Virus ◽

D Dimer

Abstract In suspected cases of disseminated intravascular coagulation, concurrent elevation of both fibrin(ogen) degradation products (FDPs) and D-dimer levels aids in confirming the diagnosis. This pattern of results reflects the action of plasmin proteolysis of cross-linked fibrin polymers as well as fibrinogen. We report the case of a patient with human immunodeficiency virus (HIV) and Castleman disease who presented with a high-positive D-dimer level and a negative FDP level in the course of a workup for disseminated intravascular coagulation. This finding suggested the possibility of either a false-positive D-dimer or a false-negative FDP level. To investigate the former, a Western blot was performed on the patient's serum to determine the presence of the D-dimer. No D-dimer band was visualized on the Western blot, confirming the false-positive nature of the D-dimer result. Insufficient quantity of patient serum, however, prevented further investigation into the etiology of this result. The false-positive D-dimer result is likely attributable to interference caused by the patient's Castleman disease–associated monoclonal gammopathy, a phenomenon that has been reported in other immunoassays. As the development of lymphoproliferative disorders is especially common within the HIV population, and hypergammaglobulinemia in Castleman disease is particularly common, clinicians should be aware of this phenomenon when the laboratory findings do not fit the clinical picture. Although it is rare, recognition of potential paraprotein interference in immunoassays will help avoid undertreatment or overtreatment of patients based on erroneous laboratory results.

Download Full-text

D-dimer kit with a High FDP/D-Dimer Ratio is Useful for Diagnosing Thrombotic Diseases

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211070584 ◽

2022 ◽

Vol 28 ◽

pp. 107602962110705

Author(s):

Nozomi Ikeda ◽

Hideo Wada ◽

Yuhuko Ichikawa ◽

Minoru Ezaki ◽

Motoko Tanaka ◽

...

Keyword(s):

Venous Thromboembolism ◽

Critically Ill ◽

Disseminated Intravascular Coagulation ◽

Critically Ill Patients ◽

Degradation Products ◽

Intravascular Coagulation ◽

Fibrin Degradation Products ◽

Peripheral Arterial ◽

Thrombotic Diseases ◽

D Dimer

Introduction Although D-dimer is a useful biomarker of thrombosis, there are many D-dimer kits, with high and low fibrinogen and fibrin degradation products (FDP)/ D-dimer ratios. Methods Plasma D-dimer levels were measured using three different kits in critically ill patients to examine the usefulness of such measurements for detecting the thrombotic diseases and determining the correlation with the FDP and FDP/D-dimer ratio. Results Although three D-dimer kits showed marked utility for diagnosing disseminated intravascular coagulation (DIC) and peripheral arterial and venous thromboembolism (PAVTE), the D-dimer levels determined using the three kits varied among diseases. Indeed, one D-dimer kit showed a high FDP/D-dimer ratio, and another kit showed a low FDP/D-dimer ratio. D-dimer kit with low FDP/D-dimer ratio tended to have high cut-off values and low specificity for diagnosing DIC and PAVTE. In D-dimer kit with high FDP/D-dimer ratio, FDP/D-dimer ratios in patients with thrombosis was significantly higher than that in patients without thrombosis. Conclusion All three D-dimer kits show utility for detecting thrombotic diseases. However, the D-dimer levels determined using the kits varied due to differences in the FDP/D-dimer ratio. In combination with the FDP level, a D-dimer kit with a high FDP/D-dimer ratio may be useful.

Download Full-text

Disseminated intravascular coagulation in dogs with gastric dilatation-volvulus syndrome

Veterinární Medicína ◽

10.17221/7141-vetmed ◽

2013 ◽

Vol 58 (No. 11) ◽

pp. 587-590 ◽

Cited By ~ 1

Author(s):

I. Uhrikova ◽

K. Machackova ◽

L. Rauserova-Lexmaulova ◽

K. Rehakova ◽

J. Doubek

Keyword(s):

Disseminated Intravascular Coagulation ◽

Partial Thromboplastin Time ◽

Degradation Products ◽

Activated Partial Thromboplastin Time ◽

Gastric Dilatation ◽

Fibrinogen Degradation Products ◽

Intravascular Coagulation ◽

Before And After ◽

Healthy Control ◽

Fibrinolytic Parameters

Gastric dilatation and volvulus syndrome is associated with changes in haemostatic profiles. The aims of this study were to compare selected haemostatic and fibrinolytic parameters between healthy dogs and dogs with gastric dilatation and volvulus syndrome, estimate the incidence of disseminated intravascular coagulation (DIC), and determine the most sensitive test for detection of DIC in these patients. Blood was collected from 22 dogs with gastric dilatation and volvulus syndrome, and nine healthy control dogs. Platelet counts, prothrombin time, activated partial thromboplastin time, fibrinogen concentrations and fibrin/fibrinogen degradation products were measured in all control dogs and patients with gastric dilatation and volvulus syndrome, before and after surgery. Significant differences between control dogs and patients were seen in activated partial thromboplastin time and fibrin/fibrinogen degradation products before surgery and all measured parameters after surgery. The incidence of DIC was 59%. The most sensitive tests for detection of DIC before surgery were those for activated partial thromboplastin time and fibrin/fibrinogen degradation products.

Download Full-text

Disseminated Intravascular Coagulation as an Initial Manifestation of Metastatic Prostate Cancer Emergently Treated with Docetaxel-Based Chemotherapy

Case Reports in Oncological Medicine ◽

10.1155/2019/6092156 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Kavita Agrawal ◽

Nirav Agrawal ◽

Levin Miles

Keyword(s):

Prostate Cancer ◽

Weight Loss ◽

Disseminated Intravascular Coagulation ◽

Metastatic Prostate Cancer ◽

Degradation Products ◽

Specific Antigen ◽

Mass Effect ◽

Whole Body ◽

Initial Manifestation ◽

Intravascular Coagulation

A 70-year-old male presented with hematuria and bruising of arms and legs for the last three days. He also complained of urinary frequency and hesitancy and weight loss of 40 pounds over a span of four months. Initial blood tests showed prothrombin time (PT) of 25.1 seconds, international normalized ratio (INR) of 2.5, partial thromboplastin time (PTT) of 43.9 seconds, fibrinogen of 60 mg/dl, fibrin degradation products (FDP) of more than 20 μg/ml, and platelets of 88,000/μl. The impression was disseminated intravascular coagulation (DIC). A search was initiated to determine the underlying etiology precipitating DIC. Due to urinary symptoms and weight loss, prostate-specific antigen (PSA) was ordered. PSA was elevated at 942 μg/dl. Computed tomography (CT) of the abdomen and pelvis without contrast showed an enlarged prostate with mass effect on the bladder base, left-sided hydronephrosis, and numerous enlarged pelvic lymph nodes. A bone scan of the whole body showed increased sclerosis of the L3 vertebral body. There was a concern for metastatic prostate cancer precipitating DIC. On first admission, our patient’s DIC was stabilized with FFP and cryoprecipitate transfusions. He refused chemotherapy, and degarelix was not economically feasible. Accordingly, he was started on androgen deprivation therapy (ADT), bicalutamide, and leuprolide as an inpatient, pending the tissue biopsy. The patient refused a prostate biopsy. A bone marrow biopsy was performed which confirmed metastatic prostate adenocarcinoma. The patient was stable for discharge with a plan for outpatient chemotherapy. Subsequently, he was lost to follow-up with the oncology. Six months after the initial presentation, he was readmitted with hematuria. Repeat PSA worsened to 1,970 μg/dl. Blood work was consistent with acute DIC. He refused chemotherapy again. So, he was restarted on ADT. However, his hematuria and DIC panel were worsening. He was emergently started on docetaxel as an inpatient (after patient agreement). Within three days of starting chemotherapy, his hematuria resolved and DIC panel showed consistent improvement.

Download Full-text