Mortality in virulent canine babesiosis is associated with a consumptive coagulopathy

Abstract

The inflammatory response to infection can activate the coagulation system via complex interactions. If uncontrolled, this may lead to a consumptive coagulopathy, which has been identified as a major risk factor for poor outcome in both human and canine medicine. This study was undertaken to prospectively determine whether the presence of a consumptive coagulopathy in dogs with Babesia rossi infection is related to mortality. A prospective, cross-sectional, observational study was performed. Seventy-two client-owned dogs diagnosed with canine babesiosis were included. Diagnosis was confirmed by polymerase chain reaction and reverse line blot and dogs infected with Babesia vogeli or Ehrlichia canis were excluded. Blood samples were collected at admission. Coagulation factor-, antithrombin (AT)-, and protein C (PC) activity, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and Ddimer concentrations were measured. The mortality rate was 18% (13/72) and results between non-survivors and survivors were compared. The median activities of all the coagulation factors were significantly lower in the non-survivors compared to the survivors. The median PT and aPTT were significantly longer in the non-survivors compared to the survivors. The median AT activity was not significantly different; however, the median PC activity was significantly decreased in the non-survivors. The median D-dimer concentration was significantly higher in the non-survivors compared to the survivors. This study showed that dogs that died from B.canis infection suffered from a more severe consumptive coagulopathy compared to survivors, characterized by procoagulant activation, inhibitor consumption, and increased fibrinolytic activity.