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.
Description:
SUPPORTING INFORMATION : DATA S1: Supporting Information. TABLE S1: Signalment, diagnosis, clinical, and thromboemboli details for the 3 dogs in which a macrothrombi was identified at post mortem in this prospective study evaluating thromboembolic disease. TABLE S2: Primary tumor and concurrent secondary tumor and/or comorbidity identified in dogs with microthrombi (excluding dogs with macrothrombi). TABLE S3: Hematology, biochemistry, and hemostatic variables in healthy unaffected dogs and the 3 dogs in which a macrothrombi was identified. TABLE S4: Medication administered to dogs diagnosed with carcinoma or sarcoma in the 2 weeks prior to euthanasia (excluding dogs with macrothrombi). TABLE S5: Variables with P value.
