Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, UK.
J Vet Intern Med. 2011 Mar-Apr;25(2):273-7. doi: 10.1111/j.1939-1676.2011.0683.x. Epub 2011 Feb 11.
Dogs with protein-losing enteropathy (PLE) have previously been reported to present with thromboembolism; however, the prevalence and pathogenesis of hypercoagulability in dogs with PLE have not been investigated so far.
Dogs with PLE are hypercoagulable compared with healthy control dogs.
Fifteen dogs with PLE. Thirty healthy dogs served as controls (HC).
A prospective study was performed including 15 dogs with PLE. All dogs were scored using the canine chronic enteropathy activity index (CCECAI). Thromboelastography (TEG) and other measures of coagulation were evaluated. Recalcified, unactivated TEG was performed and reaction time (R), kinetic time (K), alpha angle (α), and maximum amplitude (M(A)) values were recorded. Nine dogs were reassessed after initiation of immunosuppressive treatment.
All dogs with PLE in the study were hypercoagulable with decreased R (PLE: median 7.8, range [2.4-11.2]; HC: 14.1 [9.1-20.3]), decreased K (PLE: 2.5 [0.8-5.2]; HC: 8.25 [4.3-13.1]), increased α (PLE: 56.7 [38.5-78.3]; HC: 25.6 [17-42.4]), and increased M(A) (PLE: 68.2 [54.1-76.7]; HC: 44.1, [33.5-49]) (all P < .001). Median antithrombin (AT) concentration was borderline low in PLE dogs; however, mean serum albumin concentration was severely decreased (mean 1.67 g/dL ± 5.1, reference range 2.8-3.5 g/dL). Despite a significant improvement in serum albumin and CCECAI, all 9 dogs with PLE were hypercoagulable at re-examination.
The hypercoagulable state in dogs with PLE cannot be solely attributed to loss of AT. Despite good clinical response to treatment, dogs remained hypercoagulable and could therefore be predisposed to thromboembolic complications.
已有报道称，患有蛋白丢失性肠炎（PLE）的犬会出现血栓栓塞症；然而，目前尚未研究 PLE 犬的高凝状态的患病率和发病机制。
患有 PLE 的犬与健康对照犬相比存在高凝状态。
15 只患有 PLE 的犬。30 只健康犬作为对照组（HC）。
进行了一项前瞻性研究，纳入了 15 只患有 PLE 的犬。所有犬均使用犬慢性肠炎活动指数（CCECAI）进行评分。评估血栓弹力图（TEG）和其他凝血指标。进行复钙未激活 TEG，记录反应时间（R）、动力学时间（K）、α 角（α）和最大振幅（M(A)）值。9 只犬在开始免疫抑制治疗后进行了重新评估。
研究中的所有 PLE 犬均存在高凝状态，表现为 R 降低（PLE：中位数 7.8，范围 [2.4-11.2]；HC：14.1 [9.1-20.3]）、K 降低（PLE：2.5 [0.8-5.2]；HC：8.25 [4.3-13.1]）、α 升高（PLE：56.7 [38.5-78.3]；HC：25.6 [17-42.4]）和 M(A) 升高（PLE：68.2 [54.1-76.7]；HC：44.1，[33.5-49]）（均 P<.001）。尽管 PLE 犬的抗凝血酶（AT）浓度处于临界低值，但平均血清白蛋白浓度严重降低（均值 1.67 g/dL ± 5.1，参考范围 2.8-3.5 g/dL）。尽管血清白蛋白和 CCECAI 显著改善，但 9 只 PLE 犬在再次检查时仍存在高凝状态。
PLE 犬的高凝状态不能仅归因于 AT 的丧失。尽管对治疗有良好的临床反应，但犬仍处于高凝状态，因此可能容易发生血栓栓塞并发症。
