Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA.
J Vet Intern Med. 2012 Mar-Apr;26(2):230-7. doi: 10.1111/j.1939-1676.2012.00893.x. Epub 2012 Feb 28.
Portal vein thrombosis (PVT) has been reported infrequently in dogs.
To characterize the presentation, associated disease conditions, and outcome in dogs with PVT.
Client-owned dogs with a diagnosis of PVT and a complete medical record.
Records were retrospectively analyzed for presentation, history, physical examination, clinicopathologic data, diagnostic imaging, treatment, and outcome.
Thirty-three dogs were included. Common clinical signs were vomiting, diarrhea, abdominal pain, ascites, and signs of hypovolemic shock. Associated disease conditions included hepatic (14/33), neoplastic (7/33), immune (5/33), and infectious (4/33) diseases, protein-losing nephropathy (3/33), hyperadrenocorticism (2/33), protein-losing enteropathy (1/33), and pancreatitis (1/33). Fourteen dogs were receiving glucocorticoids at the time of diagnosis. Twenty-nine dogs had at least 1 predisposing condition for venous thrombosis, and 11 had 2 or more. Thrombocytopenia (24/33), increased liver enzyme activity (23/33), and hypoalbuminemia (20/33) were common laboratory abnormalities. Clinical syndromes at the time of PVT diagnosis included shock (16/33), systemic inflammatory response syndrome (SIRS), (13/33) and disseminated intravascular coagulation (3/33). Twenty-four dogs had acute and 9 had chronic PVT. Multiple thrombi were found in 17/33 dogs. Nineteen dogs survived to discharge. Dogs treated with anticoagulant therapy were more likely, whereas those with acute PVT, multiple thromboses or SIRS were less likely to survive.
Hepatic disease is a common pre-existing condition in dogs with PVT. PVT should be considered in dogs with risk factors for venous thrombosis presenting with abdominal pain, ascites, and thrombocytopenia. Studies evaluating anticoagulant therapy in the management of PVT are warranted.
门静脉血栓形成(PVT)在犬中罕见报道。
描述犬 PVT 的临床表现、相关疾病状况和结局。
诊断为 PVT 并具有完整病历的患犬。
回顾性分析病例的表现、病史、体格检查、临床病理学数据、诊断影像学、治疗和结局。
共纳入 33 只犬。常见的临床症状有呕吐、腹泻、腹痛、腹水和低血容量性休克的迹象。相关疾病状况包括肝脏疾病(14/33)、肿瘤性疾病(7/33)、免疫性疾病(5/33)和感染性疾病(4/33)、蛋白丢失性肾病(3/33)、库欣氏病(2/33)、蛋白丢失性肠炎(1/33)和胰腺炎(1/33)。诊断时,14 只犬正在接受糖皮质激素治疗。29 只犬至少有一种静脉血栓形成的易患因素,11 只犬有两种或更多。血小板减少症(24/33)、肝酶活性升高(23/33)和低白蛋白血症(20/33)是常见的实验室异常。PVT 诊断时的临床综合征包括休克(16/33)、全身炎症反应综合征(SIRS)(13/33)和弥散性血管内凝血(3/33)。24 只犬为急性 PVT,9 只为慢性 PVT。17 只犬发现多发血栓。19 只犬存活出院。接受抗凝治疗的犬更有可能存活,而急性 PVT、多发血栓或 SIRS 的犬存活可能性较小。
肝脏疾病是犬 PVT 的常见潜在疾病。对于有静脉血栓形成风险因素、表现为腹痛、腹水和血小板减少症的犬,应考虑 PVT。有必要开展评估抗凝治疗在 PVT 治疗中的作用的研究。