Barthélemy A, Magnin M, Pouzot-Nevoret C, Bonnet-Garin J-M, Hugonnard M, Goy-Thollot I
Intensive Care Unit (SIAMU), VetAgro Sup campus vétérinaire de Lyon, Université de Lyon, Marcy l'Etoile, France.
Univ Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France.
J Vet Intern Med. 2017 Jan;31(1):69-80. doi: 10.1111/jvim.14626. Epub 2016 Dec 2.
Leptospirosis in dogs is occasionally associated with a hemorrhagic syndrome, the pathophysiology of which is not fully understood.
HYPOTHESIS/OBJECTIVES: To characterize hematologic, hemostatic, and thromboelastometric abnormalities in dogs with leptospirosis and to study their association with hemorrhagic diatheses and outcomes.
Thirty-five client-owned dogs.
A prospective observational single cohort study was conducted. Results from the CBC, coagulation tests (prothrombin, activated partial thromboplastin and thrombin times, fibrinogen, fibrin(ogen) degradation products, and D-dimer concentrations), rotational thromboelastometry (TEM), signalment, hemorrhagic diatheses, occurrence of disseminated intravascular coagulation (DIC) at admission, and survival to discharge were recorded.
The most common hematologic and hemostatic abnormalities were anemia (30/35), thrombocytopenia (21/35), and hyperfibrinogenemia (15/35). Eight dogs were diagnosed with DIC. A normal TEM profile was found in 14 dogs, a hypercoagulable profile in 14 dogs, and a hypocoagulable profile in 7 dogs. The 8 dogs with hemorrhagic diatheses at admission had significantly decreased platelet counts (P = .037) and increased D-dimer concentrations (P = .015) compared with other dogs. Dogs with a hypocoagulable profile exhibited more hemorrhagic diatheses compared with the dogs that had normal and hypercoagulable profiles (P = .049). The mortality rate was lower in dogs with a hypercoagulable profile than in those with a hypocoagulable profile (21% vs 57%; P = .043). Disseminated intravascular coagulation was not a significant prognostic factor.
Thromboelastometric parameters were altered in dogs with both hypercoagulable and hypocoagulable profiles. A hypocoagulable profile was significantly correlated with hemorrhagic diathesis and higher mortality rate.
犬钩端螺旋体病偶尔会伴有出血综合征，其病理生理学尚未完全明确。
假设/目的：描述患钩端螺旋体病犬的血液学、止血和血栓弹力图异常情况，并研究它们与出血性素质及预后的关系。
35只客户拥有的犬。
进行一项前瞻性观察单队列研究。记录全血细胞计数、凝血试验（凝血酶原时间、活化部分凝血活酶时间和凝血酶时间、纤维蛋白原、纤维蛋白（原）降解产物及D - 二聚体浓度）、旋转血栓弹力图（TEM）、特征、出血性素质、入院时弥散性血管内凝血（DIC）的发生情况以及出院存活率。
最常见的血液学和止血异常为贫血（30/35）、血小板减少（21/35）和高纤维蛋白原血症（15/35）。8只犬被诊断为DIC。14只犬TEM曲线正常，14只犬呈高凝状态，7只犬呈低凝状态。入院时有出血性素质的8只犬与其他犬相比，血小板计数显著降低（P = 0.037）且D - 二聚体浓度升高（P = 0.015）。与TEM曲线正常和呈高凝状态的犬相比，呈低凝状态的犬出现更多出血性素质（P = 0.049）。呈高凝状态的犬死亡率低于呈低凝状态的犬（21%对57%；P = 0.043）。弥散性血管内凝血不是一个显著的预后因素。
TEM参数在呈高凝和低凝状态的犬中均有改变。低凝状态与出血性素质及较高死亡率显著相关。
