Evaluation of coagulation parameters in dogs with gallbladder mucoceles

Abstract

Background: Gallbladder mucocele (GBM) is a common biliary disorder in dogs.Limited information is available on the coagulation status of dogs with GBM.Hypothesis/Objectives: To determine patterns of coagulation alterations in dogs with GBM and correlate them with clinicopathologic abnormalities and ultrasonographic findings of disease severity.Animals: Twenty-three dogs with GBM identified on ultrasound examination were prospectively enrolled.Methods: At the time of GBM identification, blood and urine were collected for CBC, serum biochemical panel, urinalysis, prothrombin time, activated partial thromboplastin time (aPTT), factor VIII, protein C (PC), von Willebrand's factor (vWF), antithrombin activity, fibrinogen, D-dimers, and thromboelastrography (TEG). Gallbladder mucoceles were classified into ultrasound types 1 to 5. Medical records were reviewed for clinical presentation, underlying conditions and to determine if systemic inflammatory response syndrome (SIRS) was present.Results: Based on TEG parameters, maximal amplitude, and G, 19/23 (83%) of dogs with GBM had evaluations consistent with hypercoagulability. On plasma-based coagulation testing, dogs with GBM had increased total PC activity (20/23, 87%), fibrinogen (9/23, 39%), platelet count (9/23, 39%), and D-dimers (6/15, 40%) as well as prolongations in aPTT (9/22, 41%) and low vWF activity (5/21, 24%). No correlation was found between TEG G value and any coagulation or clinical pathology variables, ultrasound stage of GBM or disease severity as assessed by the presence of SIRS.Conclusions and Clinical Importance: Dogs with ultrasonographically identified GBM have changes in whole blood kaolin-activated TEG supporting a hypercoagulable state although traditional plasma-based coagulation testing suggests that a complex state of hemostasis exists.

Concurrent hepatopathy in dogs with gallbladder mucocele: Prevalence, predictors, and impact on long‐term outcome

“… 32 Importantly, because of the small number of dogs in the study as well as the incomplete information regarding cause of euthanasia or death, we cannot conclude from this study that fibrosis is a poor prognostic indicator in cases of GBM. Dogs with GBM may suffer from a variety of complications and concurrent disorders including necrosis and rupture, EHBDO, bacterial infection, cholecystitis, coagulation disturbances, and systemic inflammatory response syndrome, 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 all of which may have contributed to death in these patients.…”

“…A variety of complications have been associated with GBM including but not limited to GB necrosis and rupture, extra‐hepatic biliary duct obstruction (EHBDO), bacterial infection, cholecystitis, coagulation disturbances, and systemic inflammatory response syndrome. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 The impact of a number of these factors on short‐and long‐term outcomes in dogs with GBM undergoing cholecystectomy have been investigated in multiple studies. 8 , 10 , 14 , 15 In contrast, concurrent hepatic abnormalities in dogs with GBM are less well described.…”

“…The median age was 11 (range, 5-16) years. Breeds included mixed breed(13), Shetland sheepdog (4), beagle (3), Labrador retriever (3), West Highland white terrier (3), Chihuahua (2), Jack Russell terrier (2), miniature dachshund (2), shih tzu (2), Yorkshire terrier (2), and 1 each of the following Australian heeler, Australian shepherd, bichon frisé, Brussels griffon, Cairn terrier, cocker spaniel, Boxer, Maltese, miniature pinscher, miniature schnauzer, Pembroke Welsh corgi, Pomeranian, Portuguese water dog, pug, toy poodle, and Welsh terrier. Median body weight was 8.7 (range, 2.9-43.5) kilograms.Pre-operative (within 7 days of cholecystectomy) selective hematological and biochemical data is shown in Table3.…”