Hemostatic Findings in Ascitic Fluid: A Cross‐Sectional Study in 70 Dogs

Abstract

BackgroundAscitic fluids of horses and humans have fibrinolytic activity, independent of the underlying mechanism of fluid formation.ObjectiveTo determine whether coagulation and fibrinogenolytic/fibrinolytic activity (ie, low fibrinogen and increased fibrin–fibrinogen degradation products [FDPs], D‐dimer, or both) occur in all types of ascitic fluid in dogs.AnimalsA total of 70 client‐owned dogs with ascites.MethodsIn this cross‐sectional study, dogs were categorized based on the pathophysiology of fluid formation into 4 groups: transudates due to decreased osmotic pressure, transudates due to increased hydrostatic pressure, exudates, and hemorrhagic ascites. Fibrinogen, FDPs, and D‐dimer concentrations were measured and then compared in both ascitic fluid and plasma.ResultsTen dogs had transudates due to decreased colloid osmotic pressure, 18 had transudates due to increased hydrostatic pressure, 13 had exudates, and 29 had hemorrhagic ascites. Ascitic fibrinogen concentrations (n = 70) were significantly lower (median = 59 mg/dL; range: 59–122 mg/dL) than those in the plasma (median = 168 mg/dL, range: 59–879 mg/dL; P < .0001). Ascitic FDPs concentrations (n = 70) were significantly higher (<5 μg/mL: 3/70 dogs, ≥5 to <20 μg/mL: 11/70 dogs, ≥20 μg/mL: 56/70 dogs) than those in the plasma (<5 μg/mL: 17/70 dogs, ≥5 to <20 μg/mL: 28/70 dogs, ≥20 μg/mL: 25/70 dogs; P < .0001). Ascitic D‐dimer concentrations (n = 70) were significantly higher (median = 3.98 μg/mL, range: 0.02–9.19) than those in the plasma (median = 0.11 μg/mL, range: 0.01–4.08; P < .0001). Analysis of the data for each of the 4 different types of ascites showed similar results to those of all the data analyzed together.Conclusions and Clinical ImportanceAscitic fluid of dogs has evidence of coagulation activation and fibrinogenolytic/fibrinolytic activity and that this phenomenon occurs independent of the underlying mechanism that leads to the formation of ascites.

Hemostatic findings of pleural fluid in dogs and the association between pleural effusions and primary hyperfibrino(geno)lysis: A cohort study of 99 dogs

“…Therefore, pleural effusions have inherent fibrin/fibrinogenolytic activity, as has been shown in the case for human [ 26 , 41 , 42 ], and ascitic equine fluid [ 43 ]. In addition, in a recent study on dogs with ascites formed secondary to different pathophysiological mechanisms, we found that also canine abdominal effusions have the same inherent fibrin/fibrinogenolytic activity [ 44 ]. The hypothesis that pleural fluid is inherently fibrinolytic is also supported not only by the clinical observation that pleural effusions rarely form clots in vivo , but also by several studies.…”

Fibrinolysis in Dogs with Intracavitary Effusion: A Review

“…Two recent studies have investigated whether coagulation and fibrinogenolytic/fibrinolytic activity occurred in intracavitary effusion by measuring the plasma and the effusion fibrinogen, and the FDPs and D-dimer concentrations of 70 dogs with ascites and 33 dogs with pleural effusion of different pathophysiological origins [ 41 , 72 ]. Abdominal and pleural effusion fibrinogen concentrations in these 103 dogs were undetectable in most cases and significantly lower than those in the plasma while the concentrations of FDPs and D-dimers in the abdominal and pleural fluids were significantly greater than those in the plasma [ 41 , 72 ].…”

“…Abdominal and pleural fluids inherently have fibrinolytic activity [ 41 , 70 , 72 , 75 ] and are in continuous exchange with the systemic circulation [ 75 , 79 ]. Two studies regarding dogs with abdominal and pleural effusion of different pathophysiological origins evaluated whether clotting abnormalities, suggestive of PF/PHF, were more frequent in these dogs.…”

“…The major complication of anticoagulant therapy is the precipitation of bleeding events, and severe heart disease has been associated with an increased risk of bleeding during oral anticoagulant therapy [ 93 ]. Having shown that ascites has intrinsic fibrinolytic activity [ 72 ] and that this fibrinolytic activity is associated with PHF in dogs [ 42 ], another study investigated whether the presence of ascites due to right-sided congestive heart failure (CHF) was associated with PHF and bleeding in dogs [ 40 ]. To achieve this goal, the coagulation profiles of 20 ascitic dogs with right-sided CHF and 60 control dogs without intracavitary effusion (40 sick dogs without cardiac disease and 20 dogs with left-sided CHF) were studied.…”

Retrospective Study of Ascites in Canines of North Gujarat Region

“…A ccumulating unnecessary fluid in the peritoneal cavity is a collective pathological condition seen in canines due to various etiologies (Moore et al, 2003, Zoia et al, 2017a. Ascites represent a general systemic state that could manifest in diverse disease conditions in animals.…”