Introduction

Hemostatic disorders may occur in patients with protein losing nephropathy (PLN) secondary to canine visceral leishmaniosis (CVL). Our main objectives were to evaluate the prevalence of these disorders in advanced stages of CVL and their survival.

Methods

A prospective observational study was performed on 15 dogs diagnosed with advanced CVL and PLN (LeishVet stages III and IV) at the Veterinary Hospital of the University of Extremadura. Hematology, biochemistry and complete urinalysis including urine protein:creatinine (UP/C) ratio were performed. Times of thrombin (TT), prothrombin (PT) and activated partial thromboplastin (aPTT) were measured with a coagulometer (CLOT-1; RAL®; Spain). Plasmatic levels of D-dimers (DD) were measured by automated latex particle immunoassay (D-Dimer HemosIL®; Italy). Antithrombin III activity (ATIII) was determined by molecular absorption spectrometry (BCS® XP System; Germany).

Results

Fifteen dogs were included (stage III, n=7; stage IV, n=8). The median age was 70.4 months (23–128). Platelet count was normal in all cases in stage III; thrombocytopenia was observed in one dog in stage IV. Abnormalities in secondary hemostasia were found in stage III and IV respectively, such as prolongation of: TT (1/7; 3/8), PT (1/7; 0/8) and aPPT (2/7; 4/8). Decreased ATIII was observed only in three dogs in stage IV, even when all patients exhibited marked proteinuria (UP/C ranged 1.2 to 12.9). Increased DD values were found in all dogs. Clinically, four patients (one in stage III and three in stage IV) met the criteria for the diagnosis of disseminated intravascular coagulation and two dogs enclosed in LeishVet IV suffered thromboembolic events. Patients in stage IV presented higher mortality rates compared to stage III patients (62.5% vs. 0% respectively) after three months. A Student t-test was used, but no statistically significant differences were observed when surviving and non-surviving groups were contrasted (p>0.05) for any of the hemostatic parameters.

Conclusions

Dogs in advanced stages of CVL exhibit alterations in the intrinsic coagulation pathway and increased DD; decreased ATIII was only observed in some patients included in LeishVet IV. preventive antithrombotic treatment must be established in advanced LeishVet stages with PLN.

Disclosures

No disclosures to report.