Haemostatic alterations in a group of canine cancer patients are associated with cancer type and disease progression

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Abstract

Background: Haemostatic alterations are commonly detected in human and canine cancer patients. Previous studies have described haemostatic dysfunction in canine patients with haemangiosarcomas and carcinomas, and haemostasis has been assessed in dogs with various malignant and benign neoplasias. Few studies have addressed the effect of cancer type and progression of disease on the presence of haemostatic alterations in canine patients. The objective of the present study was to evaluate haemostatic variables of coagulation and fibrinolysis in a group of canine cancer patients, and to compare haemostatic changes to the cancer type and progression of disease.Methods: The study population consisted of 71 dogs with malignant neoplasia presented to the University Hospital for Companion Animals, Faculty of Life Sciences, University of Copenhagen, Denmark. The study was designed as a prospective observational study evaluating the haemostatic function in canine cancer patients stratified according to type of cancer disease and disease progression. The coagulation response was evaluated by thromboelastrography (TEG), platelet count, activated partial thromboplastin time (aPTT), prothombin time (PT), fibrinogen and antithrombin (AT); and fibrinolysis by d-dimer and plasminogen.Results: Hypercoagulability was the most common haemostatic dysfunction found. Non mammary carcinomas had increased clot strength (TEG G), aPTT and fibrinogen compared to the other groups. When stratifying the patients according to disease progression dogs with distant metastatic disease exhibited significantly increased fibrinogen, and d-dimer compared to dogs with local invasive and local non-invasive cancers.Conclusion: Hypercoagulability was confirmed as the most common haemostatic abnormality in canine cancer patients and haemostatic dysfunction in canine cancer patients was found related to the cancer type and progression of disease. Increase in TEG G, aPTT and fibrinogen were observed in non-mammary carcinomas and were speculated to overall represent a proinflammatory response associated with the disease. Dogs with distant metastatic disease exhibited increased fibrinogen and d-dimer. Future studies are needed to elucidate the clinical importance of these results. © 2012 Andreasen et al; licensee BioMed Central Ltd.

Figures

  • Table 1 Distribution of patients based on thromboelastography determined coagulability (G), cancer type and disease progression group
  • Figure 1 Thromboelastography G, activated partial thromboplastin time, prothrombin time, fibrinogen, d-dimer and platelet count grouped by cancer type. The TEG parameter G represents the clot strength. The short solid lines represent the median value for each cancer type. The dotted lines represent the reference interval (G: 3.2-7.2 x103 dyn/cm2; aPTT: 7 - 11.9 sec; PT: < 8.5 sec; fibrinogen: 1-4 g/L; d-dimer: < 0.5 mg/L; platelet count: 200-500 109/L). Overall significance is evaluated by Kruskal Wallis test and indicated by brackets. (NS): non-significant (Kruskal Wallis). Dunn’s Post Test was used to test for statistical significance between groups.┌──┐ indicates statistical significance between the groups at each end of the bar. * = Dunn’s Post Test: P < 0.05.
  • Figure 2 Thromboelastography G, activated partial thromboplastin time, prothrombin time, fibrinogen, d-dimer and platelet count grouped by progression of disease. The TEG parameter G represents the clot strength. The short solid lines represent the median value for each disease progression group. The dotted lines represent the reference interval (G: 3.2-7.2 x103 dyn/cm2; aPTT: 7 - 11.9 sec; PT: < 8.5 sec; fibrinogen: 1-4 g/L; d-dimer: < 0.5 mg/L; platelet count: 200-500 109/L). Overall significance is evaluated by Kruskal Wallis test and indicated by brackets. (NS): non-significant (Kruskal Wallis). Dunn’s Post Test was used to test for statistical significance between groups. ┌──┐ indicates statistical significance between the groups at each end of the bar. * = Dunn’s Post Test: P < 0.05. ** = Dunn’s Post test: P < 0.01.

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APA

Andreasen, E. B., Tranholm, M., Wiinberg, B., Markussen, B., & Kristensen, A. T. (2012). Haemostatic alterations in a group of canine cancer patients are associated with cancer type and disease progression. Acta Veterinaria Scandinavica, 54(1). https://doi.org/10.1186/1751-0147-54-3

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