Haemostasis impairment in bitches with pyometra

Abstract

It is well known that pyometra syndrome with endotoxemia and/or sepsis in bitches may impair different organ systems and functions including haemostasis, which may considerably influence the outcome if overlooked or underestimated. The present clinical study was carried out on thirty-seven clinical patients admitted to the Clinic for Small Animal Medicine and Surgery at the Veterinary Faculty in Ljubljana, Slovenia. Preoperative diagnosis was based on clinical signs, haematology results and ultrasonographic examination. Ovariohysterectomy was performed as final treatment. The study is aimed at the effects of pyometra syndrome on haemostatic functions as well as at the comparison between haemostatic functions and haematology and biochemistry results. Acute phase reaction with leucocytosis, neutrophilia, lymphopenia, hypoalbuminemia and hyperfibrinogenemia was identified preoperatively and up to 24 hours postoperatively. Changes in the haemostatic profile - prolonged activated partial thromboplastin time, shortened thrombin time, increased concentration of D-dimeres and thrombocytopenia - which were confirmed in the study, suggest the development of disseminated intravascular coagulation (DIC), most likely due to influence of E. coli endotoxin. The changes of haemostatic profile and concurrent acute phase reaction suggest the connection between inflammation and coagulopathy. Attention and early recognition of haemostatic function impairment should be addressed in pyometra syndrome patient in order to be able to timely substitute coagulation and anticoagulation factors with fresh blood, fresh or freshly frozen plasma or added heparin when appropriate.