Diagnosis of disseminated intravascular coagulation in dogs admitted to anintensive care unit

Objective-To describe and evaluate hemostatic function in critically ill do gs with clinical signs of diseases that predispose to disseminated intravas cular coagulation (DIC). Design-Prospective case series. Animals-59 critically ill dogs (affected dogs) with clinical signs of disea ses known to predispose to DIC and 52 clinically normal dogs (control dogs] . Procedure-Activated partial thromboplastin time (aPTT], prothrombin time(PT ), thrombin clotting time (TCT), plasma fibrinogen concentration, serum con centration of fibrin and fibrinogen-related antigens (FRA), and plasma anti thrombin III (AT III) activity were determined for all dogs. Results from a ffected dogs were compared with those of control dogs. In some affected dog s, postmortem tissue specimens were examined for evidence of microvascular thrombosis. A diagnosis of DIC was made by fulfilling at least 3 of the fol lowing criteria: 1) abnormal aPTT, PT, or TCT value, 2) low plasma fibrinog en concentration, 3) low plasma AT III activity, 4) high serum FRA concentr ation, or 5) low platelet count. To evaluate the severity of hemostatic dys function; 3 arbitrary categories (mild, moderate, and severe) were proposed . Results-A diagnostic strategy based on moderate hemostatic dysfunction iden tified DIC in 16 of 59 (27.1%) affected dogs. The AT III activity was < 70% in 15 of 16 dogs with DIC. Microvascular thrombosis was observed in tissue specimens from 7 of 8 affected dogs. Serum FRA and plasma fibrinogen conce ntrations did not contribute in establishing a diagnosis of DIG. Conclusions and Clinical Relevance-A diagnosis of DIC can be made when hemo static dysfunction is moderate in dogs with clinical signs of diseases asso ciated with DIC.