Blood clotting disorders – rare but life-threatening

There are also "bleeders" among animals: animals with blood clotting disorders. These are either congenital or caused by another underlying disease. They are rare in animals, but can quickly become life-threatening in the event of major injuries.

INHALT
Hemostasis and blood coagulation Causes Symptoms Diagnosis Treatment Prognosis Prophylaxis
Hemostasis and blood coagulation

To limit blood loss in the event of an injury, thrombi (=blood clots) form in the blood vessels. The interaction between factors that promote and inhibit coagulation is important here. Neither severe bleeding nor excessive clotting should occur. Both would quickly become life-threatening.

When a blood vessel is injured, it first contracts. The resulting slowdown in blood flow activates the adhesion of thrombocytes (=blood platelets). A thin covering forms over the wound. More thrombocytes adhere to this covering. Together with fibrinogen (=a protein soluble in blood, precursor of fibrin) they form a network. This creates an initial white thrombus. The bleeding is stopped after one to three minutes. The actual blood clotting then takes another six to ten minutes. Fibrinogen is converted into fibrin. A solid fiber network forms, into which erythrocytes (=red blood cells) are also deposited. The red thrombus is formed.

Once the blood vessel has healed, the thrombus is broken down again. Enzymes split the fibrin so that it dissolves.

Causes

Rare congenital coagulation disorders include hemophilia and Von Willebrand disease. Affected animals do not produce certain coagulation factors, or do not produce them in sufficient quantities. In dogs, Labradors, Rhodesian Ridgebacks, Havanese (hemophilia) and Dobermans, Scotch Terriers and Shelties (Von Willebrand disease) are increasingly affected. In horses, it is Quarter Horses and Thoroughbreds. In cats, hereditary coagulation disorders are not well known.

Severe diseases with high-grade inflammatory reactions can lead to complete depletion of platelets and coagulation factors. This disseminated intravascular coagulopathy (DIC) can occur in the following cases:

  • Extensive tissue necrosis (=tissue death), for example due to burns
  • Heat stroke (see corresponding article)
  • Tumors
  • Blood poisoning
  • Liver disease (see corresponding articles)
  • Poisoning (see corresponding articles)
  • Gastrointestinal diseases such as intestinal inflammation, intestinal torsion in horses (see article on colic) or gastric torsion in dogs (see corresponding article)
  • Foal septicemia (see corresponding article)

Liver disease can also lead to impaired production of coagulation-promoting and anticoagulant factors.

Thrombocytopenia (=too few platelets) also leads to a coagulation disorder. Either too few platelets are produced in the bone marrow or they are consumed or destroyed at an increased rate due to an underlying disease. Thrombocytopenia is often a incidental finding during a blood test.

Coumarin poisoning from rat poison or vernal gras and sweet clover leads to reduced coagulation. This is also the case with medications such as heparin.

Symptoms

The following signs indicate a coagulation disorder:

  • Skin or mucous membranes bleedings
  • Petechiae (=pinpoint hemorrhages)
  • Hematomas (=bruises)
  • Black stools due to blood in the stool
  • Nose bleeding

If anticoagulation is impaired, thrombi form more easily. The symptoms depend on which blood vessel is affected. The area downstream is no longer supplied with blood, or not sufficiently. For example, lameness of the hind limbs occurs when the aorta is affected. A pulmonary embolism (=blockage of a blood vessel in the lung) causes shortness of breath.

Diagnosis

Following your preliminary report of noticeable bleedings and/or hematomas and a general examination, blood will be taken from your pet. In addition to a blood count with platelet count, various coagulation tests will be performed and individual coagulation factors will be measured.

Genetic tests are available for various diseases and breeds of dogs.

Treatment

If there is an underlying condition, this is treated. A congenital coagulation disorder cannot be cured. However, there are important precautions to take. Surgery should only be performed if absolutely necessary. Medications that further reduce coagulation must not be used. Injections should also be kept to a minimum and administered with the smallest needles possible.

If surgery is urgently necessary, special medications are administered. Careful hemostasis, tight wound closure, and the use of tissue adhesive instead of sutures help to prevent bleeding as much as possible. A padded pressure bandage is applied for a few days after the operation.

If heavy bleeding occurs, a blood plasma or blood transfusion (see corresponding article) may be necessary. Platelet or coagulation factor concentrates may also be used.

Blood donation bag
A blood transfusion is necessary in the event of severe bleeding.
Prognosis

The prognosis depends on the cause and severity of the coagulation disorder. Mild forms usually go unnoticed. However, if more severe coagulation disorders remain undetected, they can be life-threatening. Despite treatment, the prognosis for DIC is cautious to poor. The survival rate is 40 percent. Animals with severe Von Willebrand disease usually do not reach the end of their first year of life. They often die in the womb.

Prophylaxis

Animals with hereditary coagulation disorders must be excluded from breeding. Genetic testing is useful in this case.

The most important precaution for animals with coagulation disorders is to avoid injury. For example, avoid rough play with your dog. Regular check-ups by a veterinarian allow you to monitor your pet's health and respond to symptoms of bleeding at an early stage.