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

Abstract

BackgroundHaemostatic 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.MethodsThe 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.ResultsHypercoagulability 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.ConclusionHypercoagulability 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.

Paraneoplastic hematological, biochemical, and hemostatic abnormalities in female dogs with mammary neoplasms

“…In female dogs with breast tumors, the results were similar to those of previous studies on animals with carcinoma (Saavedra et al 2011) and when associated with tumor progression in animals with different types of tumors (Andreasen et al 2012).…”

“…Of these animals, two belonged to Group 3, which is consistent with a later study that detected remarkable increases in D-dimer and fibrinogen levels in canine patients with distant metastases compared with patients with invasive local disease (Andreasen et al 2012). Although no significant difference exists between the groups, the findings suggest a possible relationship between D-dimer levels and tumor staging, indicating that patients with advanced-stage disease may present with consumption coagulopathy.…”

“…Abnormal clotting time in cancer patients may also be associated with the release of proinflammatory cytokines, which increase the use of coagulation factors (Andreasen et al 2012). In female dogs with breast tumors, the results were similar to those of previous studies on animals with carcinoma (Saavedra et al 2011) and when associated with tumor progression in animals with different types of tumors (Andreasen et al 2012).…”

“…Hyperfibrinogenemia, seen in 66.7% of the animals, across the five tumor stages, with differences between groups 2 and 3, may be related to progression and extent of the cancer in canine (Andreasen et al 2012) and human (Rickles et al 1992) patients. In a study of female dogs with mammary carcinoma, elevated fibrinogen levels were more evident in stages III and IV (Stockhaus et al 1999).…”

“…In veterinary medicine, particularly in mammary cancer, there are few studies that correlate abnormal laboratory findings with tumor type and staging (Stockhaus et al 1999, Andreasen et al 2012). The few studies on untreated animals suggest that changes in hematological, biochemical, and hemostatic parameters in cancer patients be investigated with the aim of identifying abnormalities, establishing the prognosis, and treating the syndrome prior to other therapeutic procedures, as these changes may have higher morbidity than that of the tumor itself (Bergman 2013).…”