Hemostatic profile and thromboembolic risk in healthy dogs treated with prednisone: a randomized controlled trial

Abstract

BackgroundThrombosis has been associated to some diseases like hyperadrenocorticism (HAC). Several drugs can alter the balance, such as the corticosteroid prednisone, used mainly for its anti-inflammatory and immunosuppressive effects. It is known that hypercortisolism can stimulate thrombi formation by increasing coagulation factors and decreasing fibrinolysis. However it is not known how prednisone administration affects hemostasis in dogs and if it is dose dependent. The aim of this study, therefore, was to demonstrate the effects of prednisone administration on dogs’ hemostatic profile.ResultsSignificant decrease of antithrombin levels was observed in both groups (anti-inflammatory and immunosuppressive doses) after 15 days of treatment. An increase of platelet aggregation was observed in dogs receiving immunosuppressive doses of prednisone (Group II).ConclusionsFrom the results obtained in our study, it is not possible to infer that hypercortisolism can increase the thromboembolic risk, despite the decreased anticoagulant factors (antithrombin levels).

Effects of immunosuppressive agents on the hemostatic system in normal dogs

“…There were no significant changes in any of the remaining hemostatic indices that were measured during prednisone administration. The results of our study are in contrast to previous studies that have demonstrated changes in multiple indices of hemostasis during prednisone treatment . In one previous study, in contrast to our study, platelet aggregation with ADP as an agonist increased when dogs were administered immunosuppressive dosages of prednisone .…”

“…The results of our study are in contrast to previous studies that have demonstrated changes in multiple indices of hemostasis during prednisone treatment . In one previous study, in contrast to our study, platelet aggregation with ADP as an agonist increased when dogs were administered immunosuppressive dosages of prednisone . Unfortunately, a direct comparison between this previous study and our study cannot be made because differences in the aggregometry protocol and ADP concentration used do not provide consistent conditions to allow assessment of the effects of prednisone on platelet aggregation.…”

“…Although previous studies have evaluated the effects of cyclosporine on the hemostatic system in dogs, 11,12 comparable studies evaluating the effects of other immunosuppressive drugs on hemostasis have either not been performed in dogs or have measured only a limited range of drugs or hemostatic indices. [16][17][18][19][20] In dogs, the effects of azathioprine, mycophenolate mofetil, and leflunomide on the hemostatic system are currently almost completely unknown.…”

A Remote Assay for Measuring Canine Platelet Activation and the Inhibitory Effects of Antiplatelet Agents

“…Altered platelet activity influences morbidity and survival in dogs and cats as well as humans, due to activated platelets contributing to intravascular clot formation . Dogs with immune‐mediated hemolytic anemia (IMHA), hyperadrenocorticism, those receiving exogenous corticosteroids, protein‐losing nephropathies (PLN), various neoplastic and infectious diseases, pancreatitis, and enteropathies are at increased risk of thromboembolic complications from altered platelet activity …”

Fatal pulmonary thromboembolism in a two‐year‐old dog receiving long‐term corticosteroid therapy

“…In dogs that received an immunosuppressive dose of prednisone (2.0 mg/kg twice daily orally), a significant increase in platelet aggregation was found, which can also cause an increased risk of thromboemboli 8. Antithrombin concentrations were also found to be lower in dogs with hyperadrenocorticism compared with healthy dogs 16.…”