Platelet function in dogs with chronic liver disease

Abstract

Objectives To assess platelet function, buccal mucosal bleeding time and plasma von Willebrand factor concentration in dogs with chronic inflammatory and/or fibrotic liver disease and to compare results with those obtained in healthy dogs. Materials and Methods Preliminary study including 18 dogs with chronic inflammatory and/or fibrotic liver disease undergoing liver biopsy and 18 healthy age‐matched control dogs. Platelet function was assessed by measuring closure time with the PFA‐100® analyser using adenosine diphosphate (ADP) as an agonist. Buccal mucosal bleeding time, closure time and plasma von Willebrand factor antigen were measured in dogs in both groups. After undergoing ultrasound‐guided needle biopsy, dogs were monitored for haemorrhage to determine if there was an association of any measurement with post‐biopsy bleeding. Results The closure time was not different between the liver disease group (median 76.3; range 53 to 118.5 seconds) and control group (72.8; 57 to 89.5 seconds). The buccal mucosal bleeding time was longer in the liver disease group (median 138; range 95 to 229 seconds) than the control group (103; 63 to 200 seconds). The plasma von Willebrand factor antigen concentration was not different between the liver disease group (median 203; range 109 to 351%) and control group (165.5; 63 to 246%). Clinical Significance In this study, dogs with chronic necroinflammatory and/or fibrotic liver disease did not have overt, clinically relevant derangements in platelet function as assessed by buccal mucosal bleeding time, closure time and von Willebrand factor analysis. In addition, none of the dogs undergoing percutaneous ultrasound‐guided biopsy in the study exhibited bleeding complications post‐biopsy procedure.

Multiplate platelet aggregometry in dogs undergoing laparoscopic liver biopsy for diagnosis of chronic hepatopathy

“…Interestingly, Wilkinson et al . (2021) found that mean vWF antigen concentrations in their population of dogs with chronic hepatopathies were higher than those of an age‐matched healthy control population; however, the difference was not significant. Importantly, their study may have been underpowered to detect this difference.…”

“…Additionally, Wilkinson et al . (2021) discussed that ADP may be unable to detect platelet function defects if these defects are a consequence of storage pool defects that affect ADP content in dense granules. In this case when adding ADP to the sample, the defect would be corrected producing a normal result.…”

“…A recent study evaluated platelet function in dogs with chronic liver disease through measurement of closure times via the PFA‐100 analyser using adenosine diphosphate (ADP) as an agonist (Wilkinson et al . 2021). In this study, derangements of platelet function were not detected in 18 dogs with chronic inflammatory and/or fibrotic liver disease when compared to 18 healthy age‐matched control dogs.…”

“…Platelet function abnormalities are well described in humans with chronic liver disease and both intrinsic and extrinsic factors are thought to contribute to impairment of platelet function (Witters et al 2008, Hugenholtz et al 2009, Lambert 2016, Adam et al 2020. A recent study evaluated platelet function in dogs with chronic liver disease through measurement of closure times via the PFA-100 analyser using adenosine diphosphate (ADP) as an agonist (Wilkinson et al 2021). In this study, derangements of platelet function were not detected in 18 dogs with chronic inflammatory and/or fibrotic liver disease when compared to 18 healthy age-matched control dogs.…”

“…In this study, derangements of platelet function were not detected in 18 dogs with chronic inflammatory and/or fibrotic liver disease when compared to 18 healthy age-matched control dogs. Wilkinson et al (2021) postulated that the PFA-100 may have been too restrictive a test to detect platelet function abnormalities in this population, and those results may have differed if an alternative platelet function testing instrument was utilised. These investigators suggested that future studies should evaluate platelet function using different techniques in dogs with chronic hepatobiliary disorders.…”