title: Mortality in virulent canine babesiosis is associated with a consumptive coagulopathy.
abstract: The inflammatory response to infection can activate the coagulation system via complex interactions. If uncontrolled, this may lead to a consumptive coagulopathy, a major risk factor for a poor clinical outcome. This prospective observational study was conducted to determine whether consumptive coagulopathy in dogs with Babesia rossi infection is related to mortality. Seventy-two client-owned dogs diagnosed with canine babesiosis were included. Diagnosis was confirmed by polymerase chain reaction and reverse line blot and dogs co-infected with Babesia vogeli or Ehrlichia canis were excluded. Blood samples were collected at admission. Coagulation factor-, antithrombin (AT)-, and protein C (PC)-activity, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer concentrations were measured. The mortality rate was 18% (13/72 dogs) and the median activities of all the coagulation factors were significantly lower in the non-survivors compared to the survivors. Median PT and aPTT were significantly longer in the non-survivors compared to the survivors. Median AT activity was not significantly different but median PC activity was significantly decreased in the non-survivors. Median D-dimer concentrations were significantly higher in non-survivors compared to survivors. This study showed that dogs that died from B. rossi infection had a more severe consumptive coagulopathy compared to survivors, characterized by procoagulant activation, inhibitor consumption, and increased fibrinolytic activity.
authors.affiliation: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, South Africa. amelia.goddard@up.ac.za
authors.forename: Amelia
authors.initials: A
authors.lastname: Goddard
authors.forename: Bo
authors.initials: B
authors.lastname: Wiinberg
authors.forename: Johan P
authors.initials: JP
authors.lastname: Schoeman
authors.forename: Annemarie T
authors.initials: AT
authors.lastname: Kristensen
authors.forename: Mads
authors.initials: M
authors.lastname: Kjelgaard-Hansen
mesh_terms: D000818:Animals; D001404:Babesiosis / Q000150:complications / Q000401:mortality / Q000662:veterinary*; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000662:veterinary*; D004283:Dog Diseases / Q000209:etiology / Q000401:mortality*; D004285:Dogs; D005260:Female; D008297:Male