title: Diagnostic utility of D-dimer concentrations in dogs with pulmonary embolism.
abstract: BACKGROUND
  Pulmonary embolism (PE) is a complication of systemic disease in dogs. Antemortem diagnosis is challenging because of the lack of a confirmatory test.
  
  
  OBJECTIVE
  To retrospectively determine the diagnostic utility of D-dimer concentrations in dogs with necropsy-confirmed PE.
  
  
  METHODS
  Ten dogs with PE confirmed at necropsy that had D-dimer concentrations measured and 10 control dogs with D-dimer concentrations available that lacked PE on necropsy.
  
  
  METHODS
  The computerized medical record database was searched for dogs with necropsy-confirmed PE that had D-dimer concentrations measured at that visit. An age-, sex-, and breed-matched control group was identified. Signalment, location of PE, and coagulation profiles were collected. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using a D-dimer concentration of 250 ng/mL.
  
  
  RESULTS
  Coagulation profiles were not different between dogs with and without PE. Using 250 ng/mL as a cut-off D-dimer concentration, the sensitivity and specificity were 80 and 30%, respectively, for the diagnosis of PE. The NPV and PPV were 60 and 53.0%, respectively. D-dimer concentration <103 ng/mL had 100% sensitivity for ruling out PE and no value was 100% specific.
  
  
  CONCLUSIONS
  D-dimer concentrations <250 ng/mL have a high sensitivity for the absence of PE, but PE still can occur in dogs with a normal D-dimer concentration. Increased D-dimer concentrations are not specific for PE.
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA.
authors.forename: S E
authors.initials: SE
authors.lastname: Epstein
authors.forename: K
authors.initials: K
authors.lastname: Hopper
authors.forename: M S
authors.initials: MS
authors.lastname: Mellema
authors.forename: L R
authors.initials: LR
authors.lastname: Johnson
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D008297:Male; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000097:blood / Q000473:pathology / Q000662:veterinary*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: Biomarker; Coagulation; Respiratory distress; Thromboembolism