title: Unexplained bleeding as primary clinical complaint in dogs infected with Angiostrongylus vasorum.
abstract: Unexplained bleeding was the primary clinical complaint in 15 dogs diagnosed with A. vasorum and was observed in the mouth, as external bleeding, as large subcutaneous hematoma, as hemoptysis, in the brain, post ovariectomy, as epistaxis, in the anterior ocular chamber and on a tracheal intubation tube. In 8 dogs the cause of bleeding initially was suspected to be a minor trauma or a surgical complication, and various surgical approaches had been undertaken to eliminate the problem. In only 3 dogs respiratory signs were observed before the bleeding prompted referral. The median time elapsed between the first recognized clinical signs attributed to A. vasorum until diagnosis was 2 weeks (range1 day to 4 months). Four dogs died, 3 on the day of admission and 1 dog 4 days after admission. Suspected causes of death were respiratory failure and cerebral hemorrhage in 2 dogs each. Four dogs had been pre-treated with NSAIDs; of these, 2 dogs developed severe hemoptysis (1 died), 1 dog developed brain hemorrhage (and died), and 1 dog developed a large subcutaneous hematoma with marked anemia. Bleeding at various sites may be the only recognized abnormality in A. vasorum infection. Without a high index of suspicion, the diagnosis and appropriate therapy may be delayed to the point of a fatal outcome. Tests of coagulation were quite variable and the cause of bleeding likely multifactorial.
authors.affiliation: Division of Cardiology, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: T
authors.initials: T
authors.lastname: Glaus
authors.affiliation: Division of critical care, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: N
authors.initials: N
authors.lastname: Sigrist
authors.affiliation: Division of Neurology, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: N
authors.initials: N
authors.lastname: Hofer-Inteeworn
authors.affiliation: Division of Neurology, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: C
authors.initials: C
authors.lastname: Kuemmerle-Fraune
authors.affiliation: Division of Neurology, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: C
authors.initials: C
authors.lastname: Mueller
authors.affiliation: Division of Neurology, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: K
authors.initials: K
authors.lastname: Geissweid
authors.affiliation: Clinic for Small Animal Internal Medicine, Department for Small Animals, Vetsuisse Faculty, University of Zurich.
authors.forename: K
authors.initials: K
authors.lastname: Beckmann
authors.affiliation: Tierärztliches Überweisungszentrum, Tenniken.
authors.forename: M
authors.initials: M
authors.lastname: Wenger
authors.affiliation: Division of Cardiology, Department for Small Animals, Vetsuisse Faculty University of Zurich.
authors.forename: J
authors.initials: J
authors.lastname: Novo Matos
mesh_terms: D000801:Angiostrongylus; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000969:Antinematodal Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology*; D004285:Dogs; D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D008297:Male; D017206:Strongylida Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D000969:Antinematodal Agents
keywords: DIC; Lymphozytose; Thrombozytopathie; Thrombozytopenie; lymphocytosis; pulmonary hypertension; pulmonäre Hypertonie; thrombocytopathy; thrombocytopenia