Hypercoagulability in dogs with blastomycosis.

Abstract

BACKGROUND: Blastomycosis is a potentially fatal fungal disease that most commonly affects humans and dogs. The organism causes systemic inflammation and has a predilection for the lungs. The inflammation might lead to a hypercoagulable state with microemboli in the pulmonary circulation which could contribute to inadequate oxygen exchange in infected dogs. HYPOTHESIS/OBJECTIVES: Dogs with blastomycosis will be hypercoagulable compared with healthy case-matched controls. ANIMALS: Client-owned dogs with a diagnosis of blastomycosis (n = 23) and healthy case-matched controls (n = 23). METHODS: Prospective case-controlled study of client-owned dogs presented to a veterinary teaching hospital with clinical signs compatible with blastomycosis. Complete blood counts, fibrinogen, PT, aPTT, thromboelastometry (TE), thrombin antithrombin complexes (TAT), and thrombin generation were evaluated. RESULTS: Cases had a leukocytosis compared with controls [mean (SD) 16.6 (7.6) &#xd7; 10(3)/&#x3bc;L versus 8.2 (1.8) &#xd7; 10(3)/&#x3bc;L, P < .001], hyperfibrinogenemia [median 784 mg/dL, range 329-1,443 versus median 178 mg/dL, range 82-257, P < .001], and increased TAT concentrations [mean (SD) 9.0 (5.7) &#x3bc;g/L versus 2.0 (2.8) &#x3bc;g/L, P < .001]. As compared to controls, cases were also hypercoagulable as evaluated by thromboelastometry and had increased in vitro thrombin generation on calibrated automated thrombography. CONCLUSIONS AND CLINICAL IMPORTANCE: Hypercoagulability occurs in dogs with systemic blastomycosis. Additional studies are needed to explore a possible contribution of thrombogenicity to the clinical manifestations of systemic blastomycosis.