Coagulation abnormalities in 5 cats with naturally occurring cytauxzoonosis

J Vet Emerg Crit Care (San Antonio). Jul-Aug 2015;25(4):538-45. doi: 10.1111/vec.12326. Epub 2015 Jun 16.

Abstract

Objective: To characterize hemostasis and determine if disseminated intravascular coagulation (DIC) is present in cats with cytauxzoonosis.

Design: Cross-sectional study.

Setting: University teaching hospital.

Animals: Five client-owned cats with cytologic and PCR-confirmed cytauxzoonosis.

Interventions: None.

Measurements and main results: Admission samples were collected for hemostasis testing including platelet count, activated partial thromboplastin time, prothrombin time, fibrinogen, antithrombin (AT), d-dimer, protein C, plasminogen, antiplasmin, factors VII, VIII, IX, X, and XI, von Willebrand factor, and thromboelastography. Results were compiled for combined criteria used to define DIC, and all 5 cats satisfied criteria using a previously described modified scoring system for DIC in cats. The abnormalities found in all 5 cats included thrombocytopenia, low protein C activity, and prolonged prothrombin time; however, none of the cats had low AT activity. None of the cats had clinical signs of hemorrhage despite thrombocytopenia, coagulation factor deficiency (5/5 cats), and thromboelastographic evidence of hypocoagulability (2/5 cats). Three of 5 cats survived to hospital discharge. The nonsurvivors had disseminated cytauxzoonosis with schizont-laden macrophages in vessels of various organs.

Conclusions: This is the first report that comprehensively describes the hemostastic status of cats with naturally occurring infection with Cytauxzoon felis. All 5 cats had laboratory evidence of overt DIC. Unlike human and canine models of sepsis-induced DIC, AT deficiency was not found in this series of cats. Further research is warranted to investigate therapeutic strategies targeting thrombotic DIC to improve survival in cats with cytauxzoonosis.

Keywords: disseminated intravascular coagulation; feline; sepsis; thromboelastography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Cell Count / veterinary
  • Blood Coagulation Tests / veterinary
  • Cat Diseases / blood*
  • Cats
  • Cross-Sectional Studies
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / veterinary*
  • Female
  • Fibrinogen
  • Hemostasis
  • Male
  • Piroplasmida*
  • Prothrombin Time / veterinary
  • Protozoan Infections / blood*
  • Sepsis / blood
  • Sepsis / veterinary
  • Thrombelastography / veterinary

Substances

  • Fibrinogen