Page 326 - WSAVA2018
P. 326

 25-28 September, 2018 | Singapore
During inflammation there is increase in plasminogen activator factor inhibitor I (PAI-I) induced markedly increase levels cytokines and liposaccharide, in the blood as a cause of hypofibrinolysis, with consequence of thrombus formation and deposition. Moreover, histones are highly conserved, positively-charged nuclear proteins, serving as the basic structure block unit of the chromatin, leak from damaged and activated immune system cells (e.g., neutrophils and mast cells) and by neutrophil extracellular traps (NETs) into the extracellular space, exhibiting toxic, pro-inflammatory and pro-thrombotic properties. Histones promote the apoptosis of vascular endothelial cells and platelet aggregation enhancing thrombus formation5.
Fig. 1: The mechanisms leading to the development of disseminated intravascular coagulation
Clinical signs
Dogs with DIC may present with several clinical presentations. Three phases of DIC are recognized:
the peracute hypercoagulable phase, the acute consumptive phase and the chronic silent phase. Both the hypercoagulable and the chronic silent phases are non-overt. The latter phase appears to be common in dogs with malignancy and other chronic disorders. The peracute and acute phases may result from an acute phenomenon (e.g. sepsis, acute pancreatitis, heatstroke, electrocution), or it represents acute decompensation of the chronic silent process.6 Acute DIC is extremely rare in cats. Regardless of the pathogenesis, dogs with acute DIC are often presented for treatment due to profuse spontaneous bleeding, either primary (petechiae, ecchymoses, hematochezia, melena, hematemesis
and hematuria) or secondary (blood in body cavities) in concert with hemostatic disorders, and constitutional signs, secondary to anemia or to parenchymal organ thromboses leading to multiple organ dysfunction.2,6-8 Clinical signs may be highly variable depending on the underlying primary disease and the phase of DIC (i.e. the

   324   325   326   327   328