Original Scientific Article
Disseminated intravascular coagulation syndrome as a complication in acute spontaneous canine babesiosis
Oksana A. Dubova,
Diana V. Feshchenko,
Tetiana I. Bakhur*,
Oksana A. Zghozinska,
Anatoliy A. Antipov,
Serhii V. Rublenko,
Volodymyr P. Goncharenko,
Raisa V. Shahanenko,
Volodymyr S. Shahanenko

Mac Vet Rev 2020; 43 (2): i - ix

10.2478/macvetrev-2020-0027

Received: 15 October 2019

Received in revised form: 04 July 2020

Accepted: 05 August 2020

Available Online First: 10 September 2020

Published on: 15 October 2020

Correspondence: Tetiana I. Bakhur, fly_13@ukr.net

Abstract

The polyetiological syndrome of disseminated intravascular coagulation (DIC) is characterized by changes in patients’ hemostasis. The aim of the current research was to elucidate the main factors for the development of DIC syndrome during canine babesiosis, and to assess their correlation level. Dogs included in this study were of various breeds and sex, weighing 10-40 kg and aged 2-7 years. They were separated in two groups (n=50) according to their diagnosis to babesiosis. Oscillometry (blood pressure, pulse rate), vascular-platelet hemostasis, coagulogram, hematological, biochemical (fibrinogen, fibrin degradation product, soluble fibrin-monomer complex) and hemodynamic (circulating blood volume) assessment methods were used. The group of dogs positive on Babesia spp., had clear manifestation of DIC with 5-7% of the erythrocyte population being affected. DIC was manifested by a significant increase in soluble fibrin-monomer complex and fibrin degradation product (p<0.001), hypofibrinogenemia (p<0.001), thrombocytopenia (p<0.001), and an increase in indicators of spontaneous aggregation ability of platelets and red blood cells (p<0.001). Significant hemodynamic disorders were observed: a decrease in circulating blood volume, circulating erythrocytes volume (p<0.05), specific circulating blood volume and hematocrit value (p<0.001). The average blood pressure was reduced (p<0.001), and the Allgöwer’s shock index was increased 2 times (p<0.05). A shock of II degree (medium, subcompensated) was confirmed. Therefore, it can be concluded that acute spontaneous dogs’ babesiosis can be characterized by the occurrence of DIC in a consumption coagulopathy form, and shock of II degree. This condition renders the patients for emergency admission.

Keywords: disseminated intravascular coagulation, babesiosis, dogs, shock, coagulopathy, hemostasis


References

  1. Solano-Gallego, L., Baneth, G. (2011). Babesiosis in dogs and cats-expanding parasitological and clinical spectra. Vet Parasitol. 18, 48-60. https://doi.org/10.1016/j.vetpar.2011.04.023
  2. Köster, L.S., Lobetti, R.G., Kelly, P. (2015). Canine babesiosis: a perspective on clinical complications, biomarkers, and treatment. Vet Med (Auckl). 6, 119-128. https://doi.org/10.2147/VMRR.S60431
  3. Lack, J.B., Reichard, M.V, Van Den Bussche, R.A. (2012). Phylogeny and evolution of the Piroplasmida as inferred from 18S rRNA sequences. Int J Parasitol. 42(4): 353-363. https://doi.org/10.1016/j.ijpara.2012.02.005
  4. Schnittger, L., Rodriguez, A.E., Florin-Christensen, M., Morrison, D.A. (2012). Babesia: a world emerging. Infect Genet Evol. 12(8): 1788-1809. https://doi.org/10.1016/j.meegid.2012.07.004
  5. Irwin, P.J. (2010). Canine babesiosis. Vet Clin North Am Small Anim Pract. 40(6): 1141-1156. https://doi.org/10.1016/j.cvsm.2010.08.001
  6. Goddard, A., Leisewitz, A.L., Kjelgaard-Hansen, M., Kristensen, A.T., Schoeman, J.P. (2016). Excessive pro-inflammatory serum cytokine concentration in virulent canine babesiosis. PLoS One 11(3): e0150113. https://doi.org/10.1371/journal.pone.0150113
  7. Roopali, B., Roy, M., Roy, S. (2018). Clinico, haemato-biochemical changes and therapeutic management of canine babesiosis. Int J Curr Microbiol App Sci. 7(8): 1384-1388. https://doi.org/10.20546/ijcmas.2018.708.158
  8. Shah, S.A., Sood, N.K., Tumati, S.R. (2011). Haemato-biochemical changes in natural cases of canine babesiosis. Asian J of Anim Sci. 5(6): 387-392. https://doi.org/10.3923/ajas.2011.387.392
  9. Levi, M. (2018). Disseminated intravascular coagulation. In: Hematology (7th Ed.) (p. 2064-2075). https://doi.org/10.1016/B978-0-323-35762-3.00139-6
  10. Rafaj, R.B., Kuleš, J., Selanec, J., Vrkić, N., Zupančič, M., Trampuš Bakija, A., Matijatko, V., Crnoqaj, M., Mrljak, V. (2013). Markers of coagulation activation, endothelial stimulation, and inflammation in dogs with babesiosis. J Vet Intern Med. 27(5): 1172-1178. https://doi.org/10.1111/jvim.12146
  11. Rafaj, R.B., Matijatko, V., Kis, I., Kucer, N., Zivicnjak, T., Lemo, N., Zvorc, Z., Brkljacić, M., Mrljak, V. (2009). Alterations in some blood coagulation parameters in naturally occurring cases of canine babesiosis. Acta Vet Hung. 57(2): 295-304. https://doi.org/10.1556/avet.57.2009.2.10
  12. Yarets, Y.I., Novikova, I.A. (2014). Laboratory methods for evaluating the hemostasis system: educational method. Manual for students of the 4th year of the medical and diagnostic faculty of medical university. 72 p. Gomel: GomState Medical University. [in Russian]     
  13. Eichenberger, R.M., Riond, B., Willi, B., Hofmann-Lehmann, R., Deplazes, P. (2016). Prognostic markers in acute babesia canis Infections. J Vet Intern Med. 30(1): 174-182. https://doi.org/10.1111/jvim.13822
  14. Kirtz, G., Leschnik, M., Hooijberg, E., Tichy, A., Leidinger, E. (2012). In-clinic laboratory diagnosis of canine babesiosis (Babesia canis canis) for veterinary practitioners in Central Europe. Tierarztl Prax Ausg K Klientiere Heimtiere 40, 87-94. https://doi.org/10.1055/s-0038-1623628
  15. Shkatula, Y.V., Khyzhnia, Y.V., Hresko, I.Y., Badion, Yu, O. (2015). Medicine of emergency situations [Internet]. Sumy: Sumy State University, 102 p. http://essuir.sumdu.edu.ua/handle/123456789/43318
  16. Soroka, N.M., Dubova, O.A., inventors; National Agrarian University, assignee. Method of lifelong diagnosis of disseminated intravascular coagulation syndrome in dogs. Ukraine patent U 200503510. 2005 Sept 15.      
  17. Schorn, M.N. (2010). Measurement of blood loss: review of the literature. J Midwifery Womens Health 55(1): 20-27. https://doi.org/10.1016/j.jmwh.2009.02.014
  18. Soroka, N.M., Dubova, O.A., Iaremenko, D.O., inventors; National Agrarian University, assignee. A method of determining the volume of circulating blood in dogs. Ukraine patent U 2200505490. 2005 Jun 8.        
  19. Dubova, O., Dubovyi, A., Feshchenko, D. (2018). Indirect evaluation method and parameters of blood pressure and its indexes in dogs. Sci Mes LNU Vet Med Biotechnol. Series: Vet Sci. 20(88): 80-84. [in Ukrainian] https://doi.org/10.32718/nvlvet8814
  20. Nathan, H.L., Cottan, K., Hezelgrave, N.L., Seed, P.T., Briley A., Bewley S., Chappell, L.C., Shennan, A.H. (2016). Determination of normal ranges of shock index and other haemodynamic variables in immediate postpartum period: a cohort study. PloS One 11(12): e0168535. https://doi.org/10.1371/journal.pone.0168535
  21. Roshal, M. (2013). Prothrombin time. In: Transfusion medicine and hemostasis, (pp. 799-803). Elsevier Inc. https://doi.org/10.1016/B978-0-12-397164-7.00124-5
  22. Roshal, M. (2013). Activated partial thromboplastin time. In: Transfusion medicine and hemostasis (2nd Ed.). Clinical and Laboratory Aspects (pp. 805-807). https://doi.org/10.1016/B978-0-12-397164-7.00125-7
  23. Wada, H., Hasegawa, K., Watanabe, M. (2017). DIC: an update on diagnosis and treatment. [Rinsho Ketsueki] The Japan J of Clinic Hematol. 58(5): 523-529. 
  24. Dubova, O.A. (2016). Shock and DIC-syndrome as a pathogenetic axis of dogs babesiosis. Sci Mes LNU Vet Med Biotechnol. 18, 2(66): 70-73. [in Ukrainian] https://doi.org/10.15421/nvlvet6615
  25. Pacagnella, R.C., Souza, J.P., Durocher, J., Perel, P., Blum, J., Winikoff, B., Gülmezoglu, A.M. (2013). A systematic review of the relationship between blood loss and clinical signs. PloS One 8(3): e57594. https://doi.org/10.1371/journal.pone.0057594
  26. Quiñones, J., Uxer, J., Gogle, J., Scorza, W., Smulian, J.C. (2010). Clinical evaluation during postpartum hemorrhage. Clin Obstet Gynecol. 53, 157-164. https://doi.org/10.1097/GRF.0b013e3181cd5d36
  27. Guly, H.R., Bouamra, O., Spiers, M., Dark, P., Coats, T., Lecky, F.E. (2011). Vital signs and estimated blood loss in patients with major trauma: Testing the validity of the ATLS classification of hypovolaemic shock. J Resuscitation. 82(5): 556-559. https://doi.org/10.1016/j.resuscitation.2011.01.013
  28. Bhagavan, N.V., Ha, Ch.-E. (2011). Biochemistry of hemostasis. In: Essentials of medical biochemistry with clinical cases (p. 473-486). Elsevier Sci. https://doi.org/10.1016/B978-0-12-095461-2.00034-5
  29. Blanco, A, Blanco, G. (2017). Medical Biochemistry (pp. 781-789). London: Academic Press. https://doi.org/10.1016/B978-0-12-803550-4.00031-8
  30. Perez, P., Kimmoun, A., Blime, V., Levy, B. (2014). Increasing mean arterial pressure in cardiogenic shock secondary to myocardial infarction: effects on hemodynamics and tissue oxygenation. Shock 41(4): 269-274. https://doi.org/10.1097/SHK.0000000000000099
  31. Leone, M., Asfar, P., Radumacher, P., Vincent, J.L., Martin, C. (2015). Optimizing mean arterial pressure in septic shock: a critical reappraisal of the literature. Crit Care. 19, 191. https://doi.org/10.1186/s13054-015-0794-z
  32. Vincent, J.L., De Backer, D. (2013). Circulatory shock. N Engl J Med. 369, 1726. https://doi.org/10.1056/NEJMra1208943
  33. Chamarthy, S. (2014). Normal coagulation and hemostasis. In: Pathobiology of human diseases. a dynamic encyclopedia of disease mechanisms (pp. 1544-1552). Elsevier.Inc. https://doi.org/10.1016/B978-0-12-386456-7.07908-9
  34. Schetters, T.P.M., Kleuskens, J.A.G.M., Crommert, J., Leeuw, P.W.J., Finizio, A.L., Gorenflot, A. (2009). Systemic inflammatory responses in dogs experimentally infected with Babesia canis; a haematological study. Vet Parasitol. 162(1): 7-15. https://doi.org/10.1016/j.vetpar.2009.02.012
  35. Holovakha, V. I., Piddubnуak, О. V., Bakhur, T. I., Vovkotrub, N. V., Antipov, A. A., Anfiorova, M. V., Gutyj, B. V., Slivinska, L. G., Kurdeko, O. P., Macynovich, A. O. (2018). Changes in erythrocytopoesis indices in dogs with babesiosis. Regulatory Mechanisms in Biosystems 9(3): 379-383. https://doi.org/10.15421/021856


Copyright

© 2020 Dubova O.A. This is an open-access article published under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Conflict of Interest Statement

The authors have declared that no competing interests exist.

Citation Information

Macedonian Veterinary Review. Volume 43, Issue 2, Pages i-ix, e-ISSN 1857-7415, p-ISSN 1409-7621, DOI: 10.2478/macvetrev-2020-0027, 2020