Hemostatic disorders: inherited

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Pathogenesis, Predisposing factors, Pathophysiology, Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Treatment, Initial symptomatic treatment, Monitoring, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Severine Tasker BSc BVSc DSAM CertSAM DipECVIM-ca MRCVS
Synonyms Bleeding disorders

Introduction

  • Signs : often associated with hemorrhage - usually present at a young age.
  • Treatment : symptomatic often requiring blood product administration.
  • Prognosis : depends on underlying cause.

Diagnosis

Clinical signs

  • Depend upon where bleeding occurs: 
    • Pulmonary hemorrhage   →   dyspnea, coughing, epistaxis.
    • Dyspnea very common as a result of intrathoracic or pulmonary hemorrhage.
    • Subcutaneous and intramuscular   →   hematomas (can be very painful).
    • Intestinal   →   hemorrhagic gastroenteritis.
    • Genitourinary   →   hematuria.
    • Cardiac   →   hemopericardium.
    • Joints   →    hemarthrosis and lameness.
    • Meningeal or cerebral bleeding   →   neurological signs, seizures.
    • Petechiation and bruising particularly apparent with platelet disorders.
Other signs
  • Anemia (apparent only after few hours of acute bleed)  Anemia: blood loss  .
  • Collapse.
  • Hypothermia  Hypothermia  .

Sequelae

Prognosis

  • Guarded: if severe case. Depends on site and underlying cause of hemorrhage and how this can be controlled.

Expected response to treatment

  • Normalization of clotting times.
  • Color returns to mucous membranes.
  • Patient becomes more alert/responsive.
  • Resorption hematoma/hemorrhages.

Reasons for treatment failure

  • Non-detection of hemorrhage (eg internal).
  • Delay in treatment.
  • Inadequate supportive therapy (plasma or blood).
  • Unmatched blood transfusion given.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Brown R (2008)Haemophilia in Maine Coon cats.Vet Rec163, 667PubMed.
  • Brooks M & DeWilde L (2006)Feline Factor XII Deficiency.Comp Contin Educ Pract Vet28, 148-155.
  • Goree M, Catalfamo J L, Aber S & Boudreaux M K (2005)Characterization of the mutations causing hemophilia B in 2 domestic cats.J Vet Intern Med19, 200-204PubMed.
  • Smith W, Day T & Mackin A (2005)Diagnosing Bleeding Disorders.Comp Contin Educ Pract Vet27, 828-843.
  • Bay J D, Scott M A & Hans J E (2000)Reference values for activated coagulation time in cats.Am J Vet Res61, 750-753PubMed.
  • Callan M B, Griot-Wenk M E, Hackner S G & Giger U (2000)Persistent thrombopathy causing bleeding in 2 domestic shorthaired cats.J Vet Intern Med14, 217-220PubMed.
  • Maggio-Price L & Dodds W J (1993)Factor IX deficiency (hemophilia B) in a family of British shorthair cats.JAVMA203, 1702-1704PubMed.
  • Cowles B Eet al(1992)Prolonged bleeding time of Chediak-Higashi cats corrected by platelet transfusion.Thromb Haemost67, 708-712PubMed.
  • Soute B A, Ulrich M M, Watson A D, Maddison J E, Ebberink R H & Vermeer C (1992)Congential deficiency of all vitamin K-dependent blood coagulation factors due to a defective vitamin K-dependent carboxylase in Devon Rex cats.Thrombosis and Haemostasis68, 521-525PubMed.
  • Littlewood J D & Evans R J (1990)A combined deficiency of factor VIII and contact activation defect in a family of cats.Br Vet J146, 30-35PubMed.
  • Maddison J Eet al(1990)Vitamin K-dependent multifactor coagulopathy in Devon Rex cats.JAVMA197, 1495-1457PubMed.
  • Kier A Bet al(1980)The inheritance pattern of factor XII (Hageman) deficiency in domestic cats.Can J Comp Med44, 309-314.
  • Cotter S Met al(1978)Hemophilia A in three unrelated cats.JAVMA172, 166-168PubMed.

Other sources of information

  • Stokol T (2005)Disorders of haemostasis.In:BSAVA Manual of Canine and Feline Clinical Pathology.Villiers E & Blackwood L (eds). pp 83-98, BSAVA, Gloucester.

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