Disseminated Intravascular Coagulation (DIC) in Pets: A Blood Clotting Disorder
Disseminated intravascular coagulation, commonly called DIC, is a common complication seen in emergency room (ER) or intensive care unit (ICU) pets. Patients don’t develop DIC as a primary cause. It’s not a disease that occurs by itself; rather, DIC is a complication that is seen as a result of secondary underlying causes in the body. With DIC, the body is unable to clot normally.
Normally, the body’s ability to clot is complex and involves multiple stages: tissue factor, platelets, clotting factors, fibrin, and components that break down fibrin. With DIC, abnormal clotting typically results in either abnormally fast clotting (called hypercoagulablity) – where the body is predisposed to throwing microscopic blood clots, or abnormally delayed clotting (called hypocoagulablity) – where the body loses the ability to clot and uncontrollable, life-threatening bleeding may be seen.
There are several primary causes that can predispose the body to this blood clotting disorder:
- Cancer (e.g., hemangiosarcoma, etc.)
- Heat stroke
- Sepsis (abnormal bacteria entering the blood stream secondary to a severe infection)
- Septic peritonitis (secondary to abnormal bacteria in the abdomen, typically due to the intestines rupturing)
- Heartworm disease (which is why it’s so important to keep your dog on year-round heartworm medication)
- Gastric dilatation-volvulus (GDV)
- Immune-mediated diseases such as immune-mediated hemolytic anemia (IMHA) or immune-mediated thrombocytopenia (ITP)
- Snake bites
- Severe hemorrhage
Clinical signs of DIC include the following:
- Bleeding from the nose
- Blood in the eye
- Small pin-point bruising of the skin (called petechiae)
- Larger bruises (called ecchymosis)
- Increased heart rate
- Difficulty breathing
- Increased respiratory rate
- Abnormal bleeding from any orifice
Keep in mind that other clinical signs may be seen due to the primary disease. For more information on each specific disease (e.g., gastric-dilatation volvulus) please see the appropriate handout or blog on Pet Health Network.
The diagnosis of DIC is based on a clotting test (typically called a “coagulation panel.”) There are several different types of clotting tests available to veterinarians, some being more complete and extensive than others. When testing for DIC, typically, three of these abnormal blood tests need to be run before the blood clotting disorder can be “defined” as DIC. Classically, it’s a low platelet count and prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT).
Types of blood clotting tests include the following:
- A platelet count: This test often comes with a complete blood count (CBC – see below). Normal platelet count
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Justine has more than 18 years of experience in the veterinary industry and is a board-certified emergency critical care veterinary specialist and toxicologist as well as the CEO and founder of Vetgirl. She is also a founding member of IDEXX’s Pet Health Network team.