Factors associated with thrombotic disease in dogs with renal proteinuria: A retrospective of 150 cases

Background: The authors investigated the risk factors for thrombotic disease (TD) in dogs with renal proteinuria, and compared the differences between dogs with thrombi in different locations (arterial, venous, or pulmonary).

Methods: They performed a retrospective case-controlled study of 150 dogs with renal proteinuria, 50 of which had TD. They compared the signalment, clinicopathological data, and comorbidities between dogs with and without TD, and between dogs with different thrombus locations, using univariate and multivariate analyses.

Results: They found that Cavalier King Charles Spaniels, lower serum albumin, lower eosinophils, and higher neutrophils were associated with TD. They also found that dogs with arterial thrombi had higher serum albumin and older age than dogs with venous or pulmonary thrombi, and dogs with venous thrombi had higher serum cholesterol and older age than dogs with pulmonary thrombi.

The distribution of sites of thrombus in this paper is as follows:

• Aorta: 20 cases (40%)

• Pulmonary vessels: 16 cases (32%)

• Limb artery: 5 cases (10%)

• Splenic vein: 3 cases (6%)

• Vena cava: 3 cases (6%)

• Portal vein: 3 cases (6%)

• Other sites: 7 cases (14%)

Limitations: The study was limited by the retrospective design, the potential for misclassification of some cases, the small numbers of different breeds and comorbidities, and the lack of renal histopathology in most cases.

Conclusions: The paper proposes that the pathogenesis of thrombotic disease (TD) in different locations (arterial, venous, or pulmonary) may depend on various factors, such as:

• Breed predisposition: Cavalier King Charles Spaniels and sighthounds are more prone to arterial thrombosis, while Miniature Schnauzers may have a higher risk of venous thrombosis.

• Serum albumin concentration: Lower albumin levels are associated with TD in general, but especially with venous thrombosis. This may reflect the loss of antithrombin or the increased platelet reactivity caused by hypoalbuminemia.

• Age: Older dogs are more likely to develop arterial or venous thrombosis than pulmonary thrombosis. This may be related to reduced arterial elasticity or hypertension in older dogs.

• Serum cholesterol concentration: Higher cholesterol levels are linked to venous thrombosis, possibly because of the prothrombotic effects of lipoprotein(a).

• Inflammation: Higher leukocyte, neutrophil, and monocyte counts are correlated with TD, suggesting that inflammatory processes may contribute to hypercoagulability.

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