Platelet function in dogs with chronic liver disease undergoing liver biopsy

Purpose

To determine if dogs with chronic liver disease have decreased platelet function and if post-liver biopsy bleeding is associated with platelet function.

Background

Chronic liver disease is common among adult dogs. Liver biopsy is usually required to identify the underlying cause and to institute optimal treatment. Since dogs with liver disease often have abnormal coagulation, bleeding is a risk of biopsy. Routine screening for clotting abnormalities in dogs with liver disease does not necessarily predict excessive biopsy-induced bleeding, which makes preventing hemorrhage during liver biopsy difficult. This study will investigate whether decreased platelet function in dogs with liver disease contributes to bleeding. The specific aims of the study are to determine if dogs with chronic liver disease have decreased platelet function and if there is a correlation between platelet function and bleeding after biopsy.

Eligibility

  • Dogs 1 year or older
  • Dogs with ALT >2.5 times the reference interval for more than one month or with biochemical evidence of hepatic dysfunction for more than one month
  • Clinical indications that a liver biopsy is warranted

Exclusion Criteria

  • Sight hound breed
  • Heart murmur
  • Concurrent illness (moderate to severe)
  • von Willebrand’s disease
  • Portosystemic shunt
  • Received the following drugs within the last 7 days: Calcium channel blockers, beta blockers, fish oil supplementation, or corticosteroids
  • Received a beta-lactam antibiotic within the last 2 days
  • Platelet count < 120,000
  • Packed cell volume or hematocrit < 35%

Study Design

Platelet function will be measured in dogs with chronic liver disease using the platelet function analyzer (PFA-100) and buccal mucosal bleeding time (BMBT). Von Willebrand factor will be measured in these patients as well. These tests require a single blood sample. Dogs will undergo routine ultrasound guided percutaneous liver biopsy under sedation. As part of routine liver biopsy, the dogs will be kept overnight in our ICU for monitoring after the procedure. An abdominal ultrasound and packed cell volume will be performed before and after liver biopsy to assess for hemorrhage.

Compensation

The study will cover the costs of the initial examination, complete blood count, plasma chemistries, plasma von Willebrand factor, buccal mucosal bleeding time, abdominal ultrasound, heartworm test, ultrasound guided liver biopsy, and clotting tests. The cost savings to the owner is over $500. Clients will be responsible for other costs, including other laboratory tests recommended and any treatment that is indicated if complications may arise.

Contact

Dr. David Panciera, Internal Medicine
Phone: 540-231-4628 | Email: Panciera@vt.edu

Ashley Wilkinson, Internal Medicine
Email: AshleyRW@vt.edu

If your query is urgent, please call the Small Animal Hospital on 540-231-4621.