Hypercoagulability in Dogs with Blastomycosis

BACKGROUND Blastomycosis is a potentially fatal fungal disease that most commonly affects humans and dogs. The organism causes systemic inflammation and has a predilection for the lungs. The inflammation might lead to a hypercoagulable state with microemboli in the pulmonary circulation which could contribute to inadequate oxygen exchange in infected dogs. HYPOTHESIS/OBJECTIVES Dogs with blastomycosis will be hypercoagulable compared with healthy case-matched controls. ANIMALS Client-owned dogs with a diagnosis of blastomycosis (n = 23) and healthy case-matched controls (n = 23). METHODS Prospective case-controlled study of client-owned dogs presented to a veterinary teaching hospital with clinical signs compatible with blastomycosis. Complete blood counts, fibrinogen, PT, aPTT, thromboelastometry (TE), thrombin antithrombin complexes (TAT), and thrombin generation were evaluated. RESULTS Cases had a leukocytosis compared with controls [mean (SD) 16.6 (7.6) × 10(3)/μL versus 8.2 (1.8) × 10(3)/μL, P < .001], hyperfibrinogenemia [median 784 mg/dL, range 329-1,443 versus median 178 mg/dL, range 82-257, P < .001], and increased TAT concentrations [mean (SD) 9.0 (5.7) μg/L versus 2.0 (2.8) μg/L, P < .001]. As compared to controls, cases were also hypercoagulable as evaluated by thromboelastometry and had increased in vitro thrombin generation on calibrated automated thrombography. CONCLUSIONS AND CLINICAL IMPORTANCE Hypercoagulability occurs in dogs with systemic blastomycosis. Additional studies are needed to explore a possible contribution of thrombogenicity to the clinical manifestations of systemic blastomycosis.