Replying to Erin B. 24/03/2024 - 20:12
Hello Erin.
I hope you are well and enjoying the course. This is a brilliant question.
Dogs with protein-losing enteropathy have an increased risk of thromboembolic disease due to several factors related to the underlying condition. PLE leads to loss of proteins, including anticoagulant proteins like antithrombin, protein C, and protein S, which play crucial roles in regulating the coagulation cascade. This loss can result in a hypercoagulable state, making these dogs more prone to forming blood clots.
Additionally, the loss of proteins, particularly albumin, in PLE can lead to decreased oncotic pressure in the blood vessels. This can cause fluid to leak out of the vessels and into the tissues, leading to oedema and potentially altering blood flow dynamics, further increasing the risk of thrombosis.
Furthermore, the inflammation and tissue damage associated with PLE can activate the coagulation system and promote platelet activation, further contributing to a prothrombotic state.
Overall, the combination of protein loss, alterations in coagulation factors, and inflammation seen in PLE contributes to an increased risk of thromboembolic disease in affected dogs.
Which cases to use clopidogrel in is a whole other question. I would only tend to use it in cases that have more severe protein loss (under 15 g/L). Some people would use it in all cases that have a low albumin. I am not sure we know when exactly to use it, but in PLE cases with more significant reductions in albumin, I definitely would.
I hope that helps!
Scott 🙂
