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Changes in D‐dimer concentration after soft tissue and orthopedic surgery in dogs

Shipov, Anna, Milgram, Josh, Shalev, Nitzan, Aroch, Itamar, Segev, Gilad
Veterinary surgery 2018 v.47 no.3 pp. 406-411
castration, coagulation, dogs, fibrinolysis, orthopedics, tissues
OBJECTIVE: D‐dimer is a specific marker of active coagulation and fibrinolysis. The objective of this study is to determine the influence of surgery on D‐dimer concentration as well as to examine the relation between the magnitude of change and invasiveness of the surgical procedures. STUDY DESIGN: Prospective clinical study. ANIMALS: Forty‐five client‐owned dogs undergoing elective neutering (n = 15), elective orthopedic (n = 15), or posttraumatic orthopedic (n = 15) surgical procedures. METHODS: Dogs undergoing elective neutering, elective orthopedic, and posttraumatic orthopedic surgical procedures were enrolled. D‐dimer concentration, measured immediately prior to, immediately after, and 24 hours after surgery (T0, T1, and T24, respectively), was compared within and among study groups. RESULTS: D‐dimer concentration was >250 ng/mL in 8 (18%) dogs at T0, in 9 (20%) at T1, and in 5 (11%) at T24. At T1 and T24, only 2 dogs had a D‐dimer concentration >500 ng/mL, and it was <750 ng/mL in all dogs. There was no difference in the proportion of increased D‐dimer concentration (>250 ng/mL) among the time points (P = 0.29). Median D‐dimer concentration did not vary between time points within the groups, except in the neutering group (P = 0.029), in which T1 concentration tended to increase compared with T0 values (161 ng/dL, range 71‐727 vs 122 ng/mL, range, 43‐353, respectively; P = .065). CONCLUSION: The surgical procedures tested in this study are unlikely to cause a direct increase in D‐dimer concentration. CLINICAL SIGNIFICANCE: Any increase in D‐dimer concentration after elective neutering, elective orthopedic, and posttraumatic orthopedic surgical procedures should be regarded as clinically important and trigger investigations to detect a hemostatic derangement.