Disseminated Intravascular Coagulation (DIC) in Cats

 

Disseminated intravascular coagulation (DIC) is a bleeding problem in which clotting factors are activated with an absence of injury. Micro clots form within the blood vessels, and the clotted material goes on to consume platelets and proteins, using them up and leaving a lack of sufficient clotting factors and platelets. This condition can lead to a disruption in normal blood flow to the organs and excessive bleeding, both external and internal.

 

Clotting factors, such as proteins in the blood plasma, are components of the bloodstream, coordinating with platelet cells to stop bleeding at the site of an injury by forming into a gel-like plug. Platelets are normal cell fragments that originate in the bone marrow and travel in the blood as it circulates through the body. Platelets act to plug tears in the blood vessels and stop bleeding.

 

DIC occurs secondarily and in response an existing diseased condition. There is no breed, gender or age predisposition, though this condition is less common in cats than in dogs.

 

Symptoms and Types

 

• Small purple-red spots beneath the surface of the skin (petechiae)
• Excessive bleeding after injury, during surgery or after taking blood
• Bleeding from the mouth, nose, anus or vagina
• Blood collecting in the chest and/or abdomen

 

Causes

 

• Gastric dilation-volvus - condition in which the stomach dilates with gas and/or fluid, and subsequently rotates around its short axis
• Heart failure
• Heartworm disease
• Heat stroke
• Breakdown of red-blood cells by the immune system
• Inflammation of the stomach and intestines with blood in the feces
• Generalized (systemic) infectious diseases which cause bacterial toxins to accumulate in the blood (endotoxemia)
• Liver disease
• Cancer
• Nephrotic syndrome - a medical condition in which protein is dropped in the urine, low levels of albumin (a type of protein) and high levels of cholesterol are found in the blood, and fluid accumulation is present in the abdomen, chest, and/or under the skin
• Inflammation of the pancreas (pancreatitis)
• Shock and low levels of oxygen in the blood and tissues (hypoxia)
• Thrombocytopenia - Low platelet or thrombocyte counts caused by the immune system destroying the platelets
• Trauma
• Venom

 

Diagnosis

 

Your veterinarian will perform a thorough physical exam on your cat, taking into account the background history of symptoms and possible incidents that might have precipitated this condition, such as a possible run-in with an insect or venomous animal. Standard tests include a blood chemical profile, a complete blood count, an electrolyte panel and a urinalysis to look for underlying systemic disease that is causing this response. Some of the possible concurrent conditions that will be found are anemia – fragmented red blood cells (RBCs) will be indicative of this; and thrombocytopenia – a low platelet count.

 

A blood clotting profile will be performed on your cat's blood to measure the time it takes to clot. Blood tests will show low levels of fibrinogen, increased D-dimers and decreased antithrombin-III (factors in the clotting process) if your cat is being affected by disseminated intravascular coagulation.

 

When thrombocytopenia is found occurring along with a prolonged clotting time and spontaneous bleeding, DIC may be safely assumed to be the conclusive diagnosis.

 

 

 

Treatment

 

Your cat should be hospitalized in an intensive care unit and treated aggressively for the underlying disease. Your cat's activity will need to be restricted to avoid incidental bleeding, which can occur as the result of even small and seemingly minor injuries. Fluid therapy, oxygen and blood plasma transfusions should be administered to the cat.

 

Your veterinarian may choose to use heparin to slow any further progression of clotting, but this drug will need to be used with extreme caution, as high doses can lead to fatal hemorrhaging.

 

Living and Management

 

If your cat has been diagnosed with disseminated intravascular coagulation, it must remain in the hospital until the bleeding has been brought under control and signs of improvement have progressed with reverse. Unfortunately, the underlying diseases that cause the body to react this way are generally very severe, and animals that are suffering from DIC, along with the causative condition, tend not to survive. Prompt and aggressive treatment is the only possible method for preventing a rapid and morbid progression.