Diagnostic utility of d-dimer concentrations in dogs with pulmonary embolism

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Pulmonary embolism (PE) is a complication of systemic disease in dogs. Antemortem diagnosis is challenging because of the lack of a confirmatory test. Objectives: To retrospectively determine the diagnostic utility of D-dimer concentrations in dogs with necropsy-confirmed PE. Animals: Ten dogs with PE confirmed at necropsy that had D-dimer concentrations measured and 10 control dogs with D-dimer concentrations available that lacked PE on necropsy. Methods: The computerized medical record database was searched for dogs with necropsy-confirmed PE that had D-dimer concentrations measured at that visit. An age-, sex-, and breed-matched control group was identified. Signalment, location of PE, and coagulation profiles were collected. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using a D-dimer concentration of 250 ng/mL. Results: Coagulation profiles were not different between dogs with and without PE. Using 250 ng/mL as a cut-off D-dimer concentration, the sensitivity and specificity were 80 and 30%, respectively, for the diagnosis of PE. The NPV and PPV were 60 and 53.0%, respectively. D-dimer concentration <103 ng/mL had 100% sensitivity for ruling out PE and no value was 100% specific. Conclusions and Clinical Importance: D-dimer concentrations <250 ng/mL have a high sensitivity for the absence of PE, but PE still can occur in dogs with a normal D-dimer concentration. Increased D-dimer concentrations are not specific for PE.

Original languageEnglish (US)
Pages (from-to)1646-1649
Number of pages4
JournalJournal of Veterinary Internal Medicine
Volume27
Issue number6
DOIs
StatePublished - Nov 2013

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embolism
Pulmonary Embolism
lungs
Dogs
dogs
necropsy
coagulation
Computerized Medical Records Systems
fibrin fragment D
Dog Diseases
Sensitivity and Specificity
dog diseases
Research Design
Databases

Keywords

  • Biomarker
  • Coagulation
  • Respiratory distress
  • Thromboembolism

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Diagnostic utility of d-dimer concentrations in dogs with pulmonary embolism. / Epstein, Steven E; Hopper, Katrina; Mellema, M. S.; Johnson, Lynelle R.

In: Journal of Veterinary Internal Medicine, Vol. 27, No. 6, 11.2013, p. 1646-1649.

Research output: Contribution to journalArticle

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abstract = "Background: Pulmonary embolism (PE) is a complication of systemic disease in dogs. Antemortem diagnosis is challenging because of the lack of a confirmatory test. Objectives: To retrospectively determine the diagnostic utility of D-dimer concentrations in dogs with necropsy-confirmed PE. Animals: Ten dogs with PE confirmed at necropsy that had D-dimer concentrations measured and 10 control dogs with D-dimer concentrations available that lacked PE on necropsy. Methods: The computerized medical record database was searched for dogs with necropsy-confirmed PE that had D-dimer concentrations measured at that visit. An age-, sex-, and breed-matched control group was identified. Signalment, location of PE, and coagulation profiles were collected. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using a D-dimer concentration of 250 ng/mL. Results: Coagulation profiles were not different between dogs with and without PE. Using 250 ng/mL as a cut-off D-dimer concentration, the sensitivity and specificity were 80 and 30{\%}, respectively, for the diagnosis of PE. The NPV and PPV were 60 and 53.0{\%}, respectively. D-dimer concentration <103 ng/mL had 100{\%} sensitivity for ruling out PE and no value was 100{\%} specific. Conclusions and Clinical Importance: D-dimer concentrations <250 ng/mL have a high sensitivity for the absence of PE, but PE still can occur in dogs with a normal D-dimer concentration. Increased D-dimer concentrations are not specific for PE.",
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N2 - Background: Pulmonary embolism (PE) is a complication of systemic disease in dogs. Antemortem diagnosis is challenging because of the lack of a confirmatory test. Objectives: To retrospectively determine the diagnostic utility of D-dimer concentrations in dogs with necropsy-confirmed PE. Animals: Ten dogs with PE confirmed at necropsy that had D-dimer concentrations measured and 10 control dogs with D-dimer concentrations available that lacked PE on necropsy. Methods: The computerized medical record database was searched for dogs with necropsy-confirmed PE that had D-dimer concentrations measured at that visit. An age-, sex-, and breed-matched control group was identified. Signalment, location of PE, and coagulation profiles were collected. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using a D-dimer concentration of 250 ng/mL. Results: Coagulation profiles were not different between dogs with and without PE. Using 250 ng/mL as a cut-off D-dimer concentration, the sensitivity and specificity were 80 and 30%, respectively, for the diagnosis of PE. The NPV and PPV were 60 and 53.0%, respectively. D-dimer concentration <103 ng/mL had 100% sensitivity for ruling out PE and no value was 100% specific. Conclusions and Clinical Importance: D-dimer concentrations <250 ng/mL have a high sensitivity for the absence of PE, but PE still can occur in dogs with a normal D-dimer concentration. Increased D-dimer concentrations are not specific for PE.

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