C68 - Assessment of Hypercoagulability, Fibrinolysis, and Inflammation in Cats with Different Manifestations of Congestive Heart Failure

Abstract: Background - Recent evidence suggests feline arterial thromboembolism (FATE) prevalence varies by congestive heart failure (CHF) manifestation. Cats with pulmonary edema (PE) had a higher incidence compared to cats with pleural effusion (PLE). No studies have investigated coagulation and fibrinolysis between CHF manifestations. Hypothesis/Objectives - Cats with PE will be more proinflammatory, hypercoagulable, and have reduced fibrinolysis compared to PLE cats. Animals - 38 cats (16 PLE, 22 PE) in active CHF Methods - Prospective clinical cohort study. Cats had an echocardiogram and blood collected after stabilization. Cardiac chamber dimensions and functional indices were measured. CBCs were performed. Fibrinolysis was measured by d-dimer, antiplasmin and plasminogen and coagulation assessed by viscoelastic coagulation monitor (VCM-Vet), thrombin-antithrombin, fibrinogen and platelet activation via flow cytometry. Associations between CHF manifestation, incidence of thrombosis and laboratory variables were assessed using Fisher’s exact test. Results - Right-heart dimensions were larger in PLE cats. No difference in left atrial size or function, or spontaneous echogenic contrast presence was found between groups. No significant differences in coagulation and fibrinolysis markers were found; plasminogen in PLE cats appeared lower compared to PE cats (164% vs. 181.5%, p = 0.084). Platelet-to-neutrophil ratio in PE cats was 17.9 vs. 32.2 in PLE cats (p = 0.07). Platelets had a net positive thrombin response in PE cats (0.03 vs. -0.01) compared to PLE cats (p = 0.10). Conclusions and Clinical Importance - Lower platelet-to-neutrophil ratio, positive thrombin response and higher plasminogen in PE cats may suggest increased propensity for thrombosis.