Assessment of gastrointestinal health and the coagulation system in dogs with right-sided heart disease: an exploratory study.

Abstract

Background: Right-sided heart disease (RHD) affects gastrointestinal function and hemostasis.

Hypothesis/objectives: Dogs with progressively severe RHD have impaired gastrointestinal function and altered hemostasis.

Animals: Eighteen client-owned dogs with RHD; group 1: 6 dogs without hepatic venous congestion, group 2: 6 dogs with hepatic venous congestion but no ascites, and group 3: 6 dogs with ascites.

Methods: Prospective, cross-sectional, exploratory study. Dogs underwent routine blood, urine, and fecal testing, measures of gastrointestinal health, coagulation testing, C-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and comprehensive echocardiography.

Results: Right atrial area higher from groups 1 to 3 (1.34 ± 0.66, 2.48 ± 1.33, 3.1 ± 0.93 cm2/kg0.71; P = .02). NT-proBNP (median; range) higher across group 1 (821; 493-3016 pmol/L), group 2 (1694; 1125-8117 pmol/L), and group 3 (5165; 3492-10 000 pmol/L) (P = .006). Measures of gastrointestinal dysfunction including serum methylmalonic acid (group 1 = 857.5 ± 322.6; group 2 = 1031.1 ± 222.5; and group 3 = 1460.5 ± 516.3 nmol/L; P = .037) and intestinal fatty acid binding protein (group 1 median = 9.3, range = 5.6-11.5; group 2 = 10.1, 8.0-20.4; and group 3 = 13.8, 10.3-17.5 ng/mL) were worse in more severely affected dogs (P = .032). Hyperfibrinolysis was observed with worsening RHD (none in group 1, 2 in group 2, and 3 in group 3). Activated partial thromboplastin time was higher with disease severity. No difference was detected among groups in cobalamin, folate, or CRP (all P > .05).

Conclusions and clinical importance: Clinicians should be aware of derangements within the gut-heart axis and coagulation system when managing dogs with RHD.