Abstract

The creatinine had been 131 umol/l in July, 173 in August, 79 in September and 213 in December. Urine specific gravity was 1.014. Thus the dog had convincing proof of renal failure. On the evening the tests were performed, the dog became quite ill, staggered could not maintain its balance well and fell down. She would fall down again after gaining her balance. Because of worsening azotemia and clinical signs the dog was euthanatized. Additional blood samples were not available. A proteinaceous material was not in clumps in the freshly made blood smear sent with the EDTA blood sample, but was extensively clumped in the smears we made after receiving the EDTA blood in the mail in December. About 12 % of the blood volume became a gel after refrigeration. This prominent change is the focus of this case report. Cryofibrinogen likely ”precipitated” out of solution after chilling. Cryofibrinogen was likely the clear material seen in large amount under the gel in the serum separator tube. Electrophoresis was attempted with plasma (assuming any fibrinogen would be absent from serum). But the plasma drop precipitated on the applicator and the SEP could not be performed. The material was not fat. It did not float to the top of the tube. Cholesterol and triglyceride were not increased in serum. At first, the serum was not in a gel form. It was liquid and flowed, but did seem a bit turbid as if lipemic. EDTA plasma was a firm gel after 1 or more days at refrigerator temperature. CF forms a gel at refrigerator temperature and then can liquify when warmed, as with this material. Cryofibrinogen is only in plasma, not serum. Cryoglobulin is in both plasma and serum. Serum would not contain fibrinogen, which would be removed with the clot. Even serum had some gel formation after 1 or more days in a refrigerator, but plasma clearly had a stronger tendency to form a gel. Thus the difference between serum and plasma in their tendency to form a gel in this case was not 100 %. Cryofibrinogen is increased by many causes, parasites (Oesophagostomum and Babesia in cattle), inflammation, neoplasia, renal disease and even familial (most causes reported in people). Cryofibrinogen clogs filters of human heart patients with hypothermia used during surgery. CF also causes a hypercoagulable state. CF may be a sequence or cause of disease. Cryoprotein aggregates may block microvasculature. CF may activate platelets to form microthrombi. The Saluki had CNS that could have been from vascular occlusion. The veterinarian diagnosed DIC in the dog. Cryofibrinogen (CF) is increased in inflammatory bowel disease in people and plasmapheresis or cryofiltration removes CF and improves patient’s symptoms (Sawada). Our dog had signs of staggering, loss of balance and would fall down suggesting blockage of blood flow in the brain and these signs caused the owner to choose to euthanatize the dog. CF may activate platelets to form microthrombi and vascular occlusion may have caused the clinical signs. CF is not commonly recognized or tested for in domestic animals but has been identified often in people with renal disease, inflammation, neoplasia etc. This case should alert us to the possibility of cryofibrinogen as a cause of disease in our patients and artifacts in our samples

Published in

Conference

American Society for Veterinary Clinical Pathology

SLU Authors

• Tvedten, Harold

  • Department of Clinical Sciences, Swedish University of Agricultural Sciences
    

UKÄ Subject classification

Veterinary Science
Animal and Dairy Science


Permanent link to this page (URI)

https://res.slu.se/id/publ/18793