Hypercoagulability and thromboembolism in dogs with functional and non-functional pituitary tumors following transsphenoidal hypophysectomy

Claudia  Huerta Gallego

Objective - To assess the incidence of postoperative thromboembolic events and determine any clinicopathological findings that correlate with hypercoagulability in dogs with pituitary tumors that had undergone transsphenoidal hypophysectomy. Design – Retrospective study. Setting – University teaching hospital. Animals – A total of 22 cases were evaluated, 17 were dogs with functional pituitary tumors, and 5 were dogs with nonfunctional pituitary tumors. Measurements and Main Results - Thromboembolic events were observed exclusively in dogs with functional pituitary tumors (6/17). While no single laboratory parameter was significantly associated with thromboembolism, dogs with functional tumors demonstrated a hypercoagulable tendency. Preoperatively, the functional group exhibited a significantly higher mean platelet count than the nonfunctional group (p = 0.020). Presurgical thromboelastography abnormalities suggestive of hypercoagulability were common in the functional group, including decreased reaction (2/16) and kinetic times (7/16) and increased alpha angle (6/16) and maximum amplitude measurements (7/16). Postoperatively, thromboelastography results remained suggestive of hypercoagulability in 9/11 functional dogs. Functional dogs with documented thromboembolism had larger pituitary to brain ratios (p = 0.006) and shorter survival times (p = 0.019) compared to functional dogs without thromboembolism. There was no significant difference in median survival time between the functional and nonfunctional groups (p = 0.120); however, the mean length of hospitalization was significantly longer in the functional group (p = 0.039). Conclusion - Dogs with functional tumors experienced higher rates of postoperative complications, prolonged hospitalizations, and an increased incidence of thromboembolic events compared to dogs with nonfunctional tumors. Traditional coagulation assays were insufficient in predicting thromboembolism in this population. The pituitary to brain ratio may serve as a valuable prognostic marker for thromboembolic risk and mortality. These findings underscore the need for larger prospective studies to assess comprehensive coagulation profiling, to improve risk stratification and guide postoperative thromboprophylaxis in dogs with hypercortisolism undergoing transsphenoidal hypophysectomy.

Hypercoagulability and thromboembolism in dogs with functional and non-functional pituitary tumors following transsphenoidal hypophysectomy

Files and links (1)

Abstract

Metrics

Details