Vet Guide to Coagulopathy of Liver Disease in Dogs 2025 🐶🩸
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Vet Guide to Coagulopathy of Liver Disease in Dogs 2025 🐶🩸
By Dr. Duncan Houston BVSc
Coagulopathy of liver disease occurs when the liver cannot produce enough clotting factors, causing prolonged bleeding. This guide explores causes, signs, diagnostics, and management to help keep your dog safe and healthy. 💊
🔍 Why It Happens
The liver synthesizes most clotting factors (II, V, VII, IX, X, XI) and proteins like fibrinogen and antithrombin; liver dysfunction impairs this process, leading to bleeding risk.
- Impaired vitamin K-dependent factor production (II, VII, IX, X)
- Platelet deficits from portal hypertension and splenic sequestration
- Fibrinolysis from an imbalance in clot breakdown systems
📍 Common Causes
- Advanced liver failure or cirrhosis
- Acute viral hepatitis or toxin-induced injury
- Obstructive bile duct disease causing cholestasis and vitamin K malabsorption
- Portosystemic shunts reducing clotting protein synthesis
⚠️ Clinical Signs
- Spontaneous bleeding: blood in vomit/stool, nosebleeds, bruising
- Excessive bleeding after minor trauma or surgery
- Signs of liver disease: jaundice, ascites, lethargy
🔬 Diagnostic Steps
- Physical & history: check for bruises, bleeding, liver disease context
- Bloodwork: CBC, biochemical profile—elevated enzymes, low albumin
- Coagulation tests: PT, aPTT prolonged, PIVKA, thrombin time, fibrinogen, antithrombin
- Imaging: Ultrasound/X-ray to evaluate liver size, shunts, ascites
- Liver biopsy: performed only if coagulation tests are safe; evaluate fibrosis, inflammation
💊 Treatment & Management
1. Supportive Care
- Vitamin K supplementation (IM/SC) for 1–2 days
- Fresh frozen plasma to replenish clotting factors before bleeding or procedures
- Whole blood if anemia and factor deficit are present
2. Addressing Liver Disease
- Treat underlying hepatitis, cholestasis, and detoxify poisons
- Correct shunts surgically if possible
- Support with hepatic diet, antioxidants, ursodiol
3. Prevention & Monitoring
- Check coagulation times before dental cleanings or surgery
- Use vitamin K or plasma prophylactically during invasive procedures
- Regular reassessment via bloodwork and coagulation panels
📊 Summary Table
| Issue | Lab Finding | Intervention |
|---|---|---|
| Vitamin K deficiency | ↑PT, PIVKA positive | Vitamin K supplementation |
| Factor deficiency | ↑PT/aPTT | Plasma transfusion |
| Liver dysfunction | ↑ALT/ALP, low albumin | Liver support & treat cause |
✅ Vet Tips from Dr Duncan Houston BVSc
- ✔ Always run coagulation panels before liver biopsy or surgery.
- ✔ Start vitamin K when PT is prolonged, pending further evaluation.
- ✔ Plasma transfusion is vital before invasive procedures if clotting is abnormal.
- ✔ Treating the liver disease helps restore normal clotting function.
If your dog has unusual bleeding, bruising, or signs of liver disease—use the AskAVet.com app for a veterinary consult.🐾❤️
