Petechien, Hämatome, Epistaxis – Was nun? Ein diagnostischer Leitfaden

Ein akut blutender Patient ist im Alltag oftmals eine Herausforderung und macht ein schnelles Handeln erforderlich, um möglicherweise lebensbedrohliche Komplikationen zu vermeiden. Dieser Artikel soll einen Leitfaden zur zielorientierten diagnostischen Aufarbeitung geben und dabei helfen, einen kühlen Kopf zu bewahren.

Publication History

Article published online:
23 February 2024

• Literatur

• 1 Stockham SL, Scott MA. Hemostasis. In: Fundamentals of veterinary clinical pathology. 2nd ed. Ames (IA): Blackwell Publishing; 2008: 259-323
• 2 Sang Y, Roest M, de Laat B. et al. Interplay between platelets and coagulation. Blood Rev 2021; 46: 100733
• 3 Couto CG. Disorders of hemostasis. In: Couto CG, Nelson RW. Small animal internal medicine. 4th ed. St. Louis (MO): Mosby Elsevier; 2009: 1242-1259
• 4 Gentry PA, Burgess H, Wood D. Hemostasis. In: Harvey JW, Bruss ML, Kaneko JJ. Clinical Biochemistry of Domestic Animals. 6th ed. San Diego (CA): Academic Press; 2008: 287-330
• 5 Stockham SL, Scott MA. Platelets. In: Fundamentals of veterinary clinical pathology. 2nd ed. Ames (IA): Blackwell Publishing; 2008: 223-259
• 6 Grindem CB, Breitschwerdt EB, Corbett WT, Jans HE. Epidemilogical survey of thrombocytopenia in dogs : a report of 987 cases. Vet Clin Pathol 1991; 20 (02) 38-43
• 7 Botsch V, Kuchenhoff H, Hartmann K, Hirschberger J. Retrospective study of 871 dogs with thrombocytopenia. Vet Rec 2009; 164 (21) 647-651
• 8 Villiers E, Ristić J. Disorders of Hemostasis. In: BSAVA Manual of Canine and Feline Clinical Pathology. 3rd ed. Gloucester (UK): British Small Animal Veterinary Association; 2016: 94-122
• 9 Atif FA, Mehnaz S, Qamar MF. et al. Epidemiology, Diagnosis and Control of Canine Infectious Cyclic Thrombocytopenia and Granulocytic Anaplasmosis: Emerging Diseases of Veterinary and Public Health Significance. Vet Sci 2021; 8 (12) 312
• 10 Willesen JL, Langhorn R, Nielsen LN. Hemostatic Dysfunction in Dogs Naturally Infected with Angiostrongylus vasorum – A Narrative Review. Pathogens 2022; 11 (02) 249
• 11 Romanelli P, REcordati C, Rigamonti P, Bertazzolo W. Erythrophagocytic multiple myeloma in a dog. J Vet Diagn Invest 2022; 34 (04) 718-722
• 12 Cowan SM, Bartges JW, Gompf RE. et al. Giant Platelet Disorders in the Cavalier King Charles Spaniel. Exp Hematol 2004; 32 (04) 344-350
• 13 Gelain ME, Bertazzolo W, Tutino G. et al. A novel point mutation in the beta1-tubulin gene in asymptomatic macrothrombocytopenic Norfolk and Cairn Terriers. Vet Clin Pathol 2014; 43 (03) 317-321
• 14 Zaldívar-López S, Marín LM, Iazbik MC. et al. Clinical pathology of Greyhounds and other sighthounds. Vet Clin Pathol 2011; 40 (04) 414-425
• 15 Sullivan PS, Evans HL, McDonald TP. Platelet concentration and hemoglobin function in greyhounds. J Am Vet Med Assoc 1994; 205 (06) 838-841
• 16 Shiel RE, Brennan SF, OʼRourke LG. et al. Hematologic Values in young pretraining healthy Greyhounds. Vet Clin Pathol 2007; 36 (03) 274-277
• 17 Couto CG, Lara A, Iazbik MC, Brooks MB. Evaluation of platelet aggregation using a point of care instrument in retired racing Greyhounds. J Vet Intern Med 2006; 20 (02) 365-370
• 18 Santoro SK, Garrett LD. Platelet concentrations and platelet assoiciated IgG in greyhounds. J Vet Intern Med 2007; 21 (01) 107-112
• 19 Segert JH, Seidel JM, Wurzer WJ, Geretschlaeger AM. vWDI is inherited in an autosomal dominant manner with incomplete penetrance in the Kromfohrländer breed. Canine Genet Epidemiol 2019; 6: 3
• 20 Barr JW, McMichael M. Inherited disorders of hemostasis in dogs and cats. Top Companion Anim Med 2012; 27 (02) 53-58
• 21 Kramer JW, Venta PJ, Klein SR. et al. A von Willebrandʼs factor genomic nucleotide variant and polymerase chain reaction diagnostic test associated with inheritable type-2 von Willebrandʼs disease in a line of german shorthaired pointer dogs. Vet Pathol 2004; 41 (03) 221-228
• 22 Mostoskey UV, Padgett GA, Stinson AW. et al. Canine Molecular Genetic Diseases. Compendium on Continuing Education for the Practicing Veterinarian 2000; 22: 480-489
• 23 Riehl J, Okura M, Mignot E, Nishino S. Inheritance of von Willebrandʼs disease in a colony of Doberman Pinschers. Am J Vet Res 2000; 61 (02) 115-120
• 24 Lobetti RG, Dippenaar T. Von Willebrandʼs disease in the German Shepherd dog. J S Afr Vet Assoc 2000; 71 (02) 118-121
• 25 Randolph JF, Center SA, Dodds WJ. Factor XII deficiency and von Willebrandʼs disease in a family of miniature poodle dogs. Cornell Vet 1986; 76 (01) 3-10
• 26 Venta PJ, Li J, Yuzbasiyan-Gurkan V. et al. Mutation causing von Willebrandʼs disease in Scottish Terriers. J Vet Intern Med 2000; 14 (01) 10-19
• 27 Bodreaux MK, Martin M. P2Y12 receptor gene mutation associated with postoperative hemorrhage in a Greater Swiss Mountain dog. Vet Clin Pathol 2011; 40 (02) 202-206
• 28 Forsythe LT, Willis SE. Evaluating oral mucosa bleeding times in healthy dogs using a spring-loaded device. Can Vet J 1989; 30 (04) 344-345
• 29 Mischke R. Hämophilie A und B beim Hund. Tierarztl Prax Kleintiere Heimtiere 2012; 40 (01) 44-53
• 30 Callan MB, Aljamali MN, Margaritis P. et al. A novel missense mutation responsible for factor VII deficiency in research Beagle colonies. J Thromb Haemost 2006; 4 (12) 2616-2622
• 31 Kaae JA, Callan MB, Brooks MB. Hereditary factor VII deficiency in the Alaskan Klee Kai dog. J Vet Intern Med 2007; 21 (05) 976-981
• 32 Johnstone IB, Norris AM. A moderately severe expression of classical hemophilia in a family of german shepherd dogs. Can Vet J 1984; 25 (05) 191-194
• 33 Aslanian ME, Sharp CR, Rozanski EA. et al. Clinical outcome after diagnosis of hemophilia A in dogs. J Am Vet Med Assoc 2014; 245 (06) 677-683
• 34 Mansell PD, Parry BW. Changes in factor VIII: coagulant activity and von Willebrand factor antigen concentration after subcutaneous injection of desmopressin in dogs with mild hemophilia A. J Vet Intern Med 1991; 5 (03) 191-194
• 35 Decambron A, Manassero M, Thibaud JL. et al. Bone haemophilic pseudotumour of the ulna: A rare complication of haemophilia in a dog. Vet Comp Orthop Traumatol 2017; 30 (05) 371-376
• 36 Lubbers C, Beukers M, Bergknut M, Paes G. Hemophilia A Resulting in Severe Hyperesthesia Due to Extraparenchymal Spinal Cord Hemorrhage in a Young Golden Retriever Puppy. Vet Sci 2022; 9 (11) 638
• 37 Brooks MB, Barnas JL, Fremont J, Ray J. Cosegregation of a factor VIII microsatellite marker with mild hemophilia A in Golden Retriever dogs. J Vet Intern Med 2005; 19 (02) 205-210
• 38 Mischke R, Kühnlein P, Kehl A. et al. Genetic analysis of hemophilic Havanese dogs. Vet Clin Pathol 2011; 40: 569
• 39 Steingräber L. Molekularbiologische Aufklärung des ursächlichen Gendefekts der Hämophilie bei der Hunderasse Hovawart [Dissertation]. Hannover: Tierärztliche Hochschule Hannover; 2022
• 40 Brenig B, Steingräber L, Shan S. et al. Christmas disease in a Hovawart family resembling human hemophilia B Leyden is caused by a single nucleotide deletion in a highly conserved transcription factor binding site of the F9 gene promoter. Heamatologica 2019; 104 (11) 2307-2313
• 41 Mauser AE, Whitlark J, Whitney KM, Lothrop jr. CD. A deletion mutation causes haemophilia B in Lhasa Apso dogs. Blood 1996; 88 (09) 3451-3455
• 42 Jolivet F, Diquélou A, Trumel C. et al. Fibronogen deficiency in a dog – a case report. BMC Vet Res 2017; 13 (01) 183
• 43 Sigrist NE, Hofer-Inteeworn N, Jud Schefer R. et al. Hyperfibrinolysis and Hypofibrinogenemia Diagnosed With Rotational Thromboelastometry in Dogs Naturally Infected With Angiostrongylus vasorum. J Vet Intern Med 2017; 31 (04) 1091-1099
• 44 Wilkerson MJ, Johnson GS, Stockham S, Riley L. Afibrinogenemia and a circulating antibody against fibrinogen in a Bichon Frise dog. Vet Clin Pathol 2005; 34 (02) 148-155
• 45 Puig J, Vilafranca M, Font A. et al. Acute intrinsic renal failure and blood coagulation disorders after a snakebite in a dog. J Small Anim Pract 1995; 36 (07) 333-336
• 46 Lara-García A, Couto CG, Iazbik MC, Brooks MB. Postoperative bleeding in retired racing greyhounds. J Vet Intern Med 2008; 22 (03) 525-533
• 47 Mischke R, Kühnlein P, Kehl A. et al. Hämophilie A beim Hund: Symptome, Blutgerinnungsanalyse und Behandlung [Hemophilia A in the dog: symptoms, blood coagulation analysis and treatment]. Berl Munch Tierarztl Wochenschr 1996; 109 (08) 279-287
• 48 Mischke R, Kühnlein P, Kehl A. et al. G244E in the canine factor IX gene leads to severe hemophilia B in Rhodesian Ridgebacks. Vet J 2011; 187 (01) 113-118
• 49 Birkbeck R, Humm K, Cortellini S. A review of hyperfibrinolysis in cats and dogs. J Small Anim Pract 2019; 60 (11) 641-655
• 50 Zoia A, Drigo M, Caldin M. et al. Fibrinolysis in Dogs with Intracavitary Effusion: A Review. Animals (Basel) 2022; 12 (19) 2487