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Von Willebrand’s Disease (VWD)

By: Dr. Leah Cohn

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Von Willebrand's disease (vWD) is caused by a deficiency of von Willebrand's factor (vWF), one of the elements that allow blood to form clots. Von Willebrand's disease can cause prolonged or excessive bleeding.

VWD is a hereditary defect that is passed from parents to offspring through genetic material. Inheritance is complicated, but vWD is equally likely to affect males and females, and one affected parent can pass the condition to his offspring. Many different dog breeds can be affected with vWD and different breeds are prone to different subtypes of the disease.

The severity of vWD varies from dog to dog, but in most, it becomes a problem only when surgery is needed or if the dog is injured.

What to Watch For

  • Prolonged or excessive bleeding after injury
  • Prolonged or excessive bleeding after surgery
  • Bleeding from the gums or nose
  • Bloody urine

    Diagnosis

    VWD cannot be diagnosed definitively with routine in-hospital testing but requires specialized tests. Diagnostic tests are needed to recognize vWD and exclude other diseases. These tests may include:

  • A complete medical history and physical examination

  • Complete blood count (CBC). This test should be performed on any bleeding dog to be certain the number of platelets (the cells which allow clots to form) is normal and to check for anemia, a deficiency of oxygen-carrying red blood cells.

  • Tests of clotting ability, including activated partial thromboplastin time (APTT) and one-stage prothrombin time (OSPT). Although results of these tests will be normal in a dog with vWD, they help rule out other diseases.

  • Buccal mucosal bleeding time. In this crude test of platelet function, vascular (blood vessel) function, and vWD, a small, precise cut is made inside the dog's lip and the time it takes to form a clot is measured. This test helps your veterinarian decide if more specific testing is indicated.

  • Measurement of von Willebrand's factor. Unfortunately, this specific blood test may need to be repeated because there is a lot of day-to-day variation in vWF concentration and because results may fall into a borderline range.

    Treatments

  • Most dogs with vWD require no treatment unless a surgery is planned or an injury is sustained.

  • Blood products from healthy dogs can stop excessive bleeding in dogs with vWD. Either the liquid part of blood (plasma), whole blood (plasma plus blood cells) or a concentrate of clotting factors (cryoprecipitate) may be given.

  • If repeated transfusions are necessary, it is important to cross match the patient's blood with the donor's blood.

  • Desmopressin acetate (DDAVP) is a hormone that can increase von Willebrand's Factor concentrations temporarily. It may be given just prior to surgery or to a healthy dog that will then be used to give blood to the dog with vWD.

  • If a dog with vWD is found to have poor thyroid function, thyroid supplementation is recommended.

    Home Care and Prevention

    Provide soft padded areas for your dog to lie on. Minimize the chance of injury by observing and fixing any sharp corners, such as on doggie doors. It is usually not necessary to limit activity as spontaneous bleeding is not common. If your dog should begin bleeding, seek veterinary assistance immediately.

    Because it is a hereditary disease, an animal born with vWD cannot be cured. Do not breed dogs that have vWD. Although careful breeding can minimize the incidence of vWD, a complex inheritance pattern makes elimination of the disease in a breed difficult.

    Minimize the chance of injury by keeping your dog confined either in a fenced area or on a leash when outdoors. If your dog should begin bleeding, seek veterinary assistance immediately.

    Inform any veterinarian treating your dog about his vWD. This is especially important prior to surgical procedures. Inform any groomer handling your dog about his condition; they will use extra care in clipping and trimming nails and can be prepared if a cut occurs.

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