Feline Disseminated Intravascular Coagulation (DIC) – NAVLE Study Guide

Overview and Clinical Importance

Disseminated intravascular coagulation (DIC) is a complex, life-threatening syndrome characterized by systemic activation of coagulation pathways, leading to widespread microvascular thrombosis and subsequent consumption of platelets and clotting factors. In cats, DIC is always secondary to another primary disease and carries a grave prognosis, with survival rates as low as 7% in retrospective studies.

DIC should be conceptualized as a continuum rather than a single event. It begins with a non-overt (compensated) phase where coagulation is activated but controlled by inhibitors, and may progress to an overt (decompensated) phase characterized by uncontrolled thrombosis and eventual hemorrhage. Unlike dogs, cats with DIC rarely present with overt bleeding (only 15% of cases), making diagnosis more challenging.

Pathophysiology

The DIC Continuum

DIC develops through distinct phases that reflect the balance between procoagulant and anticoagulant forces. The process begins with an initiating trigger from the primary disease, followed by amplification, progression, and ultimately dissemination throughout the vasculature.