Delayed Postoperative Hemorrhage (DEPOH) – Scottish Deerhound, Greyhound
A genetic variant in the SERPINF2 gene has been identified in Scottish Deerhounds and Greyhounds that is associated with an increased risk of developing delayed postoperative hemorrhage (DEPOH).
Clinical signs include unexpected and excessive bleeding or bruising that begins 1 to 4 days after surgery. Symptoms range from frank bleeding at the surgical site to progressive bruising of the surrounding skin and hemoabdomen. Coagulation screening tests—including prothrombin time, activated partial thromboplastin time, von Willebrand factor antigen, and platelet counts—are typically unremarkable.
It is important to point out that this is a disorder of clot stability, not of hemostatic clot formation. In affected dogs, bleeding is usually (but not always) delayed, typically starting within 24–48 hours after surgery or major trauma. This is due to reduced alpha-2 antiplasmin activity (hyperfibrinolysis), resulting in premature clot dissolution.
DEPOH can be prevented or treated with antifibrinolytic drugs such as EACA (epsilon-aminocaproic acid) or tranexamic acid.
DEPOH is a completely separate condition from Factor VII Deficiency. In Scottish Deerhounds, it is possible for a dog to be affected by both disorders.
Inheritance pattern: Dogs carrying one or two copies of the variant allele show an increased risk of developing DEPOH compared to non-carriers.
Delayed Postoperative Hemorrhage (DEPOH) – English Springer Spaniel, Welsh Springer Spaniel
In English Springer Spaniels (ESS) and Welsh Springer Spaniels (WSS), a genetic variant in the SERPINE1 gene has been linked to a bleeding tendency caused by hyperfibrinolysis.
Hyperfibrinolysis is a disorder in which blood clots dissolve too quickly, preventing proper wound sealing. Normally, fibrinolysis breaks down clots gradually after healing. In affected dogs, this process occurs prematurely and excessively, leading to persistent or delayed bleeding.
Clinical signs often appear from around 7 months of age, typically following surgery or trauma. Affected dogs may experience spontaneous bleeding into the abdominal cavity or subcutaneous tissue, hematomas, or bloody wound secretions. They may appear weak and lethargic, with pale gums and a low pulse.
It is important to note that this is a disorder of clot stability, not clot formation. Bleeding typically begins within 24–48 hours after surgery or trauma due to the absence of functional PAI-1 protein, which normally inhibits premature clot breakdown.
DEPOH in these breeds can be prevented or treated with antifibrinolytic agents such as EACA or tranexamic acid.
Standard coagulation tests (PT, PTT, buccal mucosal bleeding time) are usually within normal ranges, making diagnosis difficult without genetic testing. The SERPINE1 gene encodes plasminogen activator inhibitor-1 (PAI-1), which regulates clot breakdown. Due to the variant, affected dogs produce no functional PAI-1 in platelets, resulting in life-threatening bleeding.
Inheritance pattern: Autosomal recessive. Heterozygous dogs still produce detectable PAI-1 and have not shown increased bleeding risk.
