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REMEMBER The Following that has ALWAYS been recommended
by U of Pa.
FVII deficiency in Alaskan Klee Kai
dogs causing a MILD bleeding disorder
PLEASE View Others Results and Post
Yours @
WWW. ALASKANKLEEKAI.INFO
IMPORTANT POINTS
FROM DR. GIGER TO REMEMBER :
NO ALASKAN KLEE KAI WILL DIE FROM FACTOR VII.
NO AKK Should be altered SOLEY on Factor VII test results.
This is a mild disorder that only creates an issue when it is combined with
other issues
Report From AKKAOA
Specialty Seminar
Dr. Urs Giger's
presentation in Shelbyville, KY (Nov 4, 2006) about hereditary diseases in
dogs, and specifically Factor VII Deficiency in the Alaskan Klee Kai,
answered many questions, but also raised additional questions for us. It is
becoming increasingly clear that this may be a very mild bleeding tendency
in the Alaskan Klee Kai, apparently less severe than in Beagles – the first
breed found with this bleeding disorder - and much less severe than in
Scottish Deerhounds. Discrepancies in test results that are being reported,
such as a Carrier status from 2 Clear parents, may be due to errors in
labeling of samples (by owner or by lab personnel), in pedigree,
inappropriate cheek swab technique, or by other factors not yet understood.
In order to learn more about this disease, which seems to be a first joint
health approach for this breed, we need to continue to gather more
information. Here are Dr. Giger’s studies on AKK at PennGen.
Correlation between DNA test results and Bleeding Tendency:
Ideally,
Alaskan Klee Kai found to be Affected/Factor VII deficient by DNA testing
should also be tested by a PT, PTT and FVII analysis. This can be
accomplished through PennGen or the Cornell Comparative Hemostasis
Laboratory. For these studies EDTA and citrated plasma (immediately after
collection in a proper ratio of 9 parts blood and 1 part citrate sample need
to be mixed, spun and the plasma transferred into a well sealed, labeled
tube) should be collected at the same time and shipped on (dry) ice in a
double ziplock-type bag inside a safe container by overnight mail early in
the week to the laboratory. There are many laboratories and even clinics
that can run a PT and PTT but many do not have established normal ranges or
their normal ranges are wide and may miss Affecteds by these screening
tests. If they are sent to PennGen with the appropriate information,
including a description of the presence or absence of an increased bleeding
tendency, we will do these studies for the first 20 samples from Affected
(Factor VII deficient) Alaskan Klee Kai free of charge. Again, results will
be kept confidential, but are provided to the sender of the sample or owner
of the dog.
SNP Breed Profile
for Alaskan Klee Kai:
The
Alaskan Klee Kai is a novel breed with relatively few ancestors. Because of
the narrow gene pool and the likely use of a few major breeding pairs,
certain diseases may be seen more frequently in the breed. A good example is
factor VII deficiency for which there are already reliable biochemical and
DNA tests. For other diseases, little to no information is currently
available. In order to better define the breed at the DNA level, and to
have tools to tackle some of the hereditary diseases in the breed in the
near future, a breed profile with SNPs would be desirable. SNP profiles are
available for many breeds and screening mud dogs to determine the origin and
contribution of a particular mixed breed dog is becoming commercially
available. In order to get a SNP profile for Alaskan Klee Kai, EDTA blood
samples from all the different original dogs and major lines should be
analyzed. Efforts are being made to collect these samples by the Alaskan
Klee Kai breed clubs in order to assure coverage. The details of the SNP
profile will not be made available for any specific dog but used to
establish a breed profile to test others.
Meanwhile, be cautious and well informed when making breeding decisions.
Best to screen any dog that will be used for breeding, and breed Carrier to
Clear, or, obviously, Clear to Clear, and you may want to make those
decisions based on these results and the desirable traits of the dog.
Other than the
original puppy with whom all this investigation started, there have been no
other reports of serious bleeding tendency in the Alaskan Klee Kai, so
everyone is doing a really good job of testing their dogs and keeping "on
top of" any potential bleeding problems that may exist. With all these
efforts described above it is hoped to prevent and/or identify any Factor
VII deficient dogs in order for them to receive the appropriate treatment.
Indeed, plasma transfusions and, potentially, recombinant human factor VIIa,
may be helpful in addition to the use of excellent local hemostasis.
This
report reviewed and edited by Dr Giger & submitted by Lo Binkley for
AKKAOA,Inc and UAKKA, Inc
REMEMBER The Following that has ALWAYS been recommended
by U of Pa.
FVII deficiency in Alaskan Klee Kai
dogs causing a MILD bleeding disorder
PLEASE View Others Results and Post
Yours @
WWW. ALASKANKLEEKAI.INFO
IMPORTANT POINTS
FROM DR. GIGER TO REMEMBER :
NO ALASKAN KLEE KAI WILL DIE FROM FACTOR VII.
NO AKK Should be altered SOLEY on Factor VII test results.
This is a mild disorder that only creates an issue when it is combined with
other issues
|
May 15th Factor VII
Deficiency Information Update
May 3, 2006
Dear Barbara and Members of the Alaskan Klee Kai community,
Just a couple of months ago the first Alaskan Klee Kai with excessive
hemorrhage associated with Factor FVII (FVII) deficiency has been
identified
and since then a screening program has been established and is being
offered to the
Klee Kai community through the Josephine Deubler Genetic Disease
Testing
Laboratory at the University of Pennsylvania.
Incidentally, Dr, Deubler, in whose honor we named the lab, was the
first
female veterinary student who graduated from Penn, and is still very
much known
and respected for her communications, understanding and liaison between
veterinarians and breeders as well as a judge at most dog shows
including Best
of Show judge at the Westminster Dog Show in Madison Square Garden NY
and
organizer of the Bucks and Montgomery dog shows for decades. Today is
Dr.
Deublers 89th birthday and as every other day she is at work in her
office
finalizing all the organization for this weekends Bucks County Dog Show
near
New Hope PA on Saturday.
While we have received a large number of samples from Klee Kai, we need
a
little more time to better understand the distribution of the FVII
mutation in
the breed and the impact on the breed. Nevertheless I was asked to
reiterate
a few previously made statements and to answer some questions.
* FVII deficiency results in a mild bleeding tendency just like in
people and other breeds. We have identified several deficient Klee
Kais, but
none had exhibited the serious bleeding events as the first Klee Kai
studied.
Hence this bleeding disorder may remain asymptomatic in many dogs and it
appears likely that other conditions may influence the bleeding
tendency; for
instance the smaller size of the breed may protect them from serious
bleeding
episodes. Based upon the information we have FVII deficient Klee Kais
are
expected to reach a near normal life expectancy, however, at times of
surgery
and trauma and when exposed to anticoagulants, such as rodenticides or
heparin,
or certain other drugs affecting hemostasis (Aspirin) they may bleed
more
severally and may need even require blood product support. Knowing
what the
hemostatic defect is will help the veterinarian to treat most
appropriately and
to avoid the use of harmful drugs.
* Our DNA test is specific for the mutation identified
in FVII
deficient Klee Kai and detects not only deficient (homozygous) but also
carrier
and normal/clear Klee Kai. Carriers, who have one normal and one
mutant/diseased
gene/allele, have normal coagulation and routine coagulation tests and
are
therefore not at risk for bleeding. Any breed club would be delighted
to have
a DNA test to screen for a particular disease or trait rather than to
have
to base their evaluations and decisions on physical examination or
other
tests, which are generally incapable of differentiating accurately
carriers
from normals and are also requiring special overnight shipments on dry
ice of
specific samples.
* Although DNA testing is the most accurate method for
identifying
genetic diseases, no test can be a 100% accurate as humans are involved
in
collecting, labeling, testing, and reporting results. Over the more
than 10
years of genetic disease testing we have very rarely observed errors in
identifying
sires (and dams) and puppies for collection of samples as well as
mislabeling of blood tubes and brushes by breeders and pet owners, and
errors
in testing or reporting of results. As far as we know there are two
publicized
cases regarding FVII testing of Klee Kai and these are the only ones we
know
ourselves. The original samples received on a Klee Kai puppy and
supposed
parents tested repeatedly as we reported them. There is potentially a
second case
where the offspring tested as carrier and the parents as normal, and we
are
following up on that one.
* While you are likely not expecting that your
physician or local
veterinarian is emailing your or your dog's test results, or that the
human or
a veterinary testing lab is discussing test results with you, we have
been
trying to accommodate these special requests, assist the breeders as
much as we
can and provided results as soon as they become available. Clearly
emailing
everyone is additional work and introduces another potential site for
reporting errors. In the early phase of testing we recommend testing
of all
breeding animals until one has assurance that they are free by descent.
If there are
any potential inconsistencies please let us know as we have been
examining
any inquiries. However, spreading rumors on the list serves and web
sites does
not help the cause, particularly not with breeders who politicize and
apparently share some animosity against each other. Hence please be
kind to
each other as we all only want to help the Klee Kai now and in the
future.
* In order to get good DNA results we must require
excellent cheek swab
samples. While some breeders are consistently providing excellent
brush
samples others are of poor quality and require difficult, expensive, and
time-consuming additional steps to get any DNA. This clearly delays
these
results but also other samples (there are two research specialists
testing your dogs)
and bears potential additional risks of problems with test results.
Hence
please carefully follow the instructions and turn and rub the brush ten
times
against the cheek and let the brush completely dry before shipping.
* In order to get a better understanding of the
severity of the
bleeding tendency and what breeding options are most appropriate
considering
the small size and gene pool in the breed, the frequency of the trait,
and the
severity of the disease more information needs to be gathered and then
analyzed. Until such time it appears prudent to not make any breeding
decisions on
FVII test result of a single animal.
* We appreciate the great interest by the Klee Kai
community in this
mild bleeding disorder and very much hope that a calm analysis of the
test
results will lead to generally accepted breeding guidelines and a
healthy Klee
Kai breed. This DNA test is a first example for your breed from which
one
can learn and get prepared to screen for other potentially more serious
disorders that might exist in the Klee Kai as in so many other breeds.
We are pleased to be part of the health management of the Alaska Klee
Kai
and hope that our work will reduce the risk of bleeding in the breed.
Best of luck
Urs Giger
March 15 2006 Factor
VII Information update
FVII deficiency in Alaskan Klee
Kai dogs causing a mild bleeding disorder
Please post and view others
results at www.alaskankleekai.info
| Several hereditary bleeding
disorders have been identified in many different
canine breeds and involve clotting (coagulation)
factor deficiencies, platelet disorders, and von
Willebrand disease. Coagulation factor VII (FVII)
deficiency has been known to occur in Beagles
for decades, and there are a few reports of FVII
deficiency in the Alaskan Malamute, Bulldog, and
a mixed breed dog. Very recently hereditary FVII
deficiency was identified in a bleeding Alaskan
Klee Kai dog and its family, as well as
unrelated asymptomatic Alaskan Klee Kai dogs. A
DNA test to identify the mutation responsible
for FVII deficiency in Alaskan Klee Kai dogs has
been developed at the University of
Pennsylvania.
Dogs with hereditary FVII deficiency may
exhibit an increased bleeding tendency following
trauma or surgery or rarely appear to develop
spontaneous bleeding. There are few reports of
severe bleeding requiring blood transfusions,
and some FVII-deficient dogs may remain
unrecognized. As this is an autosomal recessive
disorder, the diseased/mutant gene (allele) may
be unknowingly passed on through generations not
only via asymptomatic carriers but also affected
dogs, as they may not show obvious signs.
Carriers have one mutant and one normal gene and
appear clinically normal, but they can pass the
defective gene to their offspring. Only a small
number of Alaskan Klee Kai dogs have been tested
thus far, and hence the frequency and bleeding
tendency remain to be elucidated.
Screening Alaskan Klee Kai dogs with a
clotting test (PT assay) may suggest FVII
deficiency, and measurement of plasma FVII
coagulant activity could confirm a diagnosis of
FVII deficiency. Results of the PT assay are
normal for carriers, and measurement of plasma
FVII coagulant activity will not accurately
identify carriers, as there is overlap of FVII
activities between carrier and normal dogs.
A mutation-based DNA test to screen Alaskan
Klee Kai dogs (and Beagles) for FVII deficiency
has been developed (Dr. Beth Callan, principal
investigator) and has then been established at
the Josephine Deubler Genetic Disease Testing
Laboratory of the University of Pennsylvania
School of Veterinary Medicine (Dr. Urs Giger,
director; Mr. Adam Seng, Research Specialist).
This test can clearly identify affected,
carrier, and normal (also known as clear)
Alaskan Klee Kai dogs. We recommend testing of
any Alaskan Klee Kai dog with signs of bleeding,
as well as its relatives. Furthermore, it is
advisable to screen any Alaskan Klee Kai dog,
particularly popular sires, prior to breeding to
limit the spread of this bleeding disorder.
Carriers could still be used in future breeding
programs. Knowing which dog is a carrier or
normal (clear) will allow the targeted breeding
of carriers with desirable traits to normal dogs
without ever producing affected dogs, as long as
the offspring are also tested and only clear
dogs used thereafter. With a breed of this size
you cannot afford to neuter all animals with a
mutant gene, as you want to preserve their
desirable traits and the gene pool.
The Josephine Deubler Genetic Testing
Laboratory at the University of Pennsylvania is
offering screening for FVII deficiency in
Alaskan Klee Kai dogs at a reduced introductory
rate of $50 per dog through May 31, 2006 ,
provided that a pedigree and adequate clinical
information on the submission form are included
($75 per sample without pedigree). Samples
suitable for this DNA test include 1-2 mls
EDTA-anticoagulated blood (preferable) or 2-3
cheek swabs (obtained with special cytology
brushes). Cytology brushes and test submission
forms are available through the United Alaskan
Klee Kai Association (
http://www.uakka.com ) and the Alaskan Klee
Kai Association of America (
http://akkaoa.org
). Test submission forms may also be
downloaded from our website
http://www.vet.upenn.edu/penngen . We are
also offering test kits when requested with a
self-addressed stamped envelop. For more
information on canine FVII deficiency, please
contact Dr. Beth Callan (215-898-3999;
callan@vet.upenn.edu ) or Dr. Urs Giger
(215-898-8830;
penngen@vet.upenn.edu ). Blood and dried
cheek swab samples, along with test submission
forms and pedigrees, may be submitted in a
ziploc bag to Dr. Urs Giger/FVII Rm 4006, Ryan
Veterinary Hospital, University of Pennsylvania,
3900 Spruce Street, Philadelphia, PA,
19104-6010. Test results are generally available
within 3 weeks of receipt of samples and are
sent only to submitter of samples. All
information is kept strictly confidential. |
|
Directions for taking a sample
Submission Form And
Instructions
About Factor VII
Deficiency in the Alaskan Klee Kai
February 28, 2006
FVII deficiency
in Alaskan Klee Kai dogs causing a mild bleeding disorder
Several
hereditary bleeding disorders have been identified in many different
canine breeds and involve clotting (coagulation) factor
deficiencies, platelet disorders, and von Willebrand disease.
Coagulation factor VII (FVII) deficiency has been known to occur in
Beagles for decades, and there are a few reports of FVII deficiency
in the Alaskan Malamute, Bulldog, and a mixed breed dog. Very
recently hereditary FVII deficiency was identified in a bleeding
Klee Kai dog and its family, and a DNA test to identify the mutation
responsible for FVII deficiency in Alaskan Klee Kai dogs has been
developed at the University of Pennsylvania.
Dogs with
hereditary FVII deficiency may exhibit an increased bleeding
tendency following trauma or surgery or rarely appear to develop
spontaneous bleeding. There are few reports of severe bleeding
requiring blood transfusions, and some FVII-deficient dogs may
remain unrecognized. As this is an autosomal recessive disorder,
the diseased/mutant gene (allele) may be unknowingly passed on
through generations not only via asymptomatic carriers but also
affected dogs, as they may not show obvious signs. Carriers have
one mutant and one normal gene and appear clinically normal, but
they can pass the defective gene to their offspring. Only a small
number of Alaskan Klee Kai dogs have been tested thus far, and hence
the frequency and bleeding tendency remain to be elucidated.
Screening Alaskan
Klee Kai dogs with a clotting test (PT assay) may suggest FVII
deficiency, and measurement of plasma FVII coagulant activity could
confirm a diagnosis of FVII deficiency. Results of the PT assay are
normal for carriers, and measurement of plasma FVII coagulant
activity will not accurately identify carriers, as there is overlap
of FVII activities between carrier and normal dogs.
A mutation-based
DNA test to screen Alaskan Klee Kai dogs (and Beagles) for FVII
deficiency has been established at the Josephine Deubler Genetic
Disease Testing Laboratory of the University of Pennsylvania School
of Veterinary Medicine. This test can clearly identify affected,
carrier, and normal (also known as clear) Alaskan Klee Kai dogs. We
recommend testing of any Alaskan Klee Kai dog with signs of
bleeding, as well as its relatives. Furthermore, it is advisable to
screen any Alaskan Klee Kai dog, particularly popular sires, prior
to breeding to limit the spread of this bleeding disorder. Carriers
could still be used in future breeding programs. Knowing which dog
is a carrier or normal (clear) will allow the targeted breeding of
carriers with desirable traits to normal dogs without ever producing
affected dogs, as long as the offspring are also tested and only
clear dogs used thereafter.
The Josephine
Deubler Genetic Testing Laboratory at the University of Pennsylvania
is offering screening for FVII deficiency in Alaskan Klee Kai dogs
at a reduced introductory rate of $50 per dog through May 31, 2006,
provided that a pedigree and adequate clinical information on the
submission form are included ($75 per sample without pedigree).
Samples suitable for this DNA test include 1-2 mls
EDTA-anticoagulated blood (preferable) or 3 cheek swabs (obtained
with special cytology brushes). Cytology brushes and test
submission forms are available through the United Alaskan Klee Kai
Association (http://www.uakka.com)
and the Alaskan Klee Kai Association of America (http://akkaoa.org).
Test submission forms may also be downloaded from our website
http://www.vet.upenn.edu/penngen. For more information on
canine FVII deficiency, please contact Dr. Beth Callan
(215-898-3999;
callan@vet.upenn.edu) or Dr. Urs Giger (215-898-8830;
penngen@vet.upenn.edu). Blood and dried cheek swab samples,
along with test submission forms and pedigrees, may be submitted to
Dr. Urs Giger/FVII Rm 4006, Ryan Veterinary Hospital, University of
Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104-6010.
Test results are generally available within 3 weeks of receipt of
samples and are sent only to submitter of samples. All information
is kept strictly confidential.
As of 02.16.06
Factor VII (FVII) Deficiency is an inherited bleeding disorder caused by
a deficiency of coagulation FVII. This clotting protein functions in the
tissue juice system of coagulation. This genetic disorder has been well
recognized for several decades in the commercial Beagle population**,
where it manifests as a mild disorder associated with easy bruising.
The condition also occurs in an acquired form due to vitamin K
deficiency or anticoagulant poisoning from rodent bait. Recently,
however, there have been documented reports of abnormal bleeding from
significant deficiency of FVII in a few Alaskan Klee Kai (AKK).
Right now, the impact of this finding
for the general AKK population is unknown, and there are questions to be
answered. One of these includes the ability to accurately assess the
severity and prevalence of the disease in the AKK population. While
research is ongoing to identify a DNA test to address this question,
there are some guidelines that breeders, and those with animals about to
undergo surgical procedures, can follow to minimize risk to the dogs.
Based on guidelines suggested
by Dr Jean Dodds, one of the first persons to describe FVII deficiency
in animals years ago the following information should assist those who
need practical information now. This approach should be used until such
time that a reliable DNA test is available.
Normal canine FVII levels are
50-150%.
-
Do not breed any animal with FVII
<25%.
-
Do not breed any animal affected
with FVII deficiency [i.e. a “bleeder”].
-
You can breed a “carrier” (FVII
between 26- 49 % but never showing clinical signs of bleeding) with
a dog that has FVII of at least 90%.
-
Make sure that your breeding pair
has at least one of them with FVII at least 90%, and the other one
is no less than 25% (and not bleeding).
-
If you have a dog about to undergo
a surgical procedure, and is either a bleeder, or has a FVII of
<25%, make sure that dog is given fresh- frozen plasma before and
following surgery. The dose of plasma for each transfusion is 3-5 mL
per pound of body weight.
-
Puppies can be tested as early as
6 weeks of age.
Currently, the carrier status is not
clearly defined by FVII levels. However, these guidelines should
provide a safe cushion for you and your dogs until we have tests that
can more clearly distinguish the “affected” from the “carrier”.
Additionally, low testing animals may
be at risk for illness later in life that affects the ability to clot.
This can include, among other factors, liver or kidney disease, low
platelet counts or platelet function, medication for treatment of
arthritis (non-steroidal anti-inflammatory drugs such as Rimadyl,
Deramaxx, or Metacam) or other drugs that can affect clotting, such as
aspirin, or other disease that may affect clotting times. Periods of
vaccination, viremia (viral illness), dental cleaning, or infection, or
anything causing an inflammatory response in your dog may also affect
clotting times. The older a dog gets, the less resistance it may have
to these health situations, and the marginal dog may become at greater
risk for changes in overall clotting ability and from more fragile blood
vessels.
A dog that presents with localized or
generalized demodectic mange should be evaluated for FVII Deficiency, as
the moist skin environment that results from decreased ability to
maintain normal clotting status in the tissues provides a ripe
environment for the mite infestation.
Another environmental factor that
poses an additional risk for any dog that spontaneously bleeds is
access to rodenticides (rodent poisons).
Any AKK that presents with bruising or
bleeding into the tissues from minor trauma, or with frank bleeding from
dew claw removal or other surgery, should be evaluated for FVII
Deficiency.
At this point in time, because there
are no clear cut boundaries that distinguish between carrier vs affected
vs non-carrier, non-affected status, the use of the previous guidelines,
or using FVII levels to make breeding decisions, should be helpful.
Please see Figure 1. This is a crude
illustration that depicts the rationale for the levels used for making
breeding decisions.
Fig1:
These values can be obtained
by:
-
Submitting citrated plasma sample
from your dog to the Cornell University Diagnostic Laboratory,
Comparative Coagulation Section (607-275-0622)
-
Include a copy of the dog’s
pedigree (kept strictly confidential, but essential for this to be
helpful to the researchers)
Forms for doing this include:
-
Cover sheet with pricing info
($13 per test)
-
Coagulation Sampling Flow
Chart
-
Sampling Instructions and
Shipping Info
-
General Submission Form
These can be accessed from AKKAOA’s
website as well as UAKKA’s website. They cannot be easily found on
Cornell University’s website. Anyone who needs copies mailed to you can
contact Lo Binkley at
lobink@adelphia.net or 805-379-0770/279-0771.
This has been a very
scary several weeks for some of the AKK folks who have
dogs that are “affected” or “carriers”. We all owe gratitude to Karen
Street, who has seen this all the way through to the point where there
is an
identified potential problem in at least some of the breed. We do not
yet
know to what extent.
We also owe a great debt to the
researchers at University of Wisconsin, Dr Marjory Brooks of Cornell
University, which is the only place in the country that regularly
quantifies FVII levels, and Dr Beth Callan’s group at the University of
Pennsylvania that is working on the DNA aspect of this issue. Many
thanks also goes to Dr Jean Dodds for her patience in giving so much of
her time to develop guidelines to help us address this problem now ---
until we have a more specific genetic marker test upon which to make
breeding decisions.
**Similar bleeding problems have been
reported in the Malamute and “husky type” dogs.
Please do not contact the
above-mentioned people, as we would not want to distract them from being
able to focus on finding a solution to the AKK FVII problem.
This information is being published
jointly by AKKAOA and UAKKA.
Coagulation Sampling Flowchart
Lab Fees
Lab Form
Lab Sampling Instructions |
|