Recurrent haemorrhage, due to vitamin K‐dependent coagulopathy, as the primary presenting complaint in a dog with naturally occurring hypoadrenocorticism

A 5-year-old male neutered standard poodle, presented with recurrent gingival margin haemorrhage and associated prolongations in prothrombin time and activated partial thromboplastin time, with repeatable demonstration of clinical (bleeding) and laboratory (prothrombin time, activated partial thromboplastin time) resolution with, and relapse in the absence of, vitamin K therapy; consistent with a vitamin K-dependent coagulopathy. In the absence of exposure to coumarin rodenticides, nor a history consistent with a congenital coagulopathy, investigations for malabsorptive disease (serum biochemistry, cobalamin/folate, trypsin-like-immunoreactivity, bile acid stimulation test, adrenocorticotrophic hormone stimulation test) supported a diffuse enteropathy and confirmed eunatraemic, eukalaemic hypoadrenocorticism. Clinical signs and laboratory abnormalities demonstrated sustained remission with sole physiological prednisolone therapy, supporting hypoadrenocorticism as a cause of enteric fat malabsorption and associated vitamin K deficiency. Bleeding as a primary presenting sign is a novel presentation of hypoadrenocorticism in dogs.