Delayed Post-Operative Hemorrhage (DEPOH) FAQ

Since the DEPOHGEN™ test became available early this year, some questions keep cropping up, so we thought it would be useful to compile a page of Frequently Asked Questions:

What percentage of Deerhounds have the DEPOH mutation?

Here are the latest numbers:

 # dogs with genotype:  
N/NMut/NMut/Mut# dogs testedMinor Allele Freq (%)
Scottish Deerhound (all tested to date)1811112231425
Photo by Katrina Richardson

This means that 42% of the Deerhounds tested had one or two copies of the mutation.

What is the risk of bleeding in dogs with the DEPOH mutation?

Current research shows that, compared to a clear dog, a dog with one copy of the DEPOH variant is 28 times more likely to experience delayed bleeding, while a dog with two copies is 1235 times more likely to experience delayed bleeding.

From Dr. Court: As yet, we don’t have a good idea as to the relative risk for severe bruising/bleeding after common surgical procedures (spay/castration) in mutant/mutant dogs. In our original study all mutant/mutant dogs showed severe bruising/ bleeding. However, the study was not designed to see whether any mutant/mutant dogs could undergo surgery without complications. We do know that the risk in mutant/mutant dogs is high but not 100%—and that there are various factors that can modify that risk (increase/decrease) such as age and surgical procedure/technique. For example, we have identified dogs that were mutant/mutant where they had a procedure (skin laceration repair; skin cyst removal) when young (<2 yrs) but had bleeding complications when older (C-section, amputation). There was also another mutant/mutant dog that was spayed for a pyometra and did fine. Interestingly, the surgeon used laser surgery—which is known to provide superior hemostasis and minimize tissue damage. 

Does my dog’s Factor VII status affect its DEPOH status?

No. Factor VII and DEPOH are completely unrelated conditions, and the status of one has no bearing on the other.

If my mutant/normal or mutant/mutant dog has no problem with a procedure, does that mean it will never have a problem?

No. As explained above, an affected dog can have no problems with one surgery but have a problem with subsequent procedures. We always recommend that for homozygotes (mutant/mutant), aminocaproic acid or tranexamic acid should be given either IV or orally at a dosage of 20 mg/kg beginning the day of surgery at least three hours prior to the procedure and then three times daily for five days. For heterozygotes (mutant/normal) and dogs of unknown genetic status, one of these drugs should be available and used as needed.

Where can my vet get more information?

Will my clear (normal/normal) dog form a deleterious blood clot (thrombus)?

We don’t know. There are some Deerhounds that form blood clots (thrombi) when they shouldn’t, and we are looking into it, including checking the DEPOH status of these dogs to see if there is a correlation between thrombus formation and DEPOH status, but there are many Deerhounds that are normal/normal and never have a problem with a thrombus. Some thrombus cases seem to run in families, so there is the possibility of another genetic mutation and/or an environmental factor in play. If you have a dog that has formed a thrombus, please let us know—the more cases we study, the faster we will learn about this problem.

What should I do if I want to breed a bitch that has one or two copies of the mutation?

From Dr. Court:

There are a couple of issues here:

For whelping – Based on the cases that have been referred to me, bleeding risk after whelping is much less than is the risk for C-section. I know of 2 mutant/mutant dogs that had unusually long bloody discharge after whelping—but nothing requiring treatment. I don’t expect a problem with heterozygotes (mutant/normal). Regardless, I think it is a good idea to have oral Amicar or tranexamic acid on hand for mutant/normal and mutant/mutant dogs to give if the bleeding seems excessive. 

For C-section – For mutant/mutant dogs, the current recommendation for surgery is prophylactic treatment. The drugs should be started before surgery. Since a C-section is often unplanned and time is important, IV administration (dilute 1:3 in saline and give over 20 minutes) starting about 1 hour before surgery is recommended, followed by oral dosing every 8 hours for 5 days. Consider using tranexamic acid (20 mg/kg) instead of Amicar if it is available.

For heterozygous (mutant/normal) dogs, the current recommendation for surgery—including C-section—is to have Amicar or tranexamic acid available to give during or after surgery if bleeding seems excessive. But it depends where a breeder is on the risk/benefit equation; if very concerned, then the breeder should go ahead with prophylactic treatment (as described for mutant/mutant dogs).

One caveat regarding treating C-section dogs routinely is the potential risk to the pups from the drug getting into the milk. The only information we have is for breast-feeding women. For Amicar there is a warning on the drug label to “exercise caution” in breast-feeding women—but there is no evidence that it can get into the milk and cause problems. For tranexamic acid, the warning is similar. However, there is some evidence that the amount that gets into the milk is 100x less that what is in the mother’s blood. There is also one (admittedly small) study in breast-feeding women taking tranexamic acid that showed no adverse effects in their children.  So—theoretically—tranexamic acid might be better a better choice than Amicar. 

So—for me—the bottom line is:  

For whelping – it is not necessary to give Amicar or tranexamic acid, but do have it on hand (to be cautious).

For C-section – mutant/mutant dogs should receive prophylactic treatment. For heterozygous (mutant/normal) dogs, it depends where you are on the risk/benefit equation. If a breeder is very concerned, then they should go ahead with prophylactic treatment. But at the very least they should have Amicar or tranexamic acid on hand to give during or after surgery if bleeding seems excessive. 

The SDCA’s Guidelines for Health Testing recommend that every Deerhound owner should know the DEPOH genetic status of his/her dogs. Breeders should inform new owners in writing of their dog’s DEPOH genetic status.

If DEPOH genetic status isn’t known, test kits are available from Dr. Court’s lab at WSU. The simple cheek swab sample can be collected at home and mailed via regular first-class mail.

More information on DEPOH can be found at