Peer-reviewed veterinary case report
Arterial blood clots in cats with heart disease and treatment options
By Luis Fuentes, Virginia·Published in Journal of feline medicine and surgery·2012·Department of Veterinary Clinical Sciences, United Kingdom·View original on PubMed →
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Original publication title: Arterial thromboembolism: risks, realities and a rational first-line approach.
- Species:
- cat
Plain-English summary
A cat with heart disease developed a serious condition called arterial thromboembolism (ATE), which can cause sudden pain and paralysis in the back legs. This condition often leads to a "saddle thrombus," where a blood clot blocks blood flow, and the cat may show signs of severe pain and difficulty moving. Treatment focused on managing pain with medications like methadone and starting antithrombotic therapy with aspirin or clopidogrel to help prevent further clots. While the prognosis can be poor if multiple limbs are affected, cats with only one limb involved have a better chance of recovery.
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Abstract
PRACTICAL RELEVANCE: Feline arterial thromboembolism (ATE) is a common but devastating complication of myocardial disease, often necessitating euthanasia. A combination of endothelial dysfunction and blood stasis in the left atrium leads to local platelet activation and thrombus formation. Embolisation of the thrombus results in severe ischaemia of the affected vascular bed. With the classic 'saddle thrombus' presentation of thrombus in the terminal aorta, the diagnosis can usually be made by physical examination. The prognosis is poor for cats with multiple limbs affected by severe ischaemia, but much better where only one limb is affected or motor function is present. PATIENT GROUP: Cats with left atrial enlargement secondary to cardiomyopathy are typically predisposed, although cats with hyperthyroidism, pulmonary neoplasia and supravalvular mitral stenosis may also be at risk. MANAGEMENT: Analgesia is the main priority, and severe pain should be managed with methadone or a fentanyl constant rate infusion. Congestive heart failure (CHF) requires treatment with furosemide, but tachypnoea due to pain can mimic signs of CHF. Thrombolytic therapy is not recommended, but antithrombotic treatment should be started as soon as possible. Aspirin and clopidogrel are well tolerated. EVIDENCE BASE: Several observational studies of ATE have been reported. No randomised, blinded, controlled studies have been reported in cats at risk, for either treatment or prevention of ATE, although such a study comparing aspirin and clopidogrel in cats is currently under way.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/22736680/