Peer-reviewed veterinary case report
Treatment of sudden aortic blood clots in cats with tissue
By Guillaumin, Julien et al.·Published in Journal of feline medicine and surgery·2022·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism.
- Species:
- cat
Plain-English summary
A group of cats with a serious condition called feline aortic thromboembolism (FATE), which causes blood clots that can affect their limbs, was treated with a medication called tissue plasminogen activator (TPA) to see if it would help. While both the TPA and placebo groups showed some improvement in limb function after 48 hours, the survival rates were similar, with 45% of the TPA group and 30% of the placebo group surviving to discharge. Unfortunately, the study found that TPA did not significantly improve survival rates, and complications like kidney injury were similar in both groups.
People also search for: cat blood clot treatment · feline aortic thromboembolism symptoms · TPA for cats · cat limb problems · cat survival rates after thromboembolism
Abstract
OBJECTIVES: The aim of this study was to investigate the impact of tissue plasminogen activator (TPA) on the treatment of feline aortic thromboembolism (FATE). METHODS: Cats diagnosed with FATE involving ⩾2 limbs were enrolled in a prospective, multicenter, double-blinded, randomized, placebo-controlled study within 6 h of an event. Diagnosis was made by clinical findings and one confirmatory criterion. Cats received placebo or TPA (1 mg/kg/h with the first 10% by bolus). All cats received pain control and thromboprophylaxis. The primary outcome was a change from baseline in a published limb score at 48 h. Secondary outcomes included 48 h survival, survival to discharge and complication proportions. Statistical analyses included pattern-mixture models, logistic regression and Fisher's exact, Student's- and Mann-Whitney-Wilcoxon tests. RESULTS: Based on a power analysis, 40 cats were enrolled; however, only 20 survived to 48 h (TPA, n = 12; placebo, n = 8 [ = 0.34]). There was a statistically significant improvement in limb scores compared with baseline for both groups (<0.001). Limb score at 48 h was 1 point lower (better) in the TPA group ( = 0.19). Thrombolysis had no statistically significant effect on 48 h survival ( = 0.22). Lower affected limb lactate was associated with better 48 h survival (odds ratio 1.53, 95% confidence interval 1.08-2.17; = 0.02). The survival to discharge rates were 45% (TPA) and 30% (placebo; = 0.51). Complications in the TPA and placebo groups included acute kidney injury (22% and 19%, respectively; = 1.00) and/or reperfusion injuries (33% and 19%, respectively; = 0.45). CONCLUSIONS AND RELEVANCE: Survival and complication rates of acute FATE were not different with or without thrombolysis. High in-hospital mortality decreased the statistical power to detect a statistically significant difference between treatments with regard to our primary outcome.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36350753/