Peer-reviewed veterinary case report
Clopidogrel and rivaroxaban blood clot treatment in cats
By Lo, Sara T et al.·Published in Journal of feline medicine and surgery·2022·William R Pritchard Veterinary Medical Teaching Hospital, United States·View original on PubMed →
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Original publication title: Dual therapy with clopidogrel and rivaroxaban in cats with thromboembolic disease.
- Species:
- cat
Plain-English summary
A group of cats with heart disease and a serious condition called arterial thromboembolism (ATE) were treated with two medications, clopidogrel and rivaroxaban, to prevent blood clots. Out of 32 cats, five experienced mild side effects like nosebleeds or blood in their stool, but none needed hospitalization. On average, these cats lived about 257 days after starting treatment, with those who had ATE in multiple limbs living even longer. The combination therapy was effective, as only a small number of cats had a recurrence of ATE while on the medications.
People also search for: cat heart disease treatment · cat blood clot prevention · clopidogrel rivaroxaban side effects · feline arterial thromboembolism management
Abstract
OBJECTIVES: Feline arterial thromboembolism (ATE), an often devastating outcome, was recently shown to affect 11.3% of cats with hypertrophic cardiomyopathy over 10 years. Current American College of Veterinary Internal Medicine guidelines recommend the use of clopidogrel in cats at risk for ATE, with addition of a factor Xa inhibitor in very high risk or post-ATE cases. To date, no studies have examined the safety or efficacy of this combined antithrombotic therapy. This retrospective case series aimed to assess the frequency and type of adverse events that occurred in cats prescribed dual clopidogrel and rivaroxaban therapy. Secondary aims were to evaluate indications for dual therapy and clinical outcome. METHODS: The study included 32 cats prescribed clopidogrel (18.75 mg PO q24h) and rivaroxaban (2.5 mg PO q24h) on an outpatient basis over a 5-year period. RESULTS: Cats were prescribed dual therapy for at least one of the following: ATE event (n = 18), presence of an intracardiac thrombi (n = 17) or presence of spontaneous echocardiographic contrast (SEC) (n = 16). Five cats experienced adverse effects that could be attributed to medications, a median of 13 days from initiation (epistaxis, hematemesis, hematochezia or hematuria). No cat required hospitalization as a result of these events. Median survival time from onset of therapy was 257 days (interquartile range [IQR] = 38-497) for all cats, 502 days (IQR = 171-663) for ATE cats, 725 days (IQR = 133-856) for cats with an ATE to two or more limbs and 301 days (IQR = 221-431) for cats with only one limb affected. Recurrence rate of ATE while on dual therapy was 16.7%; no cat newly developed an ATE while on dual therapy. CONCLUSIONS AND RELEVANCE: Dual antithrombotic therapy with clopidogrel and rivaroxaban resulted in a low reported incidence of adverse events. Cats placed on dual therapy for an ATE event experienced a low rate of recurrence and effective thromboprophylaxis was achieved in cats with intracardiac thrombi or SEC.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33966532/