Saddle thrombus in cats causing sudden hind leg paralysis and pain

Abstract

Feline Arterial Thromboembolism (FATE) is one of the leading causes of sudden-onset hindlimb paralysis in cats and is often the first clinical sign of an underlying, subclinical cardiac disease. This review aims to evaluate the clinical significance of thromboembolic events, particularly those involving the aortic bifurcation, commonly referred to as “saddle thrombus.” Saddle thrombus typically occurs when thrombi formed in the left atrium, usually due to conditions such as hypertrophic cardiomyopathy (HCM), enter the systemic circulation and obstruct the iliac arteries at their bifurcation. Affected cats present with dramatic clinical signs, including sudden pain, cold extremities, and paralysis. Diagnosis is primarily based on physical examination findings and is supported by Doppler ultrasonography and echocardiographic imaging. Treatment involves anticoagulant medications, analgesics, supportive therapies, and management of the underlying cardiac condition. This review provides a comprehensive overview of the pathogenesis, clinical progression, diagnostic methods, differential diagnoses, and current treatment strategies related to FATE. Rapid diagnosis and appropriate clinical intervention play a critical role in determining both the survival time and quality of life of affected patients.