Peer-reviewed veterinary case report
How clopidogrel and rivaroxaban together affect cat blood clotting
By Lo, Sara T et al.·Published in Journal of veterinary internal medicine·2023·University of California Davis School of Veterinary Medicine, United States·View original on PubMed →
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Original publication title: Synergistic inhibitory effects of clopidogrel and rivaroxaban on platelet function and platelet-dependent thrombin generation in cats.
- Species:
- cat
Plain-English summary
A group of nine healthy 1-year-old cats was tested to see how well a combination treatment of clopidogrel and rivaroxaban worked to reduce platelet activation, which can lead to blood clots. The cats received each treatment for a week, and the results showed that the combination treatment significantly lowered the number of activated platelets and improved their response to certain triggers compared to using either medication alone. Importantly, none of the cats experienced any side effects from the treatments. This suggests that using both medications together could be a safer and more effective option for managing blood clot risks in cats with heart issues.
People also search for: cat blood clot treatment · clopidogrel rivaroxaban for cats · cat heart disease medication
Abstract
BACKGROUND: Dual antithrombotic treatment (DAT) with clopidogrel and rivaroxaban sometimes is prescribed to cats with hypertrophic cardiomyopathy at risk of thromboembolism. To date, no studies have evaluated their combined effects on platelet function. OBJECTIVES/HYPOTHESIS: Evaluate the safety of DAT in healthy cats and compare, ex vivo, platelet-dependent thrombin generation and agonist-induced platelet activation and aggregation in cats treated with clopidogrel, rivaroxaban, or DAT. We hypothesized that DAT would safely modulate agonist-induced platelet activation and aggregation more effectively than single agent treatment. ANIMALS: Nine apparently healthy 1-year-old cats selected from a research colony. METHODS: Unblinded, nonrandomized ex vivo cross-over study. All cats received 7 days of rivaroxaban (0.6 ± 0.1 mg/kg PO), clopidogrel (4.7 ± 0.8 mg/kg PO), or DAT with defined washout periods between treatments. Before and after each treatment, adenosine diphosphate (ADP)- and thrombin-induced platelet P-selectin expression was evaluated using flow cytometry to assess platelet activation. Platelet-dependent thrombin generation was measured by fluorescence assay. Platelet aggregation was assessed using whole blood impedance platelet aggregometry. RESULTS: No cats exhibited adverse effects. Of the 3 treatments, only DAT significantly decreased the number of activated platelets (P = .002), modulated platelet activation in response to thrombin (P = .01), dampened thrombin generation potential (P = .01), and delayed maximum reaction velocity (P = .004) in thrombin generation. Like clopidogrel, DAT inhibited ADP-mediated platelet aggregation. However, rivaroxaban alone resulted in increased aggregation and activation in response to ADP. CONCLUSION AND CLINICAL IMPORTANCE: Treatment combining clopidogrel and rivaroxaban (DAT) safely decreases platelet activation, platelet response to agonists, and thrombin generation in feline platelets more effectively than monotherapy with either clopidogrel or rivaroxaban.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37208839/