Feline arterial thromboembolism

20: 173: 742: 365:. Aortic thrombosis does occasionally occur in dogs, but here the thrombi arise directly at the aortic branch; as a thromboembolic event, as in cats, they are extremely rare. There are also isolated case reports of thromboembolism in the domestic horse, whereas in other species they are of no practical significance. In laboratory animals used in human medical stroke research, thrombi are artificially generated. 722:. In addition, fentanyl is only effective for about 30 minutes, while levomethadone is effective for about 5 hours, based on data for dogs, which limits further treatment at home. Continuous drip infusion with the combination of fentanyl and lidocaine has been described. Lidocaine, in addition to its analgesic effect, also protects to some extent against damage caused by reopening of the occluded vessel ( 939:) for aortic thromboembolism is uncertain to poor. According to a U.S. study, only about one-third of cats survive arterial thromboembolism, with half of those who die being euthanized without attempted treatment. In a U.K. study, about 60% of patients were euthanized. Only 27% survived the first 24 hours. The median survival time was 94 days, and after one year only 2% of the animals were still alive. 907:) with a high level of personnel and equipment. Surgical removal of the thrombus is also rarely performed in veterinary medicine because of the associated risks, although it can be successful in individual cases. It is associated with the same complications as thrombolysis and is therefore no longer recommended. Therefore, the current focus is on endogenous dissolution of the clot and thus spontaneous 67:. Arterial thromboembolism occurs suddenly and is very painful. The blockage of the terminal portion of the aorta results in an undersupply of blood to the hind legs. The result is paralysis, cold hind extremities and later severe tissue damage. Rarely, other blood vessels are also affected; the symptoms of failure then depend on the supply area of the affected artery. Since drug 844:, where body temperature is normally measured in cats. Measurement in the axillary region or in the ear is unreliable. However, comparison between axillary and rectal temperature at least provides clues to distinguish between local and general undertemperature. In the case of the latter, an application of heat is indicated. 734:, does not have sufficient analgesic effect for initial treatment, at least not when there is total occlusion of both external iliac arteries. It can be used for continuing treatment at home, especially since it can be easily administered through the oral mucosa and has a duration of action of about 8 hours. 176:

Thrombus in the terminal branch of the aorta in a cat. 1 opened aorta with thrombus, 2 external iliac arteries, 3 common trunk of both internal iliac arteries, 4 circumflex ilium profunda, 5 mesenteric caudal artery, 6 descending colon. circumflexa ilium profunda, 5 A. mesenterica caudalis, 6 Colon

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Prognosis depends largely on the extent and duration of damage, with bilateral complete occlusions of the iliac arteries having the lowest chance of survival. If only one limb is affected and there is residual motor function, there is a better chance that the cat will recover and continue to live

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often occur due to a new thromboembolism, which even thromboprophylaxis cannot reliably prevent. In half of the patients, a new thromboembolism occurs despite treatment with clopidogrel. In addition, the extent of the heart disease, in particular the extent of atrial enlargement and the pumping

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In contrast, the prognosis is favorable for occlusion of smaller cerebral arteries. There is often a reduction in the signs of failure within two to three weeks, as other areas of the brain take over the function of the infarcted area. Occlusion of the brachial artery also has a good chance of

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recommend coagulation prophylaxis already in the presence of certain cardiac changes, i.e., before the occurrence of thromboembolism. For example, one study showed that a flow velocity in the left heart ear of less than 0.2 m/s was associated with the occurrence of thrombi and spontaneous

245:. As the clot matures, the fibrin content increases and the clot may exhibit stratification. Even in healthy animals, injuries to the endothelium occur spontaneously from time to time, but there is a balance between thrombus formation and breakdown. Substances such as 920: 353:(aortic bifurcation syndrome), which corresponds to the most common localization in cats, is extremely rare in humans. In domestic dogs, arterial thromboembolism occurs much less frequently than in cats; common underlying diseases in dogs are protein-losing 943:

with a good quality of life. If the internal body temperature is above 37.2 °C - the normal temperature in domestic cats is about 39 °C - the prospect of treatment is better than if the temperature is more severely below normal. Excess blood potassium (

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Other occlusions are much less common and the clinical presentation depends on the body part or organ affected. Occlusion of the brachial artery occurs predominantly on the right side and causes sudden paralysis of the forelimb. Thromboembolism of the

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Hogan, Daniel F. (2015). "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The double-blind, randomized, positive-controlled feline arterial thromboembolism; clopidogrel vs. aspirin trial (FAT CAT)".

477:, usually with a fatal outcome, and is therefore often no longer presented to a veterinarian at all, so that its frequency is possibly underestimated. Occlusion of renal or intestinal vessels causes severe abdominal pain ( 839:

The benefit of external heat application in cats with hypothermia is controversial. Often the anterior part of the body has a normal temperature and the undertemperature only affects the posterior part and thus also the

812:. Pimobendan also increases blood flow in the left atrium and heart ear to a small extent and additionally improves atrial function. On the other hand, if there is no congestive heart failure but reduced 54:

are affected. Heart disease is the most common underlying cause of arterial thromboembolism. It leads to the formation of blood clots in the heart, which leave it with the bloodstream and obstruct larger

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Feline arterial thromboembolism is a rare disease, accounting for approximately 0.1-0.3% of the total number of feline patients. The median age at onset of thromboembolism is 12 years (1 to 21 years).

926: 925: 922: 921: 927: 377:. The extent of further signs of the disease depends on the location of the clot and whether the vessel is completely or only partially blocked. Occlusion of the iliac arteries results in partial ( 983:

echocardiographic contrast (smoke). Spontaneous echocardiographic contrast is an aggregation of red blood cells and thus a thrombus precursor that resembles smoke on sonographic imaging. However,

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do not provide adequate pain relief and may increase circulatory disturbances in animals, causing renal or gastrointestinal damage. Only metamizole is suitable for subsequent further treatment.

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without attempted treatment, and only one-quarter to one-third of animals survive such an event. In about half of the recovered cats, thromboembolism recurs despite anticoagulation prophylaxis.

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Schober, Karsten E.; Maerz, Imke (2006). "Assessment of left atrial appendage flow velocity and its relation to spontaneous echocardiographic contrast in 89 cats with myocardial disease".

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In most cases, the diagnosis can already be made in the most common location (aortic thrombosis) based on the previous report and clinical signs (peracute posthand paralysis without

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can be used to visualize thrombi and their precursors in the heart and to assess the functional status of the heart. Loss of pulse at the femoral artery can also be detected by

469:) depends strongly on the vessel affected and thus on the area of the brain damaged. In most cases, there are unilateral neurological deficits. Occlusion of a coronary artery ( 265:

and nitric oxide inhibit platelet aggregation. Conservative treatment of arterial thromboembolism in cats is also based on this endogenous dissolution of the clot (see below).

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as another effective drug is also being discussed. A 2021 study was able to show that the combination of clopidogrel and rivaroxaban is an effective recurrence prophylaxis.

385:) of the hind extremities. In most cases, both hind legs are affected. The muscles are hardened and painful after about 10 hours, especially the lower leg muscles. The 141:, HCM). Up to 17% of cats with HCM experience arterial thromboembolism, but cats with other cardiomyopathies are also at increased risk. Cats with abnormally increased 71:

in cats does not achieve satisfactory results, the focus today is on the self-dissolution of the clot by the body's own repair processes. Accompanying pain therapy and

773:. For long-term prophylaxis, clopidogrel is preferably administered because it significantly prolongs survival compared with aspirin. The use of the active ingredient 493: 899:, so that the survival rate is often lower than with conservative treatment. In human medicine, such treatments are only performed in highly specialized facilities ( 169:, represent another risk group. There is an increased genetic predisposition in male cats, which is related to the higher incidence of heart disease in male cats. 1130:

Smith, Stephanie A. (2003). "Arterial thromboembolism in cats: acute crisis in 127 cases (1992–2001) and long-term management with low-dose aspirin in 24 cases".

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is not known, as it is very rare. Anecdotal reports indicate that cats can survive such an event and lung function can return to normal with formation of

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should continue to exclude primarily trauma to the spinal cord (traffic accident, window fall), which may be due to an event not observed by the owner. A

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are performed and the underlying disease is treated. The mortality of arterial thromboembolism in cats is very high. Fifty to 60% of affected animals are

622:). However, all laboratory values are not specific for arterial thromboembolism and play only a minor role in confirming the diagnosis. Determination of 634:(T4) concentration in the blood is useful for detecting hyperthyroidism; hyperthyroidism was not previously known in 1.7% of cats with thromboembolism. 50:. Relative to the total number of feline patients, the disease is rare, but relatively common in cats with heart disease: about one-sixth of cats with 560:

of this method is between 80 and 90 %, the specificity is 100 %. A thromboembolism of the lung often remains undetected; in this case, a

345:, acute lower limb ischemia) are displaced. Less frequently, thromboembolism of the vessels of the arm, upper mesenteric artery or renal arteries ( 397:

is markedly decreased or absent in 78% of cases. The paws are cold and especially the area of the claws and pads often show bluish discoloration (

2116:"Evaluation of point-of-care thoracic ultrasound and NT-proBNP for the diagnosis of congestive heart failure in cats with respiratory distress" 166: 276:. In cats, this occurs predominantly in the aorta in the area of its terminal branch, i.e., at the outlet of the two external iliac arteries ( 3100: 3082: 2884:"Risk factors associated with sudden death vs. congestive heart failure or arterial thromboembolism in cats with hypertrophic cardiomyopathy" 2347: 2296: 1972: 1738: 923: 718:

being the most effective. However, both agents are not approved for use in cats in the EU and must therefore be redirected in the sense of a

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In cats, the blood clots originate mainly in the left atrial auricle. They or parts of them are carried along with the blood flow, enter the

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FATE syndrome develops in approximately 70% of cases as a result of heart disease, most commonly heart disease with cardiac wall thickening (

646:). Existing cardiac disease provides further clues, but cardiac disease is already known in only about 15% of cats with thromboembolism. 753:, is the second important pillar of FATE treatment. It should be carried out as early as possible. For this purpose, agents to inhibit 800:

and thus unload the heart. In advanced heart disease with ventricular dilatation (DCM) or heart disease with cardiac wall thickening (

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of simultaneous occlusion of several vessels with paralysis of all limbs or of cerebellum and kidneys with severe balance disorders.

3048: 1664: 872: 660:, can usually be ruled out by questioning the animal's owner. In addition, tilt window syndrome is not associated with severe pain. 254: 2338:

Wolfgang Löscher (2006), Wolfgang Löscher, Fritz Rupert Ungemach und Reinhard Kroker (ed.), "Vollsynthetische Morphinabkömmlinge",

302:, which contributes to the high painfulness of the disease. Only in 10% of cases are other blood vessels affected, for example the 699:

Treatment of arterial thromboembolism in cats consists of pain management, prevention of further clot formation, and treatment of

557: 2749:"Thrombolysis with tissue plasminogen activator (TPA) in feline acute aortic thromboembolism: a retrospective study of 16 cases" 2493: 2079:

Pouchelon, J. L. (1997). "Diagnosis of pulmonary thromboembolism in a cat using echocardiography and pulmonary scintigraphy".

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and a "gallop rhythm" - a sequence of heart sounds reminiscent of a galloping horse. Up to two-thirds of FATE patients are in

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Peterson, M. E.; Aucoin, D. P. (1993). "Comparison of disposition of carbimazole and methimazole in clinically normal cats".

594:(AST) are elevated due to the death of muscle cells in the blood. If cardiac disease is present, which is often the case, 2680: