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Guillaumin J. Feline Aortic Thromboembolism: Recent advances and future prospects. J Feline Med Surg 2024; 26:1098612X241257878. [PMID: 38857617 DOI: 10.1177/1098612x241257878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
PRACTICAL RELEVANCE Feline aortic thromboembolism (FATE) is commonly encountered in clinical medicine, especially in emergency situations. This often devastating syndrome usually develops secondarily to severe heart disease, and has short- and long-term consequences. CLINICAL FEATURES The clinical presentation of FATE is consistent with peripheral ischemic neuropathy, usually in both pelvic limbs. Diagnosis is relatively straightforward, but can be assisted with Doppler ultrasound, point-of-care ultrasound or infrared thermal imaging. RECENT ADVANCES AND FUTURE PROSPECTS Interpretation of survival rates in cats with FATE has been hampered by historically high admission euthanasia, but recent studies suggest a survival rate with supportive care of 30-40%. Moreover, with advances in post-FATE thromboprophylaxis, median survival times of over 1 year are being achieved. Future directions include use of thrombolytic agents and treatment of common FATE sequelae such as acute kidney injury and reperfusion injury. OUTLINE This article, aimed at small animal veterinarians, including emergency practitioners, reviews key aspects of the clinical presentation, diagnosis and treatment options for FATE, with a view to guiding client and veterinarian decision-making. Three case studies are included to illustrate the practical application of information presented in the review. EVIDENCE BASE There are limited prospective studies on FATE, although the recent literature reflects a resurgence in clinical research interest in the past few years. Advances in FATE treatment will benefit many cats and it is important that research efforts continue to identify appropriate treatment modalities.
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Affiliation(s)
- Julien Guillaumin
- DVM, Dip ACVECC, Dip ECVECC Emergency and Critical Care, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Tosuwan J, Surachetpong SD, Hunprasit V. Assessment of left atrial myocardial deformation using two-dimensional speckle-tracking echocardiography in cats with cardiogenic and non-cardiogenic arterial thromboembolism. Int J Vet Sci Med 2023; 11:11-22. [PMID: 37025927 PMCID: PMC10071954 DOI: 10.1080/23144599.2023.2196853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Arterial thromboembolism (ATE) in cats usually relates to cardiogenic causes that can be diagnosed by conventional echocardiography. Two-dimensional speckle-tracking echocardiography (2D-STE) is a new ultrasound modality with higher sensitivity. Our objective was to investigate left atrial myocardial deformation in cats with both cardiogenic and non-cardiogenic ATE and normal cats using 2D-STE. Twenty-three normal cats and 21 cats with ATE cats were recruited and performed conventional echocardiography and 2D-STE. From the results, left atrial (LA) strain and strain rate from 2D-STE were significantly decreased in cats with cardiogenic ATE (P < 0.001), but there was no significant difference in non-cardiogenic ATE compared with normal cats. From the correlation test, the use of left atrial strain during the reservoir phase (LASr) could represent the overall LA deformation. The intra- and inter-observer coefficient of variation of LASr was less than 15%. The logistic regression revealed that the LASr value of less than 11% was a significant factor for the occurrence of ATE (odd ratio = 189.0, P < 0.001). In conclusion, LASr derived by 2D-STE is a repeatable and non-invasive technique to assess LA myocardial deformation in cats with ATE. By 2D-STE, impaired LA function was detected in cats with cardiogenic ATE. LASr < 11% may use as a predictor of the risk of ATE occurrence in cats.
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Lee H, Lee D, Kim S, Koo Y, Chae Y, Yun T, Yang MP, Kim S, Kang BT, Kim H. Case report: Evaluation of hindlimb ischemia using 18F-fluorodeoxyglucose positron emission tomography in a cat with cardiogenic arterial thromboembolism. Front Vet Sci 2023; 10:1223866. [PMID: 37745211 PMCID: PMC10511747 DOI: 10.3389/fvets.2023.1223866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
A 12-year-old castrated male domestic shorthair cat weighing 6.7 kg presented with acute hindlimb paralysis and tachypnea. The femoral pulse was absent bilaterally. Thoracic radiography showed finding compatible with cardiogenic pulmonary edema. Echocardiography revealed hypertrophic cardiomyopathy phenotype and a spontaneous echocardiographic contrast in the left atrium, suggesting cardiogenic arterial thromboembolism. Oxygen supplementation, diuretics, and antithrombotic and thrombolytic agents were also administered. However, hindlimb motor function was not restored. Severely increased aspartate aminotransferase and creatinine phosphokinase, as well as neutropenia with a degenerative left shift were identified, and amputation was considered to prevent sepsis caused by necrosis of the ischemic tissues. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography was performed to evaluate the metabolic activity of the muscle tissues and determine the level of amputation. There was no 18F-FDG uptake in the extremities of either the hind limbs or the caudal parts of the bilateral femoral muscle mass, suggesting a loss of metabolic activity in the area. Considering the wide affected area, a decreased quality of life was predicted postoperatively, and the cat was euthanized at the owner's request. Postmortem muscle biopsy confirmed weak atrophy of the left femoral muscle and prominent atrophy of the right calf. This case report describes the use of 18F-FDG PET in a cat with ischemia caused by cardiogenic arterial thromboembolism.
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Affiliation(s)
- Hyeongyeong Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Dohee Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Sanggu Kim
- Laboratory of Veterinary Pathology and Platelet Signaling, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Yoonhoi Koo
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Yeon Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Taesik Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Mhan-Pyo Yang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Soochong Kim
- Laboratory of Veterinary Pathology and Platelet Signaling, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Byeong-Teck Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Hakhyun Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
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Galer J, Ibarrola P, Royaux E. Polyneuropathy and primary erythrocytosis in a cat. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Jack Galer
- Davies Veterinary Specialists Hitchin UK
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Tindale C, Cinti F, Cantatore M, Freeman A, Cavaliere L, Vallefuoco R, Rossanese M. Clinical characteristics and long-term outcome of lung lobe torsions in cats: a review of 10 cases (2000-2021). J Feline Med Surg 2022; 24:1072-1080. [PMID: 34719995 PMCID: PMC10812318 DOI: 10.1177/1098612x211054816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
CASE SERIES SUMMARY Lung lobe torsion is rare in cats. The aim of this multi-institution retrospective study was to describe clinical and diagnostic findings, treatments and outcomes of lung lobe torsion (LLT) in 10 cats. Dyspnoea and tachypnoea were the most common clinical signs. Pleural effusion was present in nine cats at presentation. Fluid analysis confirmed chylothorax in three cats. Nine cats underwent CT and five cats had thoracic radiographs taken. A diagnosis was made preoperatively in six cats, while in the other four cats it was made at exploratory thoracotomy. Affected lung lobes were the right cranial (n = 4/11), left cranial (n = 4/11) and right middle (n = 3/11). One cat had a concurrent torsion of two lung lobes. Lung lobectomy was successfully performed in all cases. Based on clinical, diagnostic and lung histopathology findings, three cats had idiopathic and seven cats secondary LLT. Intraoperative complications included hypotension and hypothermia in four and five cats, respectively. Postoperative complications occurred in six cats and lead to euthanasia or death in four cats, whereas complications resolved in the other two cats. Three cats were euthanased within 5 weeks of discharge. For the three cats surviving long term, including one euthanased at 252 days postoperatively, owner-described outcomes and quality of life were considered good to excellent. RELEVANCE AND NOVEL INFORMATION Secondary LLT associated with underlying thoracic pathology was associated with high complication rates and poor outcomes. Long-term outcomes of cats undergoing surgery for LLT and surviving the perioperative period were deemed good to excellent.
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Affiliation(s)
- Catherine Tindale
- The Royal Veterinary College Department of Clinical Science and Services, Hatfield, UK
| | - Filippo Cinti
- Apuana-AniCura Veterinary Clinic, Marina di Carrara (MS), Italy
| | | | - Alistair Freeman
- University of Liverpool Small Animal Teaching Hospital, Liverpool, UK
| | | | | | - Matteo Rossanese
- The Royal Veterinary College Department of Clinical Science and Services, Hatfield, UK
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Zoia A, Drigo M, Caldin M, Simioni P, Piek CJ. Fibrinolysis in Dogs with Intracavitary Effusion: A Review. Animals (Basel) 2022; 12:ani12192487. [PMID: 36230236 PMCID: PMC9558497 DOI: 10.3390/ani12192487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary In blood vessels there is a balance between clot formation and its dissolution. Fibrinolysis normally allows the breakdown of blood clots during the healing of injured blood vessels. This process is mediated by the activation of a blood enzyme (plasmin) which breaks down a meshed protein (fibrin) which holds blood clots at the site of the vessel injury. In some diseases, the activation of plasmin becomes excessive, leading to bleeding tendencies (hyperfibrinolysis). Under normal conditions, abdominal and thoracic cavities are filled with a small amount of fluid deriving from the blood. The results of recent studies have shown that, in dogs, all types of pathologic intracavitary fluids have an increased fibrinolytic activity. This increased fibrinolytic activity is also present in their blood, in some cases reaching a hyperfibrinolytic state. Hyperfibrinolysis and bleeding tendencies have also been documented in cardiopathic dogs with ascites. The latter result is surprising considering that thrombotic events are commonly documented in humans and cats with some cardiac diseases. Abstract Physiologic fibrinolysis is a localized process in which stable fibrin strands are broken down by plasmin in response to thrombosis. Plasmin activation can also take place separately from the coagulation process, resulting in pathologic fibrinolysis. When plasmin activation exceeds the neutralizing capacity of plasmin inhibitors, severe bleeding can potentially take place. Although the processes which regulate coagulation and fibrinolysis in the blood are well known, it is less clear as to what extent the same processes take place in the body cavities and whether they influence systemic hemostasis. The results of the studies herein cited demonstrate that coagulation followed by fibrinogenolytic/fibrinolytic activity takes place in all kinds of canine ascitic and pleural fluids. Moreover, systemic clotting abnormalities suggesting primary fibrinolysis/primary hyperfibrinolysis (i.e., elevated plasma fibrin/fibrinogen degradation products [FDPs] and normal D-dimer concentrations with fibrinogen concentrations ≤ 100 mg/dL or above this cut-off, respectively) occur in dogs with intracavitary effusion. Enhanced fibrinolytic activity in dogs with intracavitary effusion can also be detected using rotational thromboelastometry (ROTEM), although the degree of agreement between ROTEM and FDPs, D-dimer and fibrinogen concentrations is poor. Finally, contrary to the thrombotic events commonly documented in some humans and cats with cardiac diseases, bleeding tendencies due to primary fibrinolysis/primary hyperfibrinolysis have been documented in dogs with cardiogenic ascites.
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Affiliation(s)
- Andrea Zoia
- Division of Internal Medicine, San Marco Veterinary Clinic, Viale dell’Industria 3, 35030 Veggiano, Italy
- Correspondence: ; Tel.: +39-049-8561098
| | - Michele Drigo
- Department of Medicina Animale, Produzione e Salute, Padua University, Viale dell’Università 16, 35020 Legnaro, Italy
| | - Marco Caldin
- Laboratorio d’Analisi Veterinarie San Marco, Viale dell’Industria 3, Veggiano, 35030 Padua, Italy
| | - Paolo Simioni
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua Medical School, Via Giustiniani 2, 35128 Padua, Italy
| | - Christine J. Piek
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, 8 Heidelberglaan, 3584 CS Utrecht, The Netherlands
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Busato F, Drigo M, Zoia A. Reduced risk of arterial thromboembolism in cats with pleural effusion due to congestive heart failure. J Feline Med Surg 2022; 24:e142-e152. [PMID: 35549930 PMCID: PMC10812273 DOI: 10.1177/1098612x221094663] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of the study was to determine whether cardiogenic pleural effusion in cats is associated with a lower risk of arterial thromboembolism (ATE) compared with cats with cardiac disease without evidence of pleural effusion. METHODS A cross-sectional study was conducted on owned cats with natural occurring cardiac diseases. Cats included were classified in three groups: those with cardiac disease but no evidence of congestive heart failure (CHF); those with evidence of cardiogenic pulmonary oedema; and those with evidence of cardiogenic pleural effusion. Prevalence of ATE was calculated and the variables analysed for an association with this outcome were the presence and type of CHF, sex and neuter status, age, breed, type of cardiac diseases and left atrial (LA) dimension. A multivariable logistic regression model was used to fit the association between ATE and these variables. RESULTS A total of 366 cats with cardiac disease met the inclusion criteria: 179 were included in the group with cardiac disease but no evidence of CHF, 66 in the group with evidence of cardiogenic pulmonary oedema and 121 in the group with evidence of cardiogenic pleural effusion. Prevalence of ATE (58/366 [15.8%]) was significantly different among groups (with no evidence of CHF, 28/179 [15.6%]; with evidence of cardiogenic pulmonary oedema, 22/66 [33.3%]; with evidence of cardiogenic pleural effusion, 8/121 [6.6%]; P <0.001). Cats with ATE had a significantly higher LA to aortic root ratio (2.30 ± 0.46) than those without ATE (2.04 ± 0.46; P <0.001). Multivariable logistic regression analysis indicated that the group with evidence of cardiogenic pleural effusion was associated with a lower risk of developing ATE compared with groups with cardiac disease but no evidence of CHF and with evidence of cardiogenic pulmonary oedema (P = 0.005 and P <0.001, respectively). CONCLUSIONS AND RELEVANCE Presence of cardiogenic pleural effusion is associated with a lower risk of developing ATE, while LA enlargement is a risk factor for ATE.
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Affiliation(s)
- Francesca Busato
- Division of Internal Medicine, San Marco Veterinary Clinic, Veggiano (PD), Italy
| | - Michele Drigo
- Department of Medicina Animale, Produzione e Salute, Padua University, Legnaro (PD), Italy
| | - Andrea Zoia
- Division of Internal Medicine, San Marco Veterinary Clinic, Veggiano (PD), Italy
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Lee M, Ko M, Ahn J, Ahn J, Yu J, Chang J, Oh S, Chang D. Evaluation of the Abdominal Aorta and External Iliac Arteries Using Three-Dimensional Time-of-Flight, Three Dimensional Electrocardiograph-Gated Fast Spin-Echo, and Contrast-Enhanced Magnetic Resonance Angiography in Clinically Healthy Cats. Front Vet Sci 2022; 9:819627. [PMID: 35782562 PMCID: PMC9249124 DOI: 10.3389/fvets.2022.819627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/11/2022] [Indexed: 11/14/2022] Open
Abstract
Arterial thromboembolism is associated with high morbidity and mortality rates in cats. Definitive diagnosis requires advanced imaging modalities, such as computed tomography angiography (CTA) and contrast-enhanced (CE) magnetic resonance angiography (MRA). However, CTA involves exposure to a large amount of ionized radiation, and CE-MRA can cause systemic nephrogenic fibrosis. Non-contrast-enhanced (NE) MRA can help accurately diagnose vascular lesions without such limitations. In this study, we evaluated the ability of NE-MRA using three-dimensional electrocardiograph-gated fast spin-echo (3D ECG-FSE) and 3D time-of-flight (3D TOF) imaging to visualize the aorta and external iliac arteries in clinically healthy cats and compared the results with those obtained using CE-MRA. All 11 cats underwent 3D ECG-FSE, 3D TOF, and CE-MRA sequences. Relative signal intensity (rSI) for quantitative image analysis and image quality scores (IQS) for qualitative image analysis were assessed; the rSI values based on the 3D TOF evaluations were significantly lower than those obtained using 3D ECG-FSE (aorta 3D TOF: 0.57 ± 0.06, aorta 3D ECG-FSE: 0.83 ± 0.06, P < 0.001; external iliac arteries 3D TOF: 0.45 ± 0.06, external iliac arteries 3D ECG-FSE:0.80 ± 0.05, P < 0.001) and similar to those obtained using CE-MRA (aorta: 0.58 ± 0.05, external iliac arteries: 0.57 ± 0.03). Moreover, IQS obtained using 3D TOF were significantly higher than those obtained using 3D ECG-FSE (aorta 3D TOF: 3.95 ± 0.15, aorta 3D ECG-FSE: 2.32 ± 0.60, P < 0.001; external iliac arteries 3D ECG-FSE: 3.98 ± 0.08, external iliac arteries 3D ECG-FSE: 2.23 ± 0.56, P < 0.001) and similar to those obtained using CE-MRA (aorta: 3.61 ± 0.41, external iliac arteries: 3.57 ± 0.41). Thus, 3D TOF is more suitable and produces consistent image quality for visualizing the aorta and external iliac arteries in clinically healthy cats and this will be of great help in the diagnosis of FATE.
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Affiliation(s)
- Minju Lee
- Section of Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Minjung Ko
- Section of Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jisoo Ahn
- Section of Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jiyoung Ahn
- Section of Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jin Yu
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Jinhwa Chang
- Korea Animal Medical Center, Cheongju, South Korea
| | - Sukhoon Oh
- Bio-Chemical Analysis Team, Korea Basic Science Institute, Daejeon, South Korea
| | - Dongwoo Chang
- Section of Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
- *Correspondence: Dongwoo Chang
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van Renen J, Fischer A, Kolb N, Wielaender F, Zablotski Y, Nessler J, Tipold A, Cappello R, Flegel T, Loderstedt S, Gnirs K, Rentmeister K, Rupp S, von Klopmann T, Steffen F, Jurina K, Del Vecchio OV, Deutschland M, König F, Gandini G, Harcourt-Brown T, Kornberg M, Bianchi E, Gagliardo T, Menchetti M, Schenk H, Tabanez J, Matiasek K, Rosati M. Clinical Course and Diagnostic Findings of Biopsy Controlled Presumed Immune-Mediated Polyneuropathy in 70 European Cats. Front Vet Sci 2022; 9:875657. [PMID: 35664840 PMCID: PMC9156799 DOI: 10.3389/fvets.2022.875657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
There is a paucity of information on the clinical course and outcome of young cats with polyneuropathy. The aim of the study was to describe the clinical features, diagnostic investigations, and outcome of a large cohort of cats with inflammatory polyneuropathy from several European countries. Seventy cats with inflammatory infiltrates in intramuscular nerves and/or peripheral nerve biopsies were retrospectively included. Information from medical records and follow up were acquired via questionnaires filled by veterinary neurologists who had submitted muscle and nerve biopsies (2011–2019). Median age at onset was 10 months (range: 4–120 months). The most common breed was British short hair (25.7%), followed by Domestic short hair (24.3%), Bengal cat (11.4%), Maine Coon (8.6%) and Persian cat (5.7%), and 14 other breeds. Male cats were predominantly affected (64.3%). Clinical signs were weakness (98.6%) and tetraparesis (75.7%) in association with decreased withdrawal reflexes (83.6%) and, less commonly, cranial nerve signs (17.1%), spinal pain/hyperesthesia (12.9%), and micturition/defecation problems (14.3%). Onset was sudden (30.1%) or insidious (69.1%), and an initial progressive phase was reported in 74.3%. Characteristic findings on electrodiagnostic examination were presence of generalized spontaneous electric muscle activity (89.6%), decreased motor nerve conduction velocity (52.3%), abnormal F-wave studies (72.4%), pattern of temporal dispersion (26.1%) and unremarkable sensory tests. The clinical course was mainly described as remittent (49.2%) or remittent-relapsing (34.9%), while stagnation, progressive course or waxing and waning were less frequently reported. Relapses were common and occurred in 35.7% of the cats' population. An overall favorable outcome was reported in 79.4% of patients. In conclusion, young age at the time of diagnosis and sudden onset of clinical signs were significantly associated with recovery (p < 0.05). Clinical and electrodiagnostic features and the remittent-relapsing clinical course resembles juvenile chronic inflammatory demyelinating polyneuropathy (CIDP), as seen in human (children/adolescents), in many aspects.
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Affiliation(s)
- Jana van Renen
- Neurology Service, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Andrea Fischer
- Neurology Service, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Ninja Kolb
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Franziska Wielaender
- Neurology Service, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Yury Zablotski
- Clinic for Ruminants With Ambulatory and Herd Health Services, Ludwig-Maximilians Universität München, Munich, Germany
| | - Jasmin Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rodolfo Cappello
- North Downs Specialist Referrals, The Brewerstreet Dairy Business Park, Bletchingley, United Kingdom
| | - Thomas Flegel
- Small Animal Department, University of Leipzig, Leipzig, Germany
| | | | - Kirsten Gnirs
- Section of Neurology and Neurosurgery, Advetia Clinic for Small Animal Medicine, Paris, France
| | - Kai Rentmeister
- Specialty Practice for Veterinary Neurology and Neurosurgery, Dettelbach, Germany
| | | | | | - Frank Steffen
- Neurology Service, Department of Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | | | | | - Gualtiero Gandini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Tom Harcourt-Brown
- Langford Veterinary Services, School of Veterinary Sciences, University of Bristol, Lower Langford, United Kingdom
| | | | - Ezio Bianchi
- Department of Veterinary Science, University of Parma, Parma, Italy
| | | | - Marika Menchetti
- Neurology and Neurosurgery Division, San Marco Veterinary Clinic, Veggiano, Italy
| | | | - Joana Tabanez
- Neurology Section, Fitzpatrick Referrals, Godalming, United Kingdom
| | - Kaspar Matiasek
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Marco Rosati
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universität München, Munich, Germany
- *Correspondence: Marco Rosati
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10
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Ruehl M, Lynch AM, O'Toole TE, Morris B, Rush J, Couto CG, Hmelo S, Sonnenshein S, Butler A, Guillaumin J. Outcome and treatments of dogs with aortic thrombosis: 100 cases (1997-2014). J Vet Intern Med 2020; 34:1759-1767. [PMID: 33463770 PMCID: PMC7517508 DOI: 10.1111/jvim.15874] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 01/30/2023] Open
Abstract
Background Aortic thrombosis (ATh) is an uncommon condition in dogs, with limited understanding of risks factors, outcomes, and treatments. Objectives/Hypothesis To describe potential risk factors, outcome, and treatments in dogs with ATh. Animals Client‐owned dogs with a diagnosis of ATh based on ultrasonographic or gross necropsy examination. Method Multicentric retrospective study from 2 academic institutions. Results One hundred dogs were identified. Anti‐thrombin diagnosis, 35/100 dogs were nonambulatory. The dogs were classified as acute (n = 27), chronic (n = 72), or unknown (n = 1). Fifty‐four dogs had at least one comorbidity thought to predispose to ATh, and 23 others had multiple comorbidities. The remaining 23 dogs with no obvious comorbidities were classified as cryptogenic. Concurrent illnesses potentially related to the development of ATh included protein‐losing nephropathy (PLN) (n = 32), neoplasia (n = 22), exogenous corticosteroid administration (n = 16), endocrine disease (n = 13), and infection (n = 9). Dogs with PLN had lower antithrombin activity than those without PLN (64% and 82%, respectively) (P = .04). Sixty‐five dogs were hospitalized with 41 subsequently discharged. Sixteen were treated as outpatient and 19 euthanized at admission. In‐hospital treatments varied, but included thrombolytics (n = 12), alone or in combination with thrombectomy (n = 9). Fifty‐seven dogs survived to discharge. Sixteen were alive at 180 days. Using regression analysis, ambulation status at the time of presentation was significantly correlated with survival‐to‐discharge (P < .001). Conclusions/Clinical Importance Dogs with ATh have a poor prognosis, with nonambulatory dogs at the time of presentation having worse outcome. Although the presence of comorbid conditions associated with hypercoagulability is common, an underlying cause for ATh was not always identified.
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Affiliation(s)
| | - Alex M Lynch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Therese E O'Toole
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - Bari Morris
- VCA Shoreline Veterinary Referral and Emergency Center, Shelton, Connecticut, USA
| | - John Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | | | | | | | - Amy Butler
- Critical Consults, LLC, Pittsburgh, Pennsylvania, USA
| | - Julien Guillaumin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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11
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Malkawi M, Woolcock AD, Lee PM, Court MH, Moore GE, Hogan DF. Comparison of metabolomics and platelet aggregometry between Plavix and generic clopidogrel in cats: a pilot study. J Feline Med Surg 2019; 21:951-958. [PMID: 30427274 PMCID: PMC11132235 DOI: 10.1177/1098612x18810887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This pilot study sought to assess the metabolism of Plavix (Bristol-Myers Squibb/Sanofi) and generic clopidogrel in cats, using a novel assay for the measurement of clopidogrel, clopidogrel carboxylic acid (CCA) and clopidogrel active metabolite (CAM-D). METHODS This was a prospective, randomized, double-blind study. Four healthy, skeletally mature cats were enrolled into the study. There were two treatment phases during which cats received either Plavix or generic clopidogrel at a dosage of 18.75 mg PO q24h for 7 days with a 2 week washout between phases. During each phase, plasma concentrations of parent drug and active and inactive metabolites were measured along with impedance platelet aggregometry in response to adenosine diphosphate (ADP). RESULTS The ratio of CAM-D between generic clopidogrel and Plavix was 0.83 (equivalence reference 1.00, 90% confidence interval 0.80-1.25). Inhibition of ADP-induced platelet aggregation was variable, with two cats classified as non-responders in both treatment phases. The concentrations of CAM-D were not predictive of aggregometry-based responsiveness to either formulation of clopidogrel. CONCLUSIONS AND RELEVANCE This is the first study comparing Plavix and generic clopidogrel in cats. Administration of the generic formulation resulted in comparable plasma concentrations of clopidogrel active metabolite when compared with Plavix.
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Affiliation(s)
- Mays Malkawi
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Andrew D Woolcock
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Pamela M Lee
- Program in Individualized Medicine (PriMe), Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Michael H Court
- Program in Individualized Medicine (PriMe), Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - George E Moore
- Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Daniel F Hogan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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Interventional Radiology Management of Vascular Obstruction. Vet Clin North Am Small Anim Pract 2018; 48:819-841. [DOI: 10.1016/j.cvsm.2018.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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13
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Vititoe KP, Fries RC, Joslyn S, Selmic LE, Howes M, Vitt JP, O'Brien RT. Detection of intra-cardiac thrombi and congestive heart failure in cats using computed tomographic angiography. Vet Radiol Ultrasound 2018; 59:412-422. [PMID: 29659090 DOI: 10.1111/vru.12616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 01/16/2018] [Accepted: 01/30/2018] [Indexed: 12/27/2022] Open
Abstract
Arterial thromboembolism is a life-threatening condition in cats most commonly secondary to cardiac disease. Echocardiography is the reference standard to evaluate for presence of a thrombus. In humans, computed tomographic (CT) angiography is becoming widely used to detect left atrial thrombi precluding the use of sedation. The purpose of this prospective, controlled, methods comparison pilot study was threefold: (1) describe new CT angiography protocol used in awake cats with cardiac disease and congestive heart failure; (2) determine accuracy of continuous and dynamic acquisition CT angiography to identify and characterize cardiac thrombi from spontaneous echocardiographic contrast using transthoracic echocardiography as our reference standard; (3) identify known negative prognostic factors and comorbidities of the thorax that CT angiography may provide that complement or supersede echocardiographic examination. Fourteen cats with heart disease were recruited; 7 with thrombi and 7 with spontaneous echocardiographic contrast. Echocardiography and awake CT angiography were performed using a microdose of contrast. Six of 7 thrombi were identified on CT angiography as filling defects by at least one reviewer within the left auricle (n = 6) and right heart (n = 1). Highest sensitivity (71.4%) was in continuous phase and highest specificity (85.7%) was in dynamic studies with fair to moderate interobserver agreement (0.38 and 0.44). CT angiography identified prognostic cardiac information (left atrial enlargement, congestive heart failure, arterial thromboembolism) and comorbidities (suspected idiopathic pulmonary fibrosis, asthma). This study indicates CT angiography can readily identify cardiac thrombi, important prognostic information and comorbidities, and can be safely performed in cats with cardiac disease and congestive heart failure.
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Affiliation(s)
- Kyle P Vititoe
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Ryan C Fries
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Stephen Joslyn
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Laura E Selmic
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Mark Howes
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Jordan P Vitt
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Robert T O'Brien
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
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Winter RL, Budke CM. Multicenter evaluation of signalment and comorbid conditions associated with aortic thrombotic disease in dogs. J Am Vet Med Assoc 2017; 251:438-442. [PMID: 28763280 DOI: 10.2460/javma.251.4.438] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess signalment and concurrent disease processes in dogs with aortic thrombotic disease (ATD). DESIGN Retrospective case-control study. ANIMALS Dogs examined at North American veterinary teaching hospitals from 1985 through 2011 with medical records submitted to the Veterinary Medical Database. PROCEDURES Medical records were reviewed to identify dogs with a diagnosis of ATD (case dogs). Five control dogs without a diagnosis of ATD were then identified for every case dog. Data were collected regarding dog age, sex, breed, body weight, and concurrent disease processes. RESULTS ATD was diagnosed in 291 of the 984,973 (0.03%) dogs included in the database. The odds of a dog having ATD did not differ significantly by sex, age, or body weight. Compared with mixed-breed dogs, Shetland Sheepdogs had a significantly higher odds of ATD (OR, 2.59). Protein-losing nephropathy (64/291 [22%]) was the most commonly recorded concurrent disease in dogs with ATD. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with ATD did not differ significantly from dogs without ATD in most signalment variables. Contrary to previous reports, cardiac disease was not a common concurrent diagnosis in dogs with ATD.
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den Toom ML, van Leeuwen MW, Szatmári V, Teske E. Effects of clopidogrel therapy on whole blood platelet aggregation, the Plateletworks® assay and coagulation parameters in cats with asymptomatic hypertrophic cardiomyopathy: a pilot study. Vet Q 2016; 37:8-15. [PMID: 27786603 DOI: 10.1080/01652176.2016.1244618] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Although scientific evidence is limited, clopidogrel is frequently used as prophylaxis for arterial thromboembolism in cats with hypertrophic cardiomyopathy (HCM). OBJECTIVES Evaluating effects of clopidogrel therapy in asymptomatic cats with HCM on (1) conventional whole blood aggregation (WBA), (2) alternative platelet aggregation assessed with tubes of the Plateletworks® assay and (3) standard coagulation parameters. ANIMALS AND METHODS Prospective, randomized, double-blind, placebo-controlled pilot study. Fourteen asymptomatic HCM cats were randomly allocated to receive placebo (n = 5) or clopidogrel (18.75 mg/cat q24h, n = 9) as part of a larger study. Aggregation responses (to 20 µM adenosine diphosphate (ADP) and 10 µg/ml collagen) in WBA and the Plateletworks® assay and standard coagulation parameters were evaluated at baseline and after seven days of therapy. RESULTS Clopidogrel therapy significantly reduced aggregation responses to ADP and collagen in the Plateletworks® agonists tubes (ADP and collagen: P < 0.001), but did not significantly reduce aggregation responses to ADP and collagen in the WBA technique (ADP: P = 0.07, collagen: P = 0.30). Clopidogrel therapy did not show a significant effect on prothrombin time, activated partial thromboplastin time, antithrombin, D-dimers and fibrinogen concentrations. CONCLUSION AND CLINICAL IMPORTANCE Clopidogrel therapy at a dose of 18.75 mg/cat q24h for seven days causes a significant decrease in in vitro platelet aggregation evaluated with the Plateletworks® assay, without affecting standard coagulation parameters in cats with asymptomatic HCM.
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Affiliation(s)
- M L den Toom
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - M W van Leeuwen
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - V Szatmári
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - E Teske
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
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16
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Boudreaux MK, Christopherson PW, Blair C. Comparison of the gene encoding, and the predicted amino acid composition of, platelet membrane receptor subunit glycoprotein Ibα in members of the family Felidae. Vet Clin Pathol 2016; 45:73-86. [PMID: 26749054 DOI: 10.1111/vcp.12312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is minimal information regarding platelet receptors in the family Felidae. Comparative studies assist with identifying amino acids critical for protein structure and function. OBJECTIVE The purpose of the study was to compare the gene encoding, and the predicted amino acid composition of, platelet membrane receptor subunit GPIbα in Felidae family members. METHODS Genomic DNA samples isolated from whole blood of 13 domestic cats and 50 big cats representing 8 different species were subjected to PCR using primers designed to flank the coding region of GPIbα in overlapping fashion. PCR products were separated via electrophoresis on agarose gels, and extracted products were submitted for sequencing. DNA sequences were used to predict the length and amino acid composition of the protein. RESULTS Varying protein lengths were predicted in Felidae family members which were primarily due to polymorphisms in the variable number of tandem repeats region encoding the macroglycopeptide region of GPIbα. Other areas of the gene and predicted amino acid compositions were fairly conserved when compared to human sequences and between Felidae family members. CONCLUSION Various polymorphisms within GPIbα, including length variants encoding the macroglycopeptide region, were identified in members of the family Felidae. More studies are needed to determine if a correlation exists between various polymorphisms and predisposition for hemorrhage or thrombosis as suggested in people.
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Affiliation(s)
- Mary K Boudreaux
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Pete W Christopherson
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Cori Blair
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
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17
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Ferasin L, DeFrancesco T. Management of acute heart failure in cats. J Vet Cardiol 2015; 17 Suppl 1:S173-89. [DOI: 10.1016/j.jvc.2015.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 09/13/2015] [Accepted: 09/17/2015] [Indexed: 10/22/2022]
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Sherwin V, Baiker K, Wapenaar W. Consequences of endocarditis in an adult cow with a ventricular septal defect. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Virginia Sherwin
- School of Veterinary Medicine & ScienceUniversity of NottinghamLeicestershireUK
| | - Kerstin Baiker
- School of Veterinary Medicine & ScienceUniversity of NottinghamLeicestershireUK
| | - Wendela Wapenaar
- School of Veterinary Medicine & ScienceUniversity of NottinghamLeicestershireUK
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dos Reis GFM, Nogueira RB, Silva AC, Oberlender G, Muzzi RAL, Mantovani MM. Spectral analysis of femoral artery blood flow waveforms of conscious domestic cats. J Feline Med Surg 2014; 16:972-8. [PMID: 24718293 PMCID: PMC11104085 DOI: 10.1177/1098612x14529123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The qualitative and quantitative aspects of femoral artery blood flow waveform spectra were evaluated in 15 male and 15 female Persian and mixed breed domestic cats (Felis catus), which were healthy and not sedated, using duplex Doppler ultrasonography (DDU). Spectral Doppler demonstrated a biphasic characteristic in 16 (53.34%) of the animals evaluated, and a triphasic characteristic in the 14 (46.66%) remaining animals. The systolic blood pressure and heart rate values were within the normal range for the species. The quantitative parameters evaluated, based on the spectral Doppler, were as follows: systolic velocity peak (SVP), recent diastolic velocity peak (RDVP), end diastolic velocity peak (EDVP), mean velocity (MV), integral velocity time (ITV), artery diameter (AD), femoral flow volume (FFV), pulsatility index (PI), resistive index (RI), systolic peak acceleration time (AT) and deceleration time (DT). The respective mean values were: 36.41 ± 7.33 cm/s, 4.69 ± 0.90 cm/s, 10.74 ± 2.74 cm/s, 23.06 ± 4.86 cm/s, 3.91 ± 1.05 cm, 0.17 ± 0.04 cm, 0.11 ± 0.08 cm(3), 3.85 ± 0.19, 1.40 ± 0.20, 39.84 ± 7.38 ms, and 114.0 ± 22.15 ms. No significant differences were found between males and females. The analyses carried out on the femoral artery flow spectrum obtained by DDU showed that it is easy to use and highly tolerated in non-sedated, healthy cats. It appears that DDU may be a useful diagnostic technique, but further studies are needed to evaluate how it compares with invasive telemetric methodology or high-definition oscillometric waveform analytic techniques.
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Affiliation(s)
| | - Rodrigo B Nogueira
- Veterinary Medicine Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - Adriana C Silva
- Veterinary Medicine Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - Guilherme Oberlender
- Veterinary Medicine Department, Federal University of South Frontier, Realeza, Paraná, Brazil
| | - Ruthnéa A L Muzzi
- Veterinary Medicine Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - Matheus M Mantovani
- Veterinary Medicine Department, Veterinary and Zootecnia School, São Paulo University, São Paulo, Brazil
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20
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Borgeat K, Wright J, Garrod O, Payne JR, Fuentes VL. Arterial thromboembolism in 250 cats in general practice: 2004-2012. J Vet Intern Med 2013; 28:102-8. [PMID: 24237457 PMCID: PMC4895537 DOI: 10.1111/jvim.12249] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 08/09/2013] [Accepted: 09/26/2013] [Indexed: 11/29/2022] Open
Abstract
Background Population characteristics and outcome of cats with arterial thromboembolism (ATE) managed in general practice (GP) have been poorly described. Hypothesis Cats with ATE presenting to GP are usually euthanized at presentation, but survival times >1 year are possible. Animals Cats with ATE managed by 3 GP clinics in the United Kingdom. Methods Records of cases presenting to GP over a 98‐month period (2004–2012) were reviewed. Cats with an antemortem diagnosis of limb ATE were included. Outcome information was obtained. Results Over 98 months, 250 cats were identified with ATE. Prevalence was approximately 0.3%. At presentation, 153 cats (61.2%) were euthanized, with 68/97 (70.1%) of the remaining cats (27.2% of the total population) surviving >24 hours after presentation. Of these, 30/68 (44.1%) survived for at least 7 days. Hypothermia (HR, 1.44; 95% CI, 1.002–2.07; P = .049) and management by Clinic 2 (HR, 5.53; 95% CI, 1.23–24.8; P = .026) were independent predictors of 24‐hour euthanasia or death. For cats surviving >24 hours, hypothermia (HR, 2.25; 95% CI, 1.12–4.48; P = .021) and failure to receive aspirin, clopidogrel, or both (HR, 8.26; 95% CI, 1.39–50; P = .001) were independent predictors of euthanasia or death within 7 days. For cats that survived ≥7 days, median survival time was 94 (95% CI, 42–164) days, with 6 cats alive 1 year after presentation. Conclusions Although 153/250 cats were euthanized at presentation, 6 cats survived >12 months. No factors were identified that predicted euthanasia on presentation.
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Affiliation(s)
- K Borgeat
- Royal Veterinary College, Hatfield, Hertfordshire, UK
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21
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Zoia A, Augusto M, Drigo M, Caldin M. Evaluation of hemostatic and fibrinolytic markers in dogs with ascites attributable to right-sided congestive heart failure. J Am Vet Med Assoc 2013; 241:1336-43. [PMID: 23113526 DOI: 10.2460/javma.241.10.1336] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether dogs with ascites secondary to right-sided congestive heart failure (CHF) have bleeding disorders associated with hypofibrinogenemia and discordant plasma fibrin-fibrinogen degradation products (FDPs) and D-dimer assay results (ie, a circulating concentration of FDPs higher than the reference range and a circulating concentration of D-dimer within the reference range). DESIGN Retrospective case-control study. ANIMALS 80 client-owned dogs. PROCEDURES Dogs with ascites secondary to right-sided CHF (group 1; n = 20), unhealthy dogs without cardiac disease (group 2; 40), and dogs with left-sided CHF (group 3; 20) were included in the study. Urine bile acids-to-creatinine concentration ratios were calculated as a marker of liver function. Differences among groups regarding coagulation profile analysis results and prevalence of discordant FDPs and D-dimer assay results were determined. RESULTS No significant differences were detected among the 3 groups regarding urine bile acids-to-creatinine concentration ratios. Plasma fibrinogen concentration was significantly lower for group 1 versus groups 2 or 3. Prevalence of discordant FDPs and D-dimer assay results was significantly higher for group 1 versus groups 2 or 3. Eighteen group 1 dogs had discordant FDPs and D-dimer assay results. Ten of these dogs had concurrent hypofibrinogenemia, 2 of which had clinical signs of bleeding. Only 10 dogs in groups 2 or 3 had discordant FDPs and D-dimer assay results; none of these dogs had hypofibrinogenemia or clinical signs of bleeding. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with right-sided CHF and ascites may be at increased risk for primary hyperfibrinogenolysis (ie, hypofibrinogenemia and discordant FDPs and D-dimer assay results).
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Affiliation(s)
- Andrea Zoia
- Department of Small Animal Clinical Study, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
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22
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Lake-Bakaar GA, Johnson EG, Griffiths LG. Aortic thrombosis in dogs: 31 cases (2000–2010). J Am Vet Med Assoc 2012; 241:910-5. [DOI: 10.2460/javma.241.7.910] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Winter RL, Sedacca CD, Adams A, Orton EC. Aortic thrombosis in dogs: presentation, therapy, and outcome in 26 cases. J Vet Cardiol 2012; 14:333-42. [PMID: 22591640 DOI: 10.1016/j.jvc.2012.02.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 01/27/2012] [Accepted: 02/18/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The pathogenesis and presentation of aortic thrombosis (AT) in dogs is not well characterized and an effective antithrombotic therapy for AT in dogs has not been identified. Our goal is to report the clinical presentation and results of therapies in dogs with AT. ANIMALS Twenty-six client-owned dogs. METHODS Retrospective review of medical records of dogs diagnosed with AT between 2003 and 2010. RESULTS Twenty-six dogs had an apparent primary mural aortic thrombus. None had structural heart disease at diagnosis. Twenty dogs were ambulatory with varying degrees of pelvic limb dysfunction. Duration of ambulatory dysfunction was 7.8 weeks (range 1 day-52 weeks). A majority of dogs (58%) had no concurrent conditions at diagnosis. Fourteen dogs were treated with a standard warfarin protocol for a median period of 22.9 months (range 0.5-53 months). Ambulatory function improved in all dogs treated with warfarin. Time until clinical improvement was 13.9 days (range 2-49 days). Dogs treated with warfarin did not become non-ambulatory, die or undergo euthanasia related to AT, or have a known serious hemorrhagic event. CONCLUSIONS The pathogenesis of AT in dogs is distinct from that of aortic thromboembolism (ATE) in cats. Aortic thrombosis in dogs is more likely to involve local thrombosis in the distal aorta with embolization to the arteries of the pelvic limb resulting in chronic progressive ambulatory dysfunction. Chronic warfarin administration is well-tolerated and appears to be an effective short-term and long-term therapy for dogs with AT.
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Affiliation(s)
- Randolph L Winter
- Department of Clinical Sciences, Texas A&M University, College Station, TX, USA.
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25
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Fiakpui NN, Hogan DF, Whittem T, Green III HW, Shipley EA, Sederquist KA. Dose determination of fondaparinux in healthy cats. Am J Vet Res 2012; 73:556-61. [DOI: 10.2460/ajvr.73.4.556] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Goggs R, Poole AW. Platelet signaling-a primer. J Vet Emerg Crit Care (San Antonio) 2012; 22:5-29. [PMID: 22316389 DOI: 10.1111/j.1476-4431.2011.00704.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Accepted: 11/25/2011] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To review the receptors and signal transduction pathways involved in platelet plug formation and to highlight links between platelets, leukocytes, endothelium, and the coagulation system. DATA SOURCES Original studies, review articles, and book chapters in the human and veterinary medical fields. DATA SYNTHESIS Platelets express numerous surface receptors. Critical among these are glycoprotein VI, the glycoprotein Ib-IX-V complex, integrin α(IIb) β(3) , and the G-protein-coupled receptors for thrombin, ADP, and thromboxane. Activation of these receptors leads to various important functional events, in particular activation of the principal adhesion receptor α(IIb) β(3) . Integrin activation allows binding of ligands such as fibrinogen, mediating platelet-platelet interaction in the process of aggregation. Signals activated by these receptors also couple to 3 other important functional events, secretion of granule contents, change in cell shape through cytoskeletal rearrangement, and procoagulant membrane expression. These processes generate a stable thrombus to limit blood loss and promote restoration of endothelial integrity. CONCLUSIONS Improvements in our understanding of how platelets operate through their signaling networks are critical for diagnosis of unusual primary hemostatic disorders and for rational antithrombotic drug design.
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Affiliation(s)
- Robert Goggs
- School of Physiology and Pharmacology, Faculty of Medical and Veterinary Sciences, University of Bristol, UK.
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Kim JH, Park HM. Unilateral femoral arterial thrombosis in a dog with malignant mammary gland tumor: clinical and thermographic findings, and successful treatment with local intra-arterial administration of streptokinase. J Vet Med Sci 2011; 74:657-61. [PMID: 22185771 DOI: 10.1292/jvms.11-0432] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An 8-year-old intact female dog presented with a sudden onset of unilateral hindlimb paralysis of 3 days duration. Based on the history and results of physical, neurological, and histopathological examinations, and blood work, an arterial thrombosis was suspected as a complication of the hypercoagulability from a malignant mammary gland tumor. Thermography provided evidence of the unilateral femoral thrombus. Initially, thrombolysis with streptokinase administered by intravenous infusion was ineffective. Thereafter, the direct delivery of streptokinase to the site of thrombus was attempted. The approach was curative. These results suggest that thermography could describe the site of the arterial thrombus, and local intra-arterial administration of streptokinase may be an effective therapy for the canine arterial thrombosis complicated by malignant mammary gland tumor.
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Affiliation(s)
- Jung-Hyun Kim
- BK21 Basic & Diagnostic Veterinary Specialist Program for Animal Diseases and Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 143-701, Korea
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Cathcart CJ, Brainard BM, Reynolds LR, Al-Nadaf S, Budsberg SC. Lack of inhibitory effect of acetylsalicylic acid and meloxicam on whole blood platelet aggregation in cats. J Vet Emerg Crit Care (San Antonio) 2011; 22:99-106. [PMID: 22316324 DOI: 10.1111/j.1476-4431.2011.00681.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 08/15/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the effects of acetylsalicylic acid (ASA) and meloxicam on feline platelet aggregation and associated platelet thromboxane production and serotonin release. DESIGN Prospective interventional study. SETTING University research facility. ANIMALS Eight healthy male castrated domestic short hair cats from a research colony. INTERVENTIONS Oral medications were administered to 8 cats for 14 days in a randomized, placebo-controlled, crossover design. Treatment groups included: aspirin (ASA) (5 mg/kg q 48 h), meloxicam (0.05 mg/kg q 24 h), and placebo (0.5 mL of water q 24 h). Thromboxane assays (TXB(2) ) and whole blood (impedance) aggregometry (WBA) were performed on samples collected before drug administration, and on days 7, 15, and 17, using adenosine diphosphate (ADP; 10 μM) and collagen (5 μg/mL) as agonists for WBA. Serotonin release was assayed on postaggregation plasma. Oral mucosal bleeding time (OMBT) and complete blood cell counts were measured on days 0 and 15. MEASUREMENTS AND MAIN RESULTS Neither medication affected WBA at any time point. OMBT decreased in the ASA group relative to baseline. No differences were detected in WBA and OMBT baseline between any groups. No difference was detected in serotonin secretion at any time point. TXB(2) was significantly decreased in the ASA group at all times after initiation of treatment but no change was noted in the meloxicam or placebo groups. CONCLUSIONS At the doses studied, neither meloxicam nor ASA had an inhibitory effect on WBA or OMBT in cats. Thromboxane concentrations were significantly decreased with ASA treatment.
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Affiliation(s)
- Curtis J Cathcart
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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Rishniw M, Pion PD. Is Treatment of Feline Hypertrophic Cardiomyopathy Based in Science or Faith? J Feline Med Surg 2011; 13:487-97. [DOI: 10.1016/j.jfms.2011.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
Abstract
Practical relevance Feline hypertrophic cardiomyopathy (HCM) is the most common cardiac disease of cats. Treatment of HCM is usually directed at controlling signs of congestive heart failure (CHF), preventing occurrence or recurrence of systemic thromboembolism or delaying/preventing/reversing progression of subclinical disease. Study objective and design Despite the laudable goals of therapy, however, little objective evidence supporting therapeutic decisions has been published. We, therefore, hypothesized that cardiologists base their treatment strategies on information other than published clinically relevant science. To gain insight into therapeutic decisions that cardiologists and clinicians with an interest in cardiology (n = 99) make for cats with HCM, and on what information they base these decisions, we presented participants with, and asked them to select therapy for, 12 hypothetical scenarios of HCM (± CHF). Responses and justifications for treatment choices were compiled and compared with the results of a comprehensive literature search for published information about treatment of feline HCM. Findings Evaluation of the therapeutic strategies chosen for these hypothetical cases of HCM suggests that cardiologists or clinicians with a strong interest in cardiology often prescribe treatments knowing that little documented evidence supports their decisions.
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Affiliation(s)
- Mark Rishniw
- Veterinary Information Network, Davis, CA 95616, USA
| | - Paul D Pion
- Veterinary Information Network, Davis, CA 95616, USA
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Stokol T, Daddona JL, Choi B. Evaluation of tissue factor procoagulant activity on the surface of feline leukocytes in response to treatment with lipopolysaccharide and heat-inactivated fetal bovine serum. Am J Vet Res 2010; 71:623-9. [DOI: 10.2460/ajvr.71.6.623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bowles DB, Coleman MG, Harvey CJ. Cardiogenic arterial thromboembolism causing non-ambulatory tetraparesis in a cat. J Feline Med Surg 2009; 12:144-50. [PMID: 19692276 DOI: 10.1016/j.jfms.2009.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2009] [Indexed: 11/24/2022]
Abstract
A 1-year-old oriental cat was presented with a peracute onset of tetraparesis and vocalisation. Clinical findings were suggestive of multi-site thromboembolic disease, and this was confirmed on post-mortem examination. An echocardiogram showed severe restrictive cardiomyopathy and spontaneous echogenic contrast. To the author's knowledge, this is the first reported case of tetraparesis secondary to cardiogenic arterial thromboembolic disease. Thromboembolic disease should be included as a differential diagnosis for any cat presented with a peracute onset of paresis or paralysis, even if there is no history of cardiac disease.
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Affiliation(s)
- Danielle B Bowles
- Veterinary Specialist Group, UNITEC, 97 Carrington Road, Mount Albert, Auckland, New Zealand.
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Gonçalves R, Penderis J, Chang YP, Zoia A, Mosley J, Anderson TJ. Clinical and neurological characteristics of aortic thromboembolism in dogs. J Small Anim Pract 2008; 49:178-84. [DOI: 10.1111/j.1748-5827.2007.00530.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Thyroid storm is a syndrome described in human medicine to define a multisystemic disorder resulting from organ exposure to excessive levels of thyroid hormone. This form of acute thyrotoxicosis, although uncommon, can be life threatening and is a significant cause of mortality in human emergency rooms. Although thyroid storm is a well-recognized clinical entity in human medicine, it has not been described in veterinary medicine. This article discusses the human syndrome and defines a similar syndrome in hyperthyroid veterinary patients. The clinical signs of and treatment modalities for feline thyroid storm are also presented.
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Affiliation(s)
- Cynthia R Ward
- Department of Small Animal Medicine, University of Georgia College of Veterinary Medicine, 501 DW Brooks Drive, Athens, GA 30602, USA.
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Lunsford KV, Mackin AJ. Thromboembolic Therapies in Dogs and Cats: An Evidence-Based Approach. Vet Clin North Am Small Anim Pract 2007; 37:579-609. [PMID: 17466757 DOI: 10.1016/j.cvsm.2007.01.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In veterinary medicine, we are forced to make use of less than ideal "evidence," such as extrapolation from experimental studies in dogs and cats without naturally occurring diseases and from clinical trials in other species (particularly human clinical trials), as well as limited information gained from veterinary clinical experience, small clinical trials, case studies, and anecdotal reports. In this article, specific treatment recommendations are made for each of the common thromboembolic conditions seen in dogs and cats. These recommendations are made with the important caveat that, to date, such suggested therapeutic approaches are based on limited evidence.
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Affiliation(s)
- Kari V Lunsford
- Department of Clinical Sciences, College of Veterinary Medicine, Mail Stop 9825, Spring Street, Mississippi State University, Mississippi State, MS 39762-6100, USA.
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Alwood AJ, Downend AB, Brooks MB, Slensky KA, Fox JA, Simpson SA, Waddell LS, Baumgardner JE, Otto CM. Anticoagulant Effects of Low-Molecular-Weight Heparins in Healthy Cats. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb02979.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Cardiomyopathy. SAUNDERS MANUAL OF SMALL ANIMAL PRACTICE 2006. [PMCID: PMC7158345 DOI: 10.1016/b0-72-160422-6/50152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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