Arterial Thromboembolism in 250 Cats in General Practice: 2004–2012

Abstract

BackgroundPopulation characteristics and outcome of cats with arterial thromboembolism (ATE) managed in general practice (GP) have been poorly described.HypothesisCats with ATE presenting to GP are usually euthanized at presentation, but survival times >1 year are possible.AnimalsCats with ATE managed by 3 GP clinics in the United Kingdom.MethodsRecords 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.ResultsOver 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.ConclusionsAlthough 153/250 cats were euthanized at presentation, 6 cats survived >12 months. No factors were identified that predicted euthanasia on presentation.

International collaborative study to assess cardiovascular risk and evaluate long‐term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study

“…Although the majority of affected cats are assumed to remain preclinical (ie, free of clinical signs), a proportion experiences serious complications, chief among which are congestive heart failure (CHF), arterial thromboembolism (ATE), and sudden cardiac death (SD). 2,5,[7][8][9][15][16][17][18][19][20]25,26,28 Certain breeds including Maine Coon, Ragdoll, British shorthair, Sphynx, Chartreux, Persian, Domestic Shorthair, and Norwegian Forest Cats are predisposed to hypertrophic cardiomyopathy, suggesting a heritable basis in these populations. [10][11][12]24,[29][30][31][32][33][34][35][36][37][38] Despite the fact that this disease is widely recognized, risk of attendant cardiovascular complications is unknown, and the natural history of preclinical feline hypertrophic cardiomyopathy remains unresolved.…”

“…49 Descriptions of cardiovascular complications in cats with hypertrophic cardiomyopathy have originated predominantly from single-site referral centers. 5,7,9,[17][18][19][20]25,26,28,29 Although informative, such results tend to concentrate severely affected cases and are subject to tertiary center referral bias. This can lead to overstating adverse outcomes and fosters the impression that the disease is dominated by pessimistic outcome.…”

Platelet Activation and Clopidogrel Effects on ADP‐Induced Platelet Activation in Cats with or without the A31P Mutation in MYBPC3

“…12,13 Here, we sought to determine whether clopidogrel would be a logical treatment option in cats with perceived risk of ATE. 3,14 In human patients, clopidogrel is a key component of antithrombotic treatment in patients with acute ischemic stroke and coronary stent implantation. [15][16][17] However, substantial interindividual variability exists and resistance to clopidogrel is Abbreviations:…”

Abnormal platelet activity in dogs and cats – impact and measurement

“…Prevalence reported at 0.3% (Borgeat 2013); platelet function testing does not differ between healthy and subclinical cats (Jandrey et al 2008); clopidogrel and aspirin reduce the likelihood of recurrent ATE (Hogan et al 2015). Routine antithrombotic medication is recommended in cats, particularly those with left atrial dilation, spontaneous echocontrast, or reduced left atrial appendage flow velocity (Goggs et al 2019).…”