Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 2—Defining rational therapeutic usage

Goggs, Robert; Bacek, Lenore M.; Bianco, Domenico; Koenigshof, Amy M.; Li, Ronald H L

doi:10.1111/vec.12791

Cited by 33 publications

(57 citation statements)

References 90 publications

(107 reference statements)

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“…Treatments for underlying causes of PE/PT/PTE are beyond the scope of this consensus statement and are reviewed elsewhere . A recent consensus statement on the rationale use of antithrombotics is relevant …”

Section: Treatmentmentioning

confidence: 99%

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Reinero

Visser

Kellihan

et al. 2020

Veterinary Internal Medicne

161

383

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Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.

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Section: Treatmentmentioning

confidence: 99%

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Reinero

Visser

Kellihan

et al. 2020

Veterinary Internal Medicne

161

383

View full text Add to dashboard Cite

show abstract

“…In dogs, PLN is associated with thromboembolic complications and thromboprophylaxis is recommended. However, no established protocols exist for determining which medications are optimal and what type of monitoring should be followed . In veterinary medicine, thromboprophylaxis, using clopidogrel or aspirin, is recommended for all dogs with PLN.…”

Section: Discussionmentioning

confidence: 99%

“…However, no established protocols exist for determining which medications are optimal and what type of monitoring should be followed. [1][2][3][4][5][6][7][8][9][10][11] In veterinary medicine, thromboprophylaxis, using clopidogrel or aspirin, is recommended for all dogs with PLN. It is unknown if prophylaxis is indicated for all underlying causes of PLN.…”

Section: Discussionmentioning

confidence: 99%

“…10 Medications for clot prevention or thromboprophylaxis therefore are recommended as part of standard management in PLN dogs. [10][11][12] Interestingly, this approach is not a standard recommendation in affected humans. In people, PLN refers to a diverse group of diseases including IgA nephropathy, post-infectious glomerulonephritis, lupus nephritis, and other glomerular diseases.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Platelet aggregometry testing during aspirin or clopidogrel treatment and measurement of clopidogrel metabolite concentrations in dogs with protein‐losing nephropathy

Shropshire

Johnson

Olver

2020

Veterinary Internal Medicne

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Background Dogs with protein‐losing nephropathy (PLN) are treated with antiplatelet drugs for thromboprophylaxis but no standardized method exists to measure drug response. It is also unknown if clopidogrel metabolite concentrations [CM] differ between healthy and PLN dogs. Objectives Assess response to aspirin or clopidogrel in PLN dogs using platelet aggregometry (PA) and compare [CM] between healthy and PLN dogs. Animals Six healthy and 14 PLN dogs. Methods Platelet aggregometry using adenosine diphosphate (ADP), arachidonic acid (AA), and saline was performed in healthy dogs at baseline and 1‐week postclopidogrel administration to identify responders or nonresponders. A decrease of ≥60% for ADP or ≥30% for AA at 1 or 3 hours postpill was used to define a responder. At 1 and 3 hours postclopidogrel, [CM] and PA were measured in healthy and PLN dogs. Platelet aggregometry was performed in PLN dogs at baseline, 1, 6, and 12 weeks after clopidogrel or aspirin administration. Results In PLN dogs receiving clopidogrel, PA differed from baseline at all time points for ADP but not for AA at any time point. Most dogs responded at 1 or both time points except for 1 dog that showed no response. For PLN dogs receiving aspirin, no differences from baseline were observed at any time point for either ADP or AA. No differences in [CM] were found at either time point between healthy and PLN dogs. Conclusions and Clinical Importance Platelet aggregometry may represent an objective method to evaluate response to clopidogrel or aspirin treatment and PLN dogs appear to metabolize clopidogrel similarly to healthy dogs.

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“…Only case 1 underwent clopidrogel therapy because the thrombus increased in size 65. We chose clopidrogel for the long-term therapy because it is considered a safe antiplatelet drug,66 is less expensive than anticoagulants and can be administered orally.…”

Section: Discussionmentioning

confidence: 99%

Left atrial thrombosis secondary to blunt cardiac injury in two dogs

Ballocco

Parpaglia

Corda

et al. 2019

Vet Record Case Reports

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Two dogs, victims of motor vehicle accidents, were hospitalised at our Veterinary Teaching Hospital with multiple injuries. Electrocardiographic abnormalities were observed in both dogs: case 1 showed ventricular arrhythmias, while case 2 manifested second degree atrioventricular block. Increased cardiac troponin-I serum levels and echocardiographic alterations compatible with left atrial wall lesions and thrombosis were detected. Based on these symptoms, the dogs were diagnosed with traumatic blunt cardiac injury. Both patients had left atrial thrombus formation, but only case 1 underwent antiplatelet therapy and experienced thromboembolic spread. Blunt cardiac injury and related consequences should be considered in traumatised patients. ECG together with cardiac troponin-I measurement and echocardiography could help clinicians to diagnose and monitor the condition.

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Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 2—Defining rational therapeutic usage

Cited by 33 publications

References 90 publications

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Platelet aggregometry testing during aspirin or clopidogrel treatment and measurement of clopidogrel metabolite concentrations in dogs with protein‐losing nephropathy

Left atrial thrombosis secondary to blunt cardiac injury in two dogs

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