Retrospective Evaluation of Intravenous Enoxaparin Administration in Feline Arterial Thromboembolism

Abstract

Induction of a hypocoagulable state is imperative in the treatment of feline arterial thromboembolism. Publications in human medicine report the use of enoxaparin intravenously in selected cases. The aim of our retrospective study was to report the regain of perfusion, short-term outcome, and complications of cats treated with a novel intravenous enoxaparin protocol (1 mg/kg bolus injection followed by 3 mg/kg/day continuous infusion) combined with oral clopidogrel administration. The secondary aim was to report the monitoring of enoxaparin with anti-Xa activity. There were 36 cats included. The probability of reaching limb reperfusion was significantly (p = 0.0148) higher with anti-Xa activity within or above the target range compared to results below the target range (19/21, 90% versus 11/20, 55%). The complications observed were acute kidney injury (15/36, 42%), hemorrhage (2/36, 6%), and neurological signs (6/36, 17%). The most common causes of death/euthanasia were cardiac instability, acute kidney injury, neurological abnormalities, and limb necrosis. The hospital discharge rate was 83% (10/12) for single limb and 29% (7/24) for dual limb thrombosis; the difference was significant (p = 0.0039). The median hospitalization time for the survivors was 119.5 (95–480) h. Our study supports the use of intravenous continuous rate infusion of enoxaparin in combination with oral clopidogrel for cats with aortic thromboembolism. We report similar discharge rates and lower hemorrhage rates than previously reported with thrombolytic treatment.

Analysis of Feline Aortic Thromboembolism Cases: A Literature Review From 2014 to 2023

“…Dyspnea and panting may occur as a result of pain. The prognosis of this condition is cautiously considered, as a study reported that 61% of cats are euthanized when this condition first occurs, and the majority of cases are bilateral (78%) (Locquet et al, 2018;Mitropoulou et al, 2022;Vezzosi et al, 2020).…”

Acute paralysis due to aortic thromboembolism in a cat – case report

“…Treatment can be pharmacological (MITROPOULOU et al, 2022), consisting of the dissolution of the thrombus and vascular surgery (VEZZOSI et al, 2020).…”

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“…Abnormally high levels of laboratory indicators are often registered in cats with ATE. Thus, in a retrospective study by Mitropoulou et al (2022), in animals hospitalised for arterial thromboembolism, hyperglycemia and high serum creatine phosphokinase activity were noted as the most common abnormalities.…”