Rhabdomyolysis cases and acute kidney injury: a 10-year experience at a regional tertiary centre

Choy, Kay Hau; McVeigh, M; Holgate, Samuel; Delmenico, Leighton; Friedman, Deborah I.

doi:10.33235/rsaj.16.3.98-105

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“…This was not examined in detail in the present study or in any of the previously mentioned cat studies [ 2 , 10 ]. Furthermore, in humans, rhabdomyolysis with myoglobinemia, hyperkalemia, and lactic acidosis, often accompanied by hypotension, has been reported to cause AKI in 51% of patients [ 33 ]. Except for one cat with urinary bleeding, none of the cats evaluated had obviously discolored urine, but all cats examined had high CPK, and some had refractory hypotension.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Intravenous Enoxaparin Administration in Feline Arterial Thromboembolism

Mitropoulou

Hassdenteufel

Lin

et al. 2022

Animals

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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.

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Section: Discussionmentioning

confidence: 99%