Surgical embolectomy in a cat with cardiogenic aortic thromboembolism

Vezzosi, Tommaso; Buralli, Carlotta; Briganti, Angela; Vannozzi, Iacopo; Giacomelli, Elena; Talamanca, G.F.; Strömberg, Anna; Domenech, Oriol; Tognetti, Rosalba

doi:10.1016/j.jvc.2020.03.002

Cited by 6 publications

(9 citation statements)

References 26 publications

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“…Photograph courtesy of Hayley Amerman plasminogen activator, streptokinase, surgical embolectomy) have been shown to be superior to antiplatelet therapy alone and may carry additional risks; however, treatment recommendations are limited by a lack of large prospective studies. 13,20,[22][23][24] Antithrombotic treatment should be started as soon as possible; clopidogrel is preferred over aspirin as it has been found to be superior for the prevention of recurrent ATE in cats, with minimal side effects. 25 Currently, there are no evidence-based guidelines for the use of anticoagulants in treatment of ATE in cats; however, it is a subject of investigation.…”

Section: Discussionmentioning

confidence: 99%

Cardiogenic arterial thromboembolism resulting in tetraplegia in a cat

Burke

Reineke

2022

Vet Record Case Reports

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A 4-year-old male neutered domestic shorthaired cat was presented for acute onset tetraplegia and respiratory signs. No pulses were palpable in any limb, and nociception was absent-all limbs were cold, and digital, metacarpal and metatarsal pads were cyanotic. Point-of-care ultrasound of the heart revealed severe left atrial enlargement, containing several large thrombi. Due to concerns for quality of life, euthanasia was elected. Postmortem findings revealed marked left atrial enlargement with thrombi filling the entire atrium, as well as emboli in both subclavian arteries and the abdominal aorta.

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Section: Discussionmentioning

confidence: 99%

Cardiogenic arterial thromboembolism resulting in tetraplegia in a cat

Burke

Reineke

2022

Vet Record Case Reports

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“…Como a paciente teve uma piora do quadro e foi constatado que o trombo havia se locomovido e afetado um outro local da aorta, levantou-se a hipótese do tratamento com trombo embolectomia, porém, a proprietária não tinha condições financeiras para arcar com os custos. De acordo com o relato de Vezzosi et al (2020), a cirurgia pode ser uma opção de tratamento mostrando bons resultados da enfermidade; porém, o tratamento antitrombótico clínico é essencial para manutenção da ação trombo embolítica e não formação de novos trombos (Lo et al, 2022).…”

Section: Discussionunclassified

Tromboembolismo arterial em felino decorrente de cardiomiopatia restritiva: Relato de caso

Oliveira

Germano

Endrigh

et al. 2022

Pubvet

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O tromboembolismo arterial (TEA), é uma síndrome caracterizada pela formação de trombos que atingem a corrente sanguínea e podem se depositar nas artérias causando uma série de complicações. As cardiomiopatias que induzem aumento do átrio esquerdo dos gatos, é o fator predisponente à ocorrência da síndrome. O diagnóstico do TEA é feito através dos sinais clínicos e exames complementares, principalmente o ecocardiograma. A terapia antitrombótica é indicada como primeira escolha, mas o prognóstico varia de reservado a ruim. Analgesia é de extrema importância no protocolo terapêutico de pacientes com TEA. A cardiomiopatia restritiva é uma cardiomiopatia importante na clínica de felinos, no qual uma baixa porcentagem de gatos demonstra sinais clínicos anterior ao evento trombótico ou Insuficiência Cardíaca Congestiva. O objetivo deste relato foi descrever a evolução de um caso de tromboembolismo arterial decorrente de cardiomiopatia restritiva não tratada em uma gata de oito anos, castrada, pesando 4,9 kg com cianose de coxins e paralisia bilateral dos membros pélvicos. Após o diagnóstico, foi instituído o protocolo terapêutico com clopidorgel, rivaroxabana, analgesia e tratamento sintomático associado. A paciente respondeu favoravelmente à terapia clínica nos primeiros três dias e, após isso, teve piora clínica, no qual foi realizado eutanásia por questões pessoais da proprietária e prognóstico desfavorável.

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“… 106 , 113 , 114 While success with surgical and rheolytic embolectomy has been reported, these techniques are rarely attempted. 115 , 116 …”

Section: Arterial Thromboembolismmentioning

confidence: 99%

The Feline Cardiomyopathies: 1. General concepts

Kittleson

Côté

2021

Journal of Feline Medicine and Surgery

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Practical relevance: The feline cardiomyopathies are the most prevalent type of heart disease in adult domestic cats. Several forms have been identified (see Parts 2 and 3), with hypertrophic cardiomyopathy (HCM) being the most common. Clinically the cardiomyopathies are often indistinguishable. Cats with subclinical cardiomyopathy may or may not have characteristic physical examination findings (eg, heart murmur, gallop sound), or radiographic cardiomegaly. Cats with severe disease may develop signs of heart failure (eg, dyspnea, tachypnea) or systemic arterial thromboembolism (ATE; eg, pain and paralysis). Sudden death is possible. Treatment usually does not alter the progression from subclinical to clinical disease and often the treatment approach, once clinical signs are apparent, is the same regardless of the type of cardiomyopathy. However, differentiating cardiomyopathy from normal variation may be important prognostically. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any breed, can be affected. Mixed-breed cats are most commonly affected but certain breeds are disproportionately prone to developing HCM. Diagnostics: Subclinical feline cardiomyopathies may be suspected based on physical examination findings, thoracic radiographs and cardiac biomarker results but often the disease is clinically silent. The definitive clinical confirmatory test is echocardiography. Left heart failure (pulmonary edema and/or pleural effusion) is most commonly diagnosed radiographically, but point-of-care ultrasound and amino terminal pro-B-type natriuretic peptide (NT-proBNP) biomarker testing can also be useful, especially when the stress of taking radiographs is best avoided. Key findings: Knowledge of pathophysiological mechanisms helps the practitioner identify the feline cardiomyopathies and understand how these diseases progress and how they manifest clinically (heart failure, ATE). Existing diagnostic tests have strengths and limitations, and being aware of these can help a practitioner deliver optimal recommendations regarding referral. Conclusions: Several types of feline cardiomyopathies exist in both subclinical (mild to severe disease) and clinical (severe disease) phases. Heart failure and ATE are the most common clinical manifestations of severe cardiomyopathy and are therapeutic targets regardless of the type of cardiomyopathy. The long-term prognosis is often guarded or poor once overt clinical manifestations are present. Areas of uncertainty: Some cats with presumed cardiomyopathy do not have echocardiographic features that fit the classic cardiomyopathies (cardiomyopathy – nonspecific phenotype). Although no definitive treatment is usually available, understanding how cardiomyopathies evolve remains worthy of investigation.

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Surgical embolectomy in a cat with cardiogenic aortic thromboembolism

Cited by 6 publications

References 26 publications

Cardiogenic arterial thromboembolism resulting in tetraplegia in a cat

Cardiogenic arterial thromboembolism resulting in tetraplegia in a cat

Tromboembolismo arterial em felino decorrente de cardiomiopatia restritiva: Relato de caso

The Feline Cardiomyopathies: 1. General concepts

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