The use of intravesicular alteplase for thrombolysis in a dog with urinary bladder thrombi

Abstract

This report describes the use of alteplase in a dog for thrombolysis of intravesicular thrombi. In patients that develop intravesicular thrombi, intravesical instillation of alteplase can be considered as a method for dissolution of these thrombi.

Intravesical Agents in the Treatment of Bladder Clots in Children

“…For one of them [ 23 ], only the abstract was available and the recoverable data were considered. Among the non-pediatric papers, we also included three case reports about animals: two concerning two dogs [ 24 , 25 ] and one about a cat [ 26 ].…”

“…In the veterinary setting, the overall attention has focused only on alteplase application [ 24 , 25 , 26 ]. Similarly to Olarte et al [ 2 ], Pineda’s group diluted 1 mg of alteplase in 10 mL of saline solution and administered 5 mL of the solution into a dog bladder, for 1 h. The procedure was repeated 8 h later and then six times at one-month intervals, due to frequent hematuria episodes and new clot development.…”

Use of tissue plasminogen activator to alleviate postoperative subcutaneous ureteral bypass obstruction secondary to blood clot in seven cats

“…12 There are also reports, in both the human and veterinary literature, of intravesicular administration of alteplase to successfully and safely dissolve urinary bladder blood clots. 14–16 Given this background, investigation of the intra-device use of alteplase to dissolve SUB blood clot occlusions in cats seems warranted. However, only anecdotal mention of it has been reported.…”

“…Additionally, the intravesicular doses used (especially in case 2) were much larger than the typical range of 0.5–1 mg reported in both the both the human pediatric and veterinary literature. 14–16 Finally, in this series, cats with large intravesicular blood clots received intravesicular infusion of alteplase via a transurethral urinary catheter alone or in addition to infusion through the SUB port. Thus, the importance of the intravesicular route of infusion in this subset of cats also needs to be determined.…”

Using alteplase nephrostomy tube installation for thrombolysis of ureter tract clot obstruction

“…The use of Alteplase for the urinary tract has yet to be approved by the Food and Drug Administration. Alteplase studies have been conducted on animals 4 and in vitro 5 for thrombolytic therapy urinary tract but yet not utilized in humans. The present case report demonstrates the first case of an alteplase installation clot dissolution in the ureter using the nephrostomy tube for an outpatient.…”