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A Real Look at Arterial Thromboembolism in Cats

Clinician's Brief (Capsule)

Cardiology

|July 2014

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Arterial thromboembolism (ATE) is typically associated with high morbidity and mortality in cats. Previous studies have recognized several factors associated with decreased survival rate, including hypothermia, >2 limbs affected, absence of motor function, hyperphosphatemia, bradycardia, and congestive heart failure (CHF).

In this study, 250 cats with ATE were identified from 3 general practices over 98 months. Prevalence was 0.003%. At presentation, 61.2% of patients were euthanized; 70.1% of the 97 remaining cats survived >24 hours after presentation. Lower rectal temperature at presentation (36oC vs 37.8oC) was significantly associated with mortality between 24 hours and 7 days. After the initial 24 hours, mortality within 7 days was significantly associated with not receiving aspirin, clopidogrel, or both. Of the 68 cats that survived the initial 24 hours, 30 (44.1%) survived at least 7 days. For cats that survived at least 7 days, median survival time was 94 days; 6 cats were alive 1 year after presentation. Of the 30 cats, 14 were later euthanized for recurrent ATE; 15 were euthanized for clinical signs of CHF. No identified factors predicted euthanasia on presentation. This study indicated a need for further evaluation of the effect of early antiplatelet treatment on outcome of cats presenting acutely with ATE. It also suggested that long term survival is possible in a small proportion of cats presenting with ATE.

Commentary

ATE is an uncommon but serious outcome for feline patients with heart disease. Most reports have originated from university centers or specialty referral practices and may not accurately represent what is seen in general practice. This valuable study attempted to identify prognostic indicators and survival data for cats that received treatment (vs euthanasia) at diagnosis, which is essential information for general practitioners to help clients make the best decision for their pets.—Amara Estrada, DVM, DACVIM (Cardiology)

Source

Arterial thromboembolism in 250 cats in general practice: 2004-2012. Borgeat K, Wright J, Garrod O, et al. JVIM 28:102-108, 2014.

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