Feline Thromboembolism: A Dangerous Disease, Prevention is Better Than Cure!
Feline Thromboembolism: A Dangerous Disease, Prevention is Better Than Cure!
Why did your cat, who was bouncing around last night, suddenly become unable to stand? Why did it take only less than six hours from the onset of the disease to death? Today, let's take a closer look at this "dangerous" disease - feline thromboembolism.
What is Feline Thromboembolism?
One-sentence version: A thrombus is a blood clot that blocks a blood vessel.
Scientific version: When blood is in a hypercoagulable state, blood stasis or vascular endothelial damage occurs, platelets, fibrin and other substances will aggregate to form blood clots and flow with the blood, which will block the vascular lumen, a phenomenon known as thromboembolism.
Common in cats is aortic thromboembolism (ATE)
Thrombi can occur in deep veins, pulmonary thromboembolism, aorta... For cats, aortic thromboembolism (ATE) is common. Hypertrophic cardiomyopathy (HCM) is one of the main causes of secondary ATE in cats.
Cats with hypertrophic cardiomyopathy have abnormally thickened left ventricular muscle walls, which compress the chamber, reduce ventricular diastole function, and blood clots in the heart, forming blood clots.
These thrombi flow down the aorta, and when they reach the pelvis, the aorta branches into two thinner arteries, where the thrombi are easily blocked.
Due to the obstruction of the thrombus, blood cannot flow smoothly to the hind limbs and tail, resulting in necrosis of the lower abdominal tissues, severe damage to blood vessels and nerves, and hind limb paralysis. This is why cats with thrombosis often develop hind limb paralysis (about 72%). Of course, blood clots can also migrate upward with the blood, which may affect the forelimbs (usually the right forelimb, about 7%), causing paralysis or loss of sensation.
What else you need to know about thrombus:
Cats with thrombosis, in addition to hind limb paralysis, usually also have pain, howling, vomiting and other symptoms.
The average age of onset of thrombosis is around 8 years old.
Since HCM is a major cause of feline thromboembolism, breeds that are prone to HCM, such as Maine Coon, Ragdoll, Persian, Abyssinian, are also prone to thrombosis.
Male cats have a higher incidence than female cats (2.5:1), which is speculated to be related to the fact that male cats are more prone to HCM.
How to treat feline thromboembolism?
Emergency management
Acute death commonly occurs within 6-36h. It is usually recommended that cats with thromboembolic symptoms be monitored for 72h (3 days). Cats that have a chance of survival within 24-72h of presentation, after aggressive treatment, their limb condition will gradually improve. In the first 24h, the cat will be in a lot of pain, so pain relief measures must be taken.
However, for cats with a body temperature below 37℃, severe congestive heart failure that cannot be relieved, limb rigidity that does not improve, reperfusion injury or systemic widespread embolism, because the cat will feel a lot of pain and treatment often does not improve, the doctor may recommend euthanasia...
Thrombectomy
Since the blood vessel is blocked, can you remove the clots that are blocking the blood vessel by surgery? It sounds reasonable. But... the kitten's condition may not be able to withstand surgery. During ATE attacks, there are often accompanying congestive heart failure, low body temperature, arrhythmia, pulmonary edema and other problems, coupled with the risks of anesthesia and the difficulty of surgical procedures themselves, so thrombectomy is not the preferred option for treating feline thromboembolism.
Thrombolytic therapy
Then, can you dissolve the thrombus with some medicine? There are indeed such thrombolytic drugs. Theoretically, within 4 hours after the onset of thromboembolic symptoms, thrombolytic therapy will have a better effect. However, the success rate of thrombolytic therapy in clinical practice is not ideal. Multiple retrospective studies have shown that the survival rate of cats receiving thrombolytic therapy is not significantly higher than that of cats receiving conservative therapy.
Moreover, in addition to dissolving thrombi, thrombolytic drugs currently used in the clinic still face the risk of reperfusion injury after thrombolytic therapy, leading to hyperkalemia, metabolic acidosis, arrhythmia, renal insufficiency and other complications.
Conservative treatment principles
Treat the underlying disease and prevent recurrent thrombus formation
Use methadone, fentanyl, buprenorphine and other painkillers to relieve pain in cats
Treat congestive heart failure to help cats diure quickly and improve hypotension
Use anticoagulants and antiplatelet aggregation drugs to control further formation and enlargement of thrombi and prevent new thrombi formation
Relieve dyspnea by oxygenation
Keep the cat warm to maintain body temperature
Generally, when we find that a cat has a thrombus, it is because the cat suddenly can't stand on its hind legs... but in fact, it is already too late... According to statistics, the survival rate of feline thromboembolism is only 33~39%, even if cured, cats still have a 37-50% chance of recurrence.
Is there any way to prevent such a dangerous feline thromboembolism? The answer is physical examination! Physical examination! Still physical examination! Especially for breeds that are prone to heart disease, as well as cats over 5 years old, remember to add echocardiography to the annual physical examination.
Summary of Experience
Feline thromboembolism is a dangerous disease, early symptoms are not obvious, once the disease occurs, it often progresses rapidly, and treatment is difficult. Therefore, regular physical examination, early detection, and active treatment are the key to preventing and treating feline thromboembolism.
Why did your cat, who was bouncing around last night, suddenly become unable to stand? Why did it take only less than six hours from the onset of the disease to death? Today, let's take a closer look at this "dangerous" disease - feline thromboembolism.
What is Feline Thromboembolism?
One-sentence version: A thrombus is a blood clot that blocks a blood vessel.
Scientific version: When blood is in a hypercoagulable state, blood stasis or vascular endothelial damage occurs, platelets, fibrin and other substances will aggregate to form blood clots and flow with the blood, which will block the vascular lumen, a phenomenon known as thromboembolism.
Common in cats is aortic thromboembolism (ATE)
Thrombi can occur in deep veins, pulmonary thromboembolism, aorta... For cats, aortic thromboembolism (ATE) is common. Hypertrophic cardiomyopathy (HCM) is one of the main causes of secondary ATE in cats.
Cats with hypertrophic cardiomyopathy have abnormally thickened left ventricular muscle walls, which compress the chamber, reduce ventricular diastole function, and blood clots in the heart, forming blood clots.
These thrombi flow down the aorta, and when they reach the pelvis, the aorta branches into two thinner arteries, where the thrombi are easily blocked.
Due to the obstruction of the thrombus, blood cannot flow smoothly to the hind limbs and tail, resulting in necrosis of the lower abdominal tissues, severe damage to blood vessels and nerves, and hind limb paralysis. This is why cats with thrombosis often develop hind limb paralysis (about 72%). Of course, blood clots can also migrate upward with the blood, which may affect the forelimbs (usually the right forelimb, about 7%), causing paralysis or loss of sensation.
What else you need to know about thrombus:
Cats with thrombosis, in addition to hind limb paralysis, usually also have pain, howling, vomiting and other symptoms.
The average age of onset of thrombosis is around 8 years old.
Since HCM is a major cause of feline thromboembolism, breeds that are prone to HCM, such as Maine Coon, Ragdoll, Persian, Abyssinian, are also prone to thrombosis.
Male cats have a higher incidence than female cats (2.5:1), which is speculated to be related to the fact that male cats are more prone to HCM.
How to treat feline thromboembolism?
Emergency management
Acute death commonly occurs within 6-36h. It is usually recommended that cats with thromboembolic symptoms be monitored for 72h (3 days). Cats that have a chance of survival within 24-72h of presentation, after aggressive treatment, their limb condition will gradually improve. In the first 24h, the cat will be in a lot of pain, so pain relief measures must be taken.
However, for cats with a body temperature below 37℃, severe congestive heart failure that cannot be relieved, limb rigidity that does not improve, reperfusion injury or systemic widespread embolism, because the cat will feel a lot of pain and treatment often does not improve, the doctor may recommend euthanasia...
Thrombectomy
Since the blood vessel is blocked, can you remove the clots that are blocking the blood vessel by surgery? It sounds reasonable. But... the kitten's condition may not be able to withstand surgery. During ATE attacks, there are often accompanying congestive heart failure, low body temperature, arrhythmia, pulmonary edema and other problems, coupled with the risks of anesthesia and the difficulty of surgical procedures themselves, so thrombectomy is not the preferred option for treating feline thromboembolism.
Thrombolytic therapy
Then, can you dissolve the thrombus with some medicine? There are indeed such thrombolytic drugs. Theoretically, within 4 hours after the onset of thromboembolic symptoms, thrombolytic therapy will have a better effect. However, the success rate of thrombolytic therapy in clinical practice is not ideal. Multiple retrospective studies have shown that the survival rate of cats receiving thrombolytic therapy is not significantly higher than that of cats receiving conservative therapy.
Moreover, in addition to dissolving thrombi, thrombolytic drugs currently used in the clinic still face the risk of reperfusion injury after thrombolytic therapy, leading to hyperkalemia, metabolic acidosis, arrhythmia, renal insufficiency and other complications.
Conservative treatment principles
Treat the underlying disease and prevent recurrent thrombus formation
Use methadone, fentanyl, buprenorphine and other painkillers to relieve pain in cats
Treat congestive heart failure to help cats diure quickly and improve hypotension
Use anticoagulants and antiplatelet aggregation drugs to control further formation and enlargement of thrombi and prevent new thrombi formation
Relieve dyspnea by oxygenation
Keep the cat warm to maintain body temperature
Generally, when we find that a cat has a thrombus, it is because the cat suddenly can't stand on its hind legs... but in fact, it is already too late... According to statistics, the survival rate of feline thromboembolism is only 33~39%, even if cured, cats still have a 37-50% chance of recurrence.
Is there any way to prevent such a dangerous feline thromboembolism? The answer is physical examination! Physical examination! Still physical examination! Especially for breeds that are prone to heart disease, as well as cats over 5 years old, remember to add echocardiography to the annual physical examination.
Summary of Experience
Feline thromboembolism is a dangerous disease, early symptoms are not obvious, once the disease occurs, it often progresses rapidly, and treatment is difficult. Therefore, regular physical examination, early detection, and active treatment are the key to preventing and treating feline thromboembolism.
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