Clinical use of tissue plasminogen activator for systemic thrombolysis in dogs and cats |
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| Institution: | 1. Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, 204 Duck Pond Drive, Blacksburg, VA 24061-0442, USA;2. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA;3. Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, 43126 PR, Italy;4. Department of Clinical Science, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Science, Box 7054, Uppsala, Sweden;5. CVCA Cardiac Care for Pets, 1209 Cromwell Bridge Road, Towson, MD 21286, USA;6. CVCA Cardiac Care for Pets, 165 Fort Evans Road NE, Leesburg, VA 20176, USA;1. Corresponding Address Kardiovet GmbH, Eystrasse 74, Kirchberg, Switzerland;2. Department for Companion Animals and Horses, University of Veterinary Medicine, Veterinärplatz, Vienna, Austria;3. Centre Hospitalier Vétérinaire des Cordeliers, 35 Avenue Du Maréchal Joffre, 77100 Meaux, France;4. Tierärztliche Gemeinschaftspraxis, An Den Wurthen 26, 17489 Greifswald, Germany;5. Medisch Centrum voor Dieren, Isolatorweg 45, 1014 AS Amsterdam, the Netherlands;6. Small Animal Teaching Hospital, Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK;7. Tierklinik Bockenheim, Juliusstrasse 12, 60487 Frankfurt, Germany;8. Ross University School of Veterinary Medicine, Basseterre, St. Kitts West Indies, St. Kitts and Nevis;9. Kleintierspezialisten Dres. Schmerbach & Höpfner, Wittestr. 30, 13509 Berlin, Germany;10. Tiergesundheitszentrum Obere Hard, Überweisungspraxis für Innere Medizin und Kardiologie, Oberer Hardweg 16, 75181 Pforzheim, Germany;11. Barton Veterinary Hospital and Surgery, CVS (UK) Ltd, 34 New Dover Road, Canterbury, Kent CT1 3BH, UK;12. North Downs Specialist Referrals, The Friesian Building 3 & 4, The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, Surrey RH1 4QP, UK;13. Clinique Vétérinaire Aquivet, 19 Avenue de La Forêt, Parc d''activités Mermoz, 33320 Eysines, France;14. Clinique Vétérinaire Armonia, Rue Serge Mauroit, 38090 Villefontaine, France;15. Aalborg Dyrehospital, Fredrikstadvej 10, 9200 Aalborg SV, Denmark;p. Kleintierzentrum Walluf, Am Klingenweg 21, 65396 Walluf, Germany;q. Tierärztliche Klinik Oberhaching, Bajuwarenring 10, 82041 Oberhaching, Germany;r. Oncovet Clinique Vétérinaire de Référés, Avenue Paul Langevin, 59650 Villeneuve d''Ascq, France;s. Ivy Court, Willington Rd, Etwall, Derbyshire DE65 6JG, UK;t. Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire SO21 2LL, UK;u. Clinic of Small Animal Medicine, Ludwig-Maximilians University, Veterinärstrasse 13, 80539 Munich, Germany;v. Clinique Vétérinaire Foch, 38 Avenue du Maréchal Foch, 34500 Beziers, France;w. Boehringer Ingelheim Vetmedica GmbH Binger Strasse 173, 55216 Ingelheim Am Rhein, Germany;1. Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, 601 Vernon L Tharp St., Columbus, OH 43210, USA;2. Ohio Veterinary Cardiology, Ltd., 1053 S. Cleveland-Massillon Rd., Akron, OH 44321, USA;3. The Heart Center, Nationwide Children''s Hospital, 700 Children''s Dr., Columbus, OH, 43205, USA |
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| Abstract: | IntroductionSystemic administration of tissue plasminogen activator (tPA) is seldomly reported in dogs and cats.AnimalsClient-owned animals receiving tPA (2010–2020).Materials and methodsMedical records of dogs and cats receiving tPA for distant known/suspected thrombus were reviewed. Fourteen dog visits (24 injections) and five cat visits (six injections) were included.ResultsCanine known/suspected thrombus included pulmonary thromboembolism (n=6), intracardiac thrombus (n=4), aortic thrombus (n=1), cranial vena cava thrombus (n=2), and femoral and iliac veins thrombus (n=1). Various canine primary diseases were represented, but open-heart surgery was the most common cause. Median time between diagnosis/suspicion of thrombus and tPA injection was 24.5 h (range, 3–150 h). Mean total tPA dose was 1.0±0.78 mg/kg.Clinical improvement occurred in 93% of dogs. Non-fatal complications were reported in 14% of dogs. Dogs’ survival to discharge was 78.6% without identifiable non-survivor characteristics. Feline known/suspected thrombus included unilateral feline aortic thromboembolism (FATE) (n=2), bilateral FATE (n=2), and right renal artery thrombus. Feline primary diseases included cardiomyopathy (n=5). Median time between diagnosis/suspicion of thrombus and tPA injection was 4 h (range, 2–17 h) and median total tPA dose was 1.0 mg/kg (range, 0.6–1.4 mg/kg).Clinical improvement occurred during 40% of the visits. All cats (n=3) with acute kidney injury (AKI) at admission developed worsening AKI and reperfusion injury. Of the remaining two visits, one developed a non-fatal AKI. Cats’ survival to discharge was 40%.ConclusionsSystemic thrombolysis with tPA seems to be effective and safe in dogs. More investigation is needed in cats. |
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| Keywords: | Thrombosis Thromboembolism Thrombus Alteplase Blood clot |
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