Pulmonary thromboembolism in cats.
TL;DR: Pulmonary thromboembolism can affect cats of any age and is associated with a variety of systemic and inflammatory disorders, including neoplasia, anemia of unidentified cause, and pancreatitis.
Abstract: Pulmonary thromboembolism (PTE) is rarely diagnosed in cats, and the clinical features of the disease are not well known. PTE was diagnosed at postmortem examination in 17 cats, a prevalence of 0.06% over a 24-year period. The age of affected cats ranged from 10 months to 18 years, although young ( 10 years) cats were more commonly affected than were middle-aged cats. Males and females were equally affected. The majority of cats with PTE (n = 16) had concurrent disease, which was often severe. The most common diseases identified in association with PTE were neoplasia, anemia of unidentified cause, and pancreatitis. Cats with glomerulonephritis, encephalitis, pneumonia, heart disease, and hepatic lipidosis were also represented in this study. Most cats with PTE demonstrated dyspnea and respiratory distress before death or euthanasia, but PTE was not recognized ante mortem in any cat studied. In conclusion, PTE can affect cats of any age and is associated with a variety of systemic and inflammatory disorders. It is recommended that the same clinical criteria used to increase the suspicion of PTE in dogs should also be applied to cats.
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TL;DR: In clinical practice, a combination of careful evaluation of the animal's history, serum PLI concentration and abdominal ultrasonography, together with pancreatic cytology or histopathology when indicated or possible, is considered to be the most practical and reliable means for an accurate diagnosis or exclusion of pancreatitis compared with other diagnostic modalities.
Abstract: Pancreatitis is the most common disorder of the exocrine pancreas in both dogs and cats. Ante-mortem diagnosis of canine and feline pancreatitis can be challenging. The clinical picture of dogs and cats with pancreatitis varies greatly (from very mild to severe or even fatal) and is characterised by non-specific findings. Complete blood count, serum biochemistry profile and urinalysis should always be performed in dogs and cats suspected of having pancreatitis, although findings are not-specific for pancreatitis. Serum amylase and lipase activities and trypsin-like immunoreactivity (TLI) concentrations have no or only limited clinical value for the diagnosis of pancreatitis in either dogs or cats. Conversely, serum pancreatic lipase immunoreactivity (PLI) concentration is currently considered to be the clinicopathological test of choice for the diagnosis of canine and feline pancreatitis. Abdominal radiography is a useful diagnostic tool for the exclusion of other diseases that may cause similar clinical signs to those of pancreatitis. Abdominal ultrasonography can be very useful for the diagnosis of pancreatitis, but this depends largely on the clinician's experience. Histopathological examination of the pancreas is considered the gold standard for the diagnosis and classification of pancreatitis, but it is not without limitations. In clinical practice, a combination of careful evaluation of the animal's history, serum PLI concentration and abdominal ultrasonography, together with pancreatic cytology or histopathology when indicated or possible, is considered to be the most practical and reliable means for an accurate diagnosis or exclusion of pancreatitis compared with other diagnostic modalities.
113 citations
TL;DR: Documented disease associations with thrombosis provide the basis for recommendations on prescribing provided in subsequent domains, and numerous knowledge gaps were identified.
Abstract: Objectives Thrombosis is a well-recognized phenomenon in dogs and cats with a significant impact on morbidity and mortality. Despite growing awareness of thrombosis and increased use of antithrombotic therapy, there is little information in the veterinary literature to guide the use of anticoagulant and antiplatelet medications. The goal of Domain 1 was to explore the association between disease and thrombosis in a number of conditions identified as potential risk factors in the current veterinary literature, to provide the basis for prescribing recommendations. Design A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs. Revised guidelines then underwent the Delphi survey process to reach consensus on the final guidelines. Diseases evaluated included immune-mediated hemolytic anemia, protein-losing nephropathy, pancreatitis, glucocorticoid therapy, hyperadrenocorticism, neoplasia, sepsis, cerebrovascular disease, and cardiac disease. Settings Academic and referral veterinary medical centers. Results Of the diseases evaluated, a high risk for thrombosis was defined as dogs with immune-mediated hemolytic anemia or protein-losing nephropathy, cats with cardiomyopathy and associated risk factors, or dogs/cats with >1 disease or risk factor for thrombosis. Low or moderate risk for thrombosis was defined as dogs or cats with a single risk factor or disease, or dogs or cats with known risk factor conditions that are likely to resolve in days to weeks following treatment. Conclusions Documented disease associations with thrombosis provide the basis for recommendations on prescribing provided in subsequent domains. Numerous knowledge gaps were identified that represent opportunities for future study.
45 citations
TL;DR: In this article, specific treatment recommendations are made for each of the common thromboembolic conditions seen in dogs and cats with the important caveat that, to date, such suggested therapeutic approaches are based on limited evidence.
Abstract: In veterinary medicine, we are forced to make use of less than ideal "evidence," such as extrapolation from experimental studies in dogs and cats without naturally occurring diseases and from clinical trials in other species (particularly human clinical trials), as well as limited information gained from veterinary clinical experience, small clinical trials, case studies, and anecdotal reports. In this article, specific treatment recommendations are made for each of the common thromboembolic conditions seen in dogs and cats. These recommendations are made with the important caveat that, to date, such suggested therapeutic approaches are based on limited evidence.
45 citations
TL;DR: Retrospective studies of dogs with confirmed thrombosis in varying locations have identified populations most likely to experience hypercoagulable states, along with a review of specific disease processes that predispose to a hypercoAGulable state.
43 citations
TL;DR: Management of pancreatitis is based on supportive therapy and dietary measures, and management of complications and/or concurrent diseases is also crucial in cats with pancreatitis.
41 citations
References
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TL;DR: The most commonly accepted risk factors for venous thromboembolism (VTE) fall into one or more of these categories, as shown in Table 1 as discussed by the authors.
288 citations
TL;DR: Neoplasia, systemic bacterial disease, and immune-mediated hemolytic anemia were diagnosed most frequently and PTE was suspected antemortem in 11 of 17 animals; all had diseases previously reported to be associated with PTE.
Abstract: Pulmonary thromboembolism (PTE) occurs as a complication to a number of commonly encountered clinical diseases. Antemortem recognition of this life-threatening disorder is hampered by nonspecificity of clinical signs. This retrospective study was performed to analyze clinical features, laboratory findings, imaging abnormalities, and concurrent postmortem diagnoses in 29 dogs with confirmed pulmonary embolism. A variety of clinicopathologic and radiographic abnormalities were noted but there were no pathognomonic findings for PTE. Arterial blood gas analyses were performed in 15 (52%) of 29 dogs; 12 (80%) of 15 exhibited hypoxemia and 15 (100%) of 15 had increased alveolar-arterial oxygen gradients. Response to supplemental O2 was variable and did not correlate with the presence or absence of additional pulmonary pathology on postmortem. At postmortem, 25 (86%) of 29 dogs had grossly visible emboli, 17 (59%) of 29 dogs had multiple disease processes, and 16 (55%) of 29 dogs had additional pulmonary pathology. PTE was suspected antemortem in 11 (38%) of 29 dogs. In dogs with respiratory signs consistent with PTE, the condition was a differential diagnosis in 11 of 17 animals; all had diseases previously reported to be associated with PTE. Neoplasia, systemic bacterial disease, and immune-mediated hemolytic anemia were diagnosed most frequently.
161 citations
"Pulmonary thromboembolism in cats." refers background or result in this paper
...2 PTE in dogs is associated with immune-mediated hemolytic anemia, 3 heartworm disease, 4 hyperadrenocorticism, 5, 6 and other disorders....
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...In particular, the aims of this study were to (1) determine the prevalence of PTE in cats, (2) determine the signalment of cats that develop PTE, (3) determine the principal diseases associated with the development of PTE in cats, and (4) determine the clinical signs associated with PTE in cats....
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...2, 5, 7 Disorders that are associated with PTE in dogs and humans often have similar pathophysiology, and PTE causes marked morbidity and mortality in both species....
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...The findings of pleural effusion, alveolar opacification, peribronchial and interstitial markings, or pulmonary vascular congestion were similar to those previously reported for dogs and cats with PTE. 2, 8, 17 In this study, radiographic abnormalities of the pulmonary vasculature were not reported in any case....
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TL;DR: The medical records of 100 cats with distal aortic thromboembolism were reviewed, and the most frequent, underlying disease was hypertrophic feline cardiomyopathy, with the left atrial size significantly increased in the majority of cases.
Abstract: The medical records of 100 cats with distal aortic thromboembolism were reviewed. The average age was 7.7 years, with the neutered male being the most common signalment (63%). Evidence of preexisting cardiac disease was noted in 11% of the cases. A murmur or arrhythmia was noted in 57% of the cases on presentation. Frequent laboratory abnormalities included elevations in blood glucose, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, and creatinine. Radiographic and electrocardiographic abnormalities were common (89% and 85%, respectively). The most frequent, underlying disease was hypertrophic feline cardiomyopathy (58%), with the left atrial size (as measured by M-mode) significantly increased in the majority of cases (mean left atrial-to-aortic ratio, 2.08). The average, long-term survival in the 37% of cases which survived the initial thromboembolic episode was 11.5 months. The remaining cases either died (28%) or were euthanized (35%).
138 citations
"Pulmonary thromboembolism in cats." refers background in this paper
...8, 16 To further investigate this unusual finding, we reviewed the records of cats with heart disease that had been identified by the initial computer search but were excluded from the study group....
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TL;DR: Progression of glomerular disease was unpredictable, with no apparent correlation between survival time and biochemical parameters at presentation, and cases with amyloidosis were more likely to be azotemic at presentation.
Abstract: Medical records of 137 dogs with protein-losing glomerular disease (PLGD) were evaluated Cases with amyloidosis (23%) were more likely to be azotemic at presentation, with significantly greater proteinuria and hypoalbuminemia than those cases with glomerulonephritis (GN; 77%) The prognosis for all cases was poor, with a median survival time of just 28 days The most common causes of death in cases with idiopathic disease were chronic renal failure (695%) or thromboembolic complications (222%) Progression of glomerular disease was unpredictable, with no apparent correlation between survival time and biochemical parameters at presentation
124 citations
Journal Article•
TL;DR: Pulmonary thromboembolism was confirmed at necropsy in 10 (32.2%) of 31 dogs treated for immune-mediated hemolytic anemia and there was a tendency (P = 0.06) for association of higher number of whole blood transfusions with pulmonary thrombosis.
Abstract: Pulmonary thromboembolism was confirmed at necropsy in 10 (32.2%) of 31 dogs treated for immune-mediated hemolytic anemia. Radiographic findings associated with thromboembolism included pronounced interstitial lung pattern and small amounts of pleural effusion. Variables associated with significantly higher incidence of pulmonary thromboembolism included hyperbilirubinemia (P = 0.023), negative Coombs test result (P = 0.032), and presence of an indwelling catheter (P = 0.04). There was a tendency (P = 0.06) for association of higher number of whole blood transfusions with pulmonary thromboembolism.
117 citations
"Pulmonary thromboembolism in cats." refers background in this paper
...2 PTE in dogs is associated with immune-mediated hemolytic anemia, 3 heartworm disease, 4 hyperadrenocorticism, 5, 6 and other disorders....
[...]
...In particular, the aims of this study were to (1) determine the prevalence of PTE in cats, (2) determine the signalment of cats that develop PTE, (3) determine the principal diseases associated with the development of PTE in cats, and (4) determine the clinical signs associated with PTE in cats....
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