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Feline cardiogenic arterial thromboembolus (ATE), also known as “saddle thrombus”, is serious and a devastating complication of heart disease in cats. Every year, it affects as many as 25% of cats with hypertrophic cardiomyopathy, a general feline heart condition.
Saddle thrombosis in cats treatment involve intensive care in a hospital setting for the first 48 hours or more. The purpose of blood clot treatment include: Pain management through the use of strong morphine-derived pain killers.
Heart disease can cause series of disturbances in blood flow through the heart. This will ultimately lead to the formation of blood clots.
For example, in cats, these blood clots can travel downstream and become lodged in the femoral arteries – the main arteries that provide blood flow to the hind limbs.
FATE strikes its victims without warming; in fact it may be the first and only sign of heart disease in some cases. When it strikes, there is a loss of blood flow to the hind legs causing severe pain, cold limbs, decreased pulses, and paralysis.
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Saddle Thrombosis in Cats Treatment
FATE no doubt, is one painful and serious condition. Because of the uncertain outlook and the possibility of underlying heart disease, at least a quarter of pet parents opt for humane euthanasia rather than treatment.
If you however opt for treatment, Cats with acute FATE require intensive care in a hospital setting for the first 48 hours or more. The goals of blood clot treatment include: Manage pain. Strong morphine-derived pain killers are used.
- Provide Support Care
Fluid therapy helps prevent dehydration and treat the circulatory shock caused by the clot, but it must be used with care in heart disease patients. Strict cage rest is advised and may last days to weeks.
A good effort of nursing care might be required to keep the paralyzed cat comfortable and clean while the hind legs slowly heal and regain function.
- Fix Underlying heart disease
Address any present underlying heart disease. Heart diuretics and medications may be used to boost heart function and treat heart failure.
- Stop further clot formation
This step is controversial. Until new studies discovered the use of human anti-clog drug, Plavix®, Aspirin has always been the go-to fix drug.
A pet with saddle thrombus is often in shock and may already begin to experience heart failure, so the situation might lead to death even with immediate veterinary care.
Even when shock or heart failure does not occur or can be controlled, your pet still had a blood clot and a heart disease in the left side of the heart that could dislodge another embolism at any time.
The bad news is that about half of pet owners decide to euthanize their pet because of the extreme pain the animal is in, the chances for recurrence of the condition, and the need for long-term management of heart disease even in cases in which the pet survives the initial crisis.
On the hand, if you choose to treat this condition, the aim of blood clot management is to address the pain, offer support and care in form of fluid therapy, and treat circulatory shock. The pet should be on cage rest and a great deal of nursing care will be needed to keep the paralyzed clean and comfortable.
An encouraging saddle thrombosis in cats treatment is medicinal leeching. Israeli borne veterinarian Dr. Sagiv Ben-Yakir has attained about a 90 percent success rate in returning cats with FATE to a normal life using leech therapy.
In addition to clot management, the underlying heart disease must be addressed. I advise that every cat who have survived an episode of excessive blood clotting should be placed on life-long ubiquinol supplementation (ubiquinol is the reduced form of CoQ10).
Prevention of the formation of added clots is also necessary. I recommend a supplement known as nattokinase for this purpose.
Most cats who survive a FATE episode will regain normal limb function within a few months. However, they generally require a great deal of nursing care until they can move freely on their own. Recurrence of aortic thromboembolism is common, generally within a year or two of the first episode.
Partnering with an integrative veterinarian using holistic preventive strategies is a really good idea.
What Is Saddle Thrombus in Cats?
FATE happens when a blood clot forms, usually in the heart, then breaks loose. It enters the circulation but eventually gets stuck, causing a blockage. This may be a small, large clot, or embolism, known as a thrombus.
The most witnessed blockage point is in the lower abdomen where the aorta, the main blood vessel leaving the heart, forms two branches going back to the back legs.
This spot is called the saddle, and is common for the blood to come to rest at the top of that point, leading to the term cat blood clot or sale thrombus.
Once blood is blocked at the saddle, the nerves and muscles swell as a result of lack in nutrients and oxygen. Also, the rear limbs grow cold.
The patient is suddenly paralyzed and in severe pain.
Who is at risk of aortic thromboembolism?
Cardiogenic arterial thromboembolus manifests mostly in cats with advanced heart disease and is rarely seen in dogs. Athough certain breeds like Ragdoll, Abyssinian, Persian, Maine, and Coon are more prone to the disease; saddle thrombus can still occur in cats of any age or breed, although it is more seen in cats 8 years and older.
Is Saddle Thrombosis Hereditary
Yes, it is believed to be hereditary in nature and male cats are twice likely to suffer from this heart condition than females.
Why Do Blood Clots Form in Cats?
90% of domesticated cats with FATE have a pre-existing heart problem such as hypertrophic cardiomyopathy (HCM).
HCM causes structural changes in the heart that promote blood clot formation. The ventricles, or lower heart chambers, particularly the left ventricle, won’t pump well when they get hit by HCM.
This cause blood to pool and stagnate in the left atrium, the top heart chamber. Where the flow of blood is stagnant, clots tend to form.
Ultimately, a fragments or clot breaks loose and enters the circulation. A big enough clot forms a classic saddle thrombus, although smaller fragments hive been known to travel to the brain, kidney, or intestine.
Other causes of clot formation in the cat include certain cancers and hyperthyroidism, especially lung cancer.
Cat Breeds Most Likely to Be Affected by Excessive Blood Clots
Since FATE is often linked with heart disease, its prevalence shows the same patters.
Since FATE is often associated with heart disease, its prevalence follows the same patterns. Abyssinians, Birmans, and ragdolls are over-represented in FATE cases as are middle-aged males, because HCM is more common in these patients.
Top Signs of FATE in Cats
The signs of FATE come on suddenly and may include:
- Screaming or Crying
- Dragging of one or both hind legs.
- Difficulty breathing.
- Open-mouthed breathing
- Vomiting
- Weakness
Your vet may also notice:
- Arrhythmia or heart murmur
- Abdominal lung sounds
- Abnormal lung sounds
- Heart murmur or arrhythmia.
- Lack of pulses in one or both hind legs.
- Nail beds and paw pads that appear cyanotic (blue-tinged).
- Rear legs that are cold to the touch.
- Leg muscles that are hard and extremely painful..
- Abnormal lung sounds.
These signs indicate immediate saddle thrombosis in cats treatment.
These signs of an aortic thromboembolism in kitties depend on which blocked and whether the blockage is a total or partial blockage. If the clot moves past the saddle and enters into just one iliac artery, only the hind leg will be involved. If it sits right at the split, both hind legs will be affected.
Once the circulation of blood is blocked at the saddle, the rear legs grow cold and hard as the nerves and muscles swell as a result of lack of nutrients and oxygen. The animal may both or one leg, scream in pain or cry out, and may pant or have open-mouthed breathing as well.
The pads or nails of the back feet may appear bluish in color as a result of lack of oxygen, and the cat may show signs of shock. Sudden paralysis is also a common symptom with this condition.
FATE is a serious medical emergency in the cat. Seek immediate emergency veterinary care if your cat is showing signs of FATE.
Diagnosis of Saddle Thrombus in Cats
FATE is diagnosed based on its distinctive clinical presentation. Diagnostic imaging and laboratory tests may be needed to confirm the diagnosis, to detect underlying heart failure or disease, and to rule out other problems.
Diagnostic workup includes:
- Biochemistry profile to determine whether organ function is appropriate
- CBC (Complete blood count)to evaluate for infection, anemia, and blood clotting factors.
- Chest x-rays to evaluate the character and size of the heart and its associated blood vessels as well as the state of the lungs.
- Doppler test to confirm the absence of blood flow in the legs.
- Echocardiogram to evaluate for heart disease.
Prognosis for aortic thromboembolism
Despite treatment, the prognosis is poor and lots of cats are euthanized due to poor quality of life and recurrences. However, newer anti-thrombotics that with hope helps cats with aortic thromboembolisms live longer are currently being evaluated and may be available in the next 5 years.
Clinical trials
There are lots of current studies looking into different treatment options for saddle thrombi and also for ways to stop new clots from forming.
We hope that the works of these researchers will determine the most effective medications available to stop cats from developing blood clots and also create better treatment option for cats that already have a “saddle thrombus” To find out about current clinical trials speak with your veterinarian.
Prevention
The best prevention for Aortic thromboembolism is to take your cat to the veterinarian at least once a year to screen for heart disease.
He/she will listen to your paw-friend’s heart for abnormal sounds like irregular rhythms or murmurs and will search for other subtle signs of heart disease.
If your veterinarian suspects heart disease, they may measure NT-proBNP blood pressure or recommend more tests like x-rays, cardiac ultrasounds, or ECGs to confirm the diagnosis and pinpoint the cause so that saddle thrombosis in cats treatment can begin immediately.
Starting treatment for heart disease earlier can improve quality of life and extend life expectancy.
Recovery of Excessive Blood Clotting in Cats
Like other medical condition, it is important to keep all follow-up appointments for your pet. Your veterinarian will almost recommend strict cage rest for your cat for a certain period of time.
Depending on the seriousness of the blood clot, this many vary from a couple of days to a couple of weeks. Nursing care may be needed until the cat can control its hind legs.
So can a cat recover from a blood clot?…. Yes, Absolutely!
Recovery depends on the severity of the obstruction and the health of the heart. Cats who only suffered a mild blockage with minor paralysis may experience a complete recovery if given the proper treatment.
Saddle Thrombus In Dogs
Now, it is core to note that cats are not the only ones that we see facing blood clot problems. More dogs are getting recognized for more problematic blood clots.
However, the disease is more manageable than the feline variety. A few disorders you may have heard dog experience include but not limited to: Cushing’s disease (an adrenal gland disorder), some cancers, immune-mediated hemolytic anemia (IMHA), heartworm disease and the medical mouthful of glomerulonephritis (a kidney disorder).
If you think your cat friend have or had a saddle thrombus see your vet ASAP! Saddle thrombosis in cats treatment is easier once it has been identified earlier.
If you have any questions or concerns about Saddle thrombosis in cats treatment, you should always visit or call your veterinarian — they are your best resource to ensure the health and well-being of your pets (cats included).
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What is the dosage for nattokinase and ubiquinol for cats who have saddle thrombus brought on by HCM?
Hi Diana,
For an average sized, 10 pound cat, the dose of Nattokinase is 75 mg split into 2 doses. We also advise long-term ubiquinol supplementation for all heart patients (as per your vets recommednation).