Thromboelastography evaluation of tissue plasminogen activator therapy in a cat with acute aortic thromboembolism due to hypertrophic cardiomyopathy

Year 2023, Volume: 2 Issue: 1, 10 - 16, 28.10.2023

Meriç Kocatürk , Pınar Levent , Zeki Yılmaz

Abstract

Acute arterial thromboembolism (ATE) is a very painful and fatal serious condition in which the thrombus lodges in the trifurcation of the aorta, resulting in death or severe damage to organs if not treated immediately. Thrombolytic agents such as tissue plasminogen activator (tPA) are preferred as a first choice of the treatment for ATE; however, they should be used carefully because of their possible side effects such as spontaneous bleeding in human and animals. Therefore, monitoring coagulation status plays an important role in the management and treatment of dissolving intravascular clots. Thromboelastography (TEG) that measures the dynamics of clot formation, strength, and lysis, and provides information of clot consistency has been accepted as a useful tool for assessing coagulation status and response to thrombolytic therapy. There is no study showing the thromboelastographic monitoring of the thrombolytic therapy with intravenous tPA in cats. Therefore, we reported here a successful thrombolysis using tPA and for the first time monitoring the lytic treatment by TEG in a cat with ATE due to hypertrophic cardiomyopathy (HCM).

Keywords

Acute aortic thromboembolism, thromboelastography, tissue plasminogen activator, cat.

Hipertrofik kardiyomiyopatiye bağlı akut aortik tromboembolisi olan bir kedide doku plazminojen aktivatörü tedavisinin tromboelastografi ile değerlendirilmesi

Abstract

Akut arteriyel tromboembolizm (ATE), trombusun aortun trifürkasyonuna yerleştiği, hemen tedavi edilmezse ölüme veya organlarda ciddi hasara yol açan çok ağrılı ve ölümcül ciddiyetli bir durumdur. ATE tedavisinde ilk seçenek olarak doku plazminojen aktivatörü (tPA) gibi trombolitik ajanlar tercih edilmektedir; ancak insan ve hayvanlarda spontan kanama gibi olası yan etkileri nedeniyle dikkatli kullanılmaları gerekir. Bu nedenle pıhtılaşma durumunun izlenmesi, çözünen intravasküler pıhtıların yönetimi ve tedavisinde önemli bir rol oynar. Pıhtı oluşumu, gücü ve lizis dinamiklerini ölçen ve pıhtı tutarlılığı hakkında bilgi sağlayan tromboelastografi (TEG), pıhtılaşma durumunu ve trombolitik tedaviye yanıtı değerlendirmede yararlı bir araç olarak kabul edilmiştir. Kedilerde intravenöz tPA ile uygulanan trombolitik tedavinin tromboelastografik takibini gösteren bir çalışma bulunmamaktadır. Bu nedenle burada hipertrofik kardiyomiyopatiye (HCM) bağlı ATE'li bir kedide tPA kullanılarak başarılı bir trombolizi rapor ettik ve ilk kez TEG ile trombolitik tedaviyi izledik.

Keywords

Akut aortik tromboembolis, tromboelastografi, doku plazminojen aktivatörü, kedi.

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