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Detection of intra-cardiac thrombi and congestive heart failure in cats using computed tomographic angiography

Kyle P Vititoe1, Ryan C Fries1, Stephen Joslyn1

  • 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL.

Veterinary Radiology & Ultrasound : the Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
|April 17, 2018
PubMed

Insights

Computed tomographic (CT) angiography can safely identify cardiac thrombi in awake cats with heart disease. This imaging technique also reveals prognostic factors and comorbidities, aiding in feline cardiovascular disease management.

Area of Science:

  • Veterinary Medicine
  • Cardiology
  • Diagnostic Imaging

Background:

  • Arterial thromboembolism is a critical condition in cats, often linked to heart disease.
  • Echocardiography is the standard for thrombus detection, but computed tomographic (CT) angiography is emerging in human medicine for left atrial thrombi detection without sedation.
  • Evaluating cardiac thrombi and comorbidities in cats with heart disease requires advanced imaging techniques.

Purpose of the Study:

  • To introduce a novel CT angiography protocol for awake cats with cardiac disease and congestive heart failure.
  • To assess the accuracy of continuous and dynamic acquisition CT angiography in identifying and characterizing cardiac thrombi versus spontaneous echocardiographic contrast, using echocardiography as the reference.
  • To identify prognostic factors and thoracic comorbidities detectable by CT angiography that may supplement echocardiography.

Main Methods:

  • A prospective, controlled methods comparison pilot study involving 14 cats with heart disease (7 with thrombi, 7 with spontaneous echocardiographic contrast).
  • Both echocardiography and awake CT angiography with microdose contrast were performed.
  • CT angiography data were analyzed for thrombi identification and characterization, comparing continuous and dynamic acquisition phases.

Main Results:

  • CT angiography identified 6 out of 7 cardiac thrombi as filling defects, primarily in the left auricle.
  • Highest sensitivity (71.4%) was observed during the continuous phase, while highest specificity (85.7%) was in dynamic studies.
  • CT angiography detected prognostic information like left atrial enlargement and congestive heart failure, along with comorbidities such as pulmonary fibrosis and asthma.

Conclusions:

  • CT angiography is a safe and effective tool for identifying cardiac thrombi in cats with heart disease and congestive heart failure.
  • The technique provides valuable prognostic information and detects comorbidities, complementing echocardiographic assessments.
  • This study supports the use of awake CT angiography as a viable diagnostic method in feline cardiology.

Keywords:
VetMousetrapTMclotfelineleft auricle

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