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Surgical embolectomy in a cat with cardiogenic aortic thromboembolism
T Vezzosi1, C Buralli2, A Briganti2
1Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122, San Piero a Grado, Pisa, Italy; Department of Cardiology, Anicura Istituto Veterinario di Novara, Strada Provinciale 9, Granozzo con Monticello, 28060, Novara, Italy.
Insights
Surgical embolectomy (SE) offers a viable treatment for cats experiencing sudden aortic thromboembolism (ATE). This procedure successfully restored blood flow, resolving ATE symptoms and preventing recurrence in a domestic longhair cat.
Area of Science:
- Veterinary Cardiology
- Emergency and Critical Care
- Surgical Intervention
Background:
- Aortic thromboembolism (ATE) is a critical condition in cats, often linked to underlying heart disease.
- Hypertrophic cardiomyopathy (HCM) is a common feline cardiac condition predisposing to ATE.
- Prompt diagnosis and intervention are crucial for managing ATE and improving patient outcomes.
Observation:
- A seven-year-old domestic longhair cat presented with acute hind limb paralysis due to ATE.
- Echocardiography revealed hypertrophic cardiomyopathy with severe left atrial enlargement.
- Abdominal ultrasonography identified a large thrombus at the aortic trifurcation, affecting both iliac arteries.
Findings:
- Emergent surgical embolectomy (SE) was performed to remove the aortoiliac thromboembolus.
- The procedure resulted in complete reperfusion of the rear limbs within hours, confirmed by clinical and ultrasound signs.
- Long-term medical management included antiplatelet drugs, furosemide, and benazepril.
Implications:
- Surgical embolectomy (SE) can be a successful alternative to conservative management for acute, bilateral aortic thromboembolism (ATE) in cats.
- This case demonstrates the potential for good long-term outcomes, with no recurrence of ATE or congestive heart failure after 18 months.
- SE should be considered in feline ATE cases with recent onset and bilateral iliac artery involvement.
Abstract:
A seven-year-old, spayed female, domestic longhair cat was referred for management of a sudden aortic thromboembolism (ATE). Echocardiography showed hypertrophic cardiomyopathy with severe left atrial enlargement. Ultrasonography of the abdominal aorta confirmed a large thrombus at the level of the aortic trifurcation, involving both iliac arteries. Considering the recent onset and bilateral involvement of the iliac arteries, the cat underwent emergent surgical embolectomy (SE) of the aortoiliac embolus. A standard caudal celiotomy was performed and the abdominal aorta was identified. Vessel loops with tourniquets were placed around the abdominal aorta proximal to the thrombus and on both iliac arteries distal to the thrombus. A full-thickness incision was made in the ventral surface of the aorta. The aortic thromboembolus was removed. The trifurcation was subsequently flushed with sterile saline. The SE resulted in a good outcome, with both clinical and ultrasound signs of complete reperfusion of the rear limbs within a few hours. Long-term treatment included antiplatelet drugs, furosemide and benazepril. Eighteen months after surgery, the cat was free of clinical signs, without recurrence of ATE or congestive heart failure. Based on the present case, SE could be considered as a feasible alternative to traditional conservative treatment in cats with a very recent onset of bilateral ATE.
