J Am Anim Hosp Assoc. 2021 May 26;57(3). doi: 10.5326/JAAHA-MS-7073.
A 5 yr old male neutered domestic shorthair with intermittent signs of urinary tract obstruction was suspected of having a blood clot in the urinary bladder secondary to trauma. The cat was hospitalized and received standard supportive therapy for urinary tract obstruction with urinary catheterization, with the addition of intravesical saline flushes in an attempt to promote bladder clot lysis. The cat was subsequently discharged after voluntary urination was observed. The cat was represented 28 hr after discharge because of clinical signs consistent with urinary tract obstruction. The cat was hospitalized and intravesical tissue plasminogen activator (tPA) infusions (0.5 mg of tPA in 10 mL of saline with 2 hr dwell time q 8 hr) were administered to break down the bladder clot (2.78 × 4.46 cm). Thirty-two hours after starting tPA, the clot was no longer visible on ultrasound. The cat was discharged with no recurrent symptoms in the subsequent 11 mo. This is the first report of tPA being used for dissolution of bladder clot in a cat. There were no observed complications, suggesting that intravesical instillation of tPA may be a safe and efficacious therapy in cats, similar to the previously reported successes in dogs and humans.
一只 5 岁雄性已绝育的家养短毛猫，间歇性出现尿路梗阻症状，疑似因外伤导致膀胱内有血凝块。该猫住院并接受了标准的支持性尿路梗阻治疗，包括导尿和膀胱内盐水冲洗，以促进膀胱内血凝块的溶解。随后，在观察到自愿排尿后，该猫出院。在出院后 28 小时，该猫因与尿路梗阻一致的临床症状而再次就诊。该猫住院并接受了膀胱内组织型纤溶酶原激活剂（tPA）输注（10 毫升生理盐水中含有 0.5 毫克 tPA，停留时间为 2 小时，每 8 小时一次），以分解膀胱内的血凝块（2.78×4.46 厘米）。在开始使用 tPA 后 32 小时，超声检查已看不到血凝块。在随后的 11 个月中，该猫没有出现复发症状。这是首例报告 tPA 用于溶解猫的膀胱内血凝块。未观察到任何并发症，表明膀胱内灌注 tPA 可能是一种安全有效的猫治疗方法，与之前在狗和人类中报告的成功案例相似。
