Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, CO, 80523-1678, USA.
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, CO, 80523-1678, USA.
J Vet Cardiol. 2022 Jun;41:154-164. doi: 10.1016/j.jvc.2022.02.006. Epub 2022 Mar 3.
Systemic administration of tissue plasminogen activator (tPA) is seldomly reported in dogs and cats.
Client-owned animals receiving tPA (2010-2020).
Medical records of dogs and cats receiving tPA for distant known/suspected thrombus were reviewed. Fourteen dog visits (24 injections) and five cat visits (six injections) were included.
Canine known/suspected thrombus included pulmonary thromboembolism (n=6), intracardiac thrombus (n=4), aortic thrombus (n=1), cranial vena cava thrombus (n=2), and femoral and iliac veins thrombus (n=1). Various canine primary diseases were represented, but open-heart surgery was the most common cause. Median time between diagnosis/suspicion of thrombus and tPA injection was 24.5 h (range, 3-150 h). Mean total tPA dose was 1.0±0.78 mg/kg. Clinical improvement occurred in 93% of dogs. Non-fatal complications were reported in 14% of dogs. Dogs' survival to discharge was 78.6% without identifiable non-survivor characteristics. Feline known/suspected thrombus included unilateral feline aortic thromboembolism (FATE) (n=2), bilateral FATE (n=2), and right renal artery thrombus. Feline primary diseases included cardiomyopathy (n=5). Median time between diagnosis/suspicion of thrombus and tPA injection was 4 h (range, 2-17 h) and median total tPA dose was 1.0 mg/kg (range, 0.6-1.4 mg/kg).Clinical improvement occurred during 40% of the visits. All cats (n=3) with acute kidney injury (AKI) at admission developed worsening AKI and reperfusion injury. Of the remaining two visits, one developed a non-fatal AKI. Cats' survival to discharge was 40%.
Systemic thrombolysis with tPA seems to be effective and safe in dogs. More investigation is needed in cats.
组织型纤溶酶原激活物（tPA）的全身给药在犬猫中很少见。
接受 tPA 治疗的患宠（2010-2020 年）。
对接受 tPA 治疗已知/疑似远处血栓的犬猫的病历进行了回顾。共纳入 14 次犬就诊（24 次注射）和 5 次猫就诊（6 次注射）。
犬已知/疑似血栓包括肺血栓栓塞症（n=6）、心内血栓（n=4）、主动脉血栓（n=1）、头腔静脉血栓（n=2）、股静脉和髂静脉血栓（n=1）。各种犬原发性疾病均有代表，但心脏直视手术是最常见的病因。从诊断/怀疑血栓到 tPA 注射的中位时间为 24.5 小时（范围 3-150 小时）。平均总 tPA 剂量为 1.0±0.78mg/kg。93%的犬临床状况改善。14%的犬出现非致命性并发症。犬出院时存活率为 78.6%，无明显的非存活特征。猫已知/疑似血栓包括单侧猫主动脉血栓栓塞症（FATE）（n=2）、双侧 FATE（n=2）和右肾动脉血栓。猫的原发性疾病包括心肌病（n=5）。从诊断/怀疑血栓到 tPA 注射的中位时间为 4 小时（范围 2-17 小时），总 tPA 剂量中位数为 1.0mg/kg（范围 0.6-1.4mg/kg）。40%的就诊时临床状况改善。所有就诊时患有急性肾损伤（AKI）的猫（n=3）均出现 AKI 恶化和再灌注损伤。其余两次就诊中，有一次发生非致命性 AKI。猫出院时存活率为 40%。
tPA 全身溶栓在犬中似乎是有效且安全的。猫还需要更多的研究。
