Yarsley Ella, Sharp Claire R, Boyd Corrin J, Seo Joonbum, Mooney Erin
School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia.
Centre for Terrestrial Ecosystem Science and Sustainability, Harry Butler Institute, Murdoch University, Murdoch, WA, Australia.
Front Vet Sci. 2025 Jun 20;12:1561003. doi: 10.3389/fvets.2025.1561003. eCollection 2025.
The use of rivaroxaban, an oral direct factor Xa inhibitor, has only been described in a small number of publications in cats. The study objective was to describe the use of rivaroxaban in a large population of hospitalised cats.
Cases were retrospectively identified from June 2017 to July 2024 at seven veterinary specialty hospitals. Any cat prescribed rivaroxaban was eligible for inclusion. Data extracted from the medical records included signalment (age, sex, breed), body weight, reason for commencing rivaroxaban, dose and duration of rivaroxaban, concurrent anticoagulant and antiplatelet therapies, potential rivaroxaban adverse effects, and outcome. Non-parametric descriptive statistics are reported.
In total, 66 cats were included. Median rivaroxaban dose was 2.5 mg (Min-Max 1.25-10, Q1-Q3 2.5-5.0), equal to 0.73 mg/kg/day (Min-Max 0.28-1.87, Q1-Q3 0.53-1.0). A total of 36 cats (54.5%) were within the suggested dose range of 0.5-1 mg/kg/day of the Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines, 14 (21.2%) were below, while 16 (24.2%) were above. Median duration of rivaroxaban was 26.5 days (Min-Max 0-442, Q1-Q3 2-60), although followup was variable. The indication for rivaroxaban administration was confirmed thrombosis (48, 72.7%), strong clinical suspicion of thrombosis (6, 9.1%), and prophylaxis (12, 18.2%). Most thrombi were arterial, including aortic thromboembolism affecting both pelvic limbs (25/54 cats with thrombosis, 46.3%), arterial thrombosis affecting a single limb (16, 29.6%), and cardiac chamber thrombus (7, 13%). Cardiac disease was the most common thrombosis risk factor (53/66, 80.3%). Other CURATIVE defined risk factors included immune-mediated haemolytic anaemia in four cats (6.1%) and sepsis in one cat. Other thromboprophylaxis administered included clopidogrel in 58 cats (87.9%), dalteparin in 8 cats (12.1%), and aspirin in 4 cats (6.1%). Potential adverse effects prompting rivaroxaban discontinuation included one case each of vomiting, a cerebrovascular accident, gastrointestinal bleeding, and haemorrhagic pleural effusion. Forty-five cats (68.2%) survived to hospital discharge, 14 (21.2%) were euthanised, two (3%) died, and five (7.6%) were taken home against medical advice.
Rivaroxaban was well tolerated in a large population of cats, predominantly prescribed for arterial thrombosis associated with cardiac disease.
口服直接Xa因子抑制剂利伐沙班在猫中的应用仅在少数出版物中有描述。本研究的目的是描述利伐沙班在大量住院猫中的应用情况。
回顾性分析2017年6月至2024年7月期间七家兽医专科医院的病例。任何开具利伐沙班处方的猫均符合纳入标准。从病历中提取的数据包括特征（年龄、性别、品种）、体重、开始使用利伐沙班的原因、利伐沙班的剂量和疗程、同时使用的抗凝和抗血小板治疗、利伐沙班潜在的不良反应以及结局。报告了非参数描述性统计数据。
共纳入66只猫。利伐沙班的中位剂量为2.5毫克（最小值-最大值1.25-10，第一四分位数-第三四分位数2.5-5.0），相当于0.73毫克/千克/天（最小值-最大值0.28-1.87，第一四分位数-第三四分位数0.53-1.0）。共有36只猫（54.5%）在《兽医重症监护中抗血栓药物合理使用共识》（CURATIVE）指南建议的0.5-1毫克/千克/天剂量范围内，14只（21.2%）低于该范围，16只（24.2%）高于该范围。利伐沙班的中位疗程为26.5天（最小值-最大值0-442，第一四分位数-第三四分位数2-60），尽管随访情况各不相同。使用利伐沙班的指征为确诊血栓形成（48只，72.7%）、强烈临床怀疑血栓形成（6只，9.1%）和预防（12只，18.2%）。大多数血栓为动脉性，包括影响双后肢的主动脉血栓栓塞（25/54只血栓形成猫，46.3%）、影响单肢的动脉血栓形成（16只，29.6%）和心腔血栓（7只，13%）。心脏病是最常见的血栓形成危险因素（53/66，80.3%）。其他CURATIVE定义的危险因素包括4只猫（6.1%）的免疫介导性溶血性贫血和1只猫的败血症。其他预防性用药包括58只猫（87.9%）使用氯吡格雷、8只猫（12.1%）使用达肝素和4只猫（6.1%）使用阿司匹林。促使停用利伐沙班的潜在不良反应包括呕吐、脑血管意外、胃肠道出血和出血性胸腔积液各1例。45只猫（68.2%）存活至出院，14只（21.2%）实施安乐死，2只（3%）死亡，5只（7.6%）不听从医嘱自行回家。
利伐沙班在大量猫中耐受性良好，主要用于治疗与心脏病相关的动脉血栓形成。
