Thromboembolic Disease- CardioRush

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Alterations in blood flow, damage to vascular endothelium, change in coagulation proteins and platelets causing hypercoagulability
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Terms in this set (34)
Alterations in blood flow, damage to vascular endothelium, change in coagulation proteins and platelets causing hypercoagulability
What are the 3 contributors to Virchows triad that predispose to thrombus formation?
True
True or false: thrombus formation is a common cause of deterioration in critically ill animals, but less common in those with mild disease
Heparin, LMWH, clopidogrel, aspirin, warfarin, rivaroxaban
What are some drugs that are used to treat hypercoagulability?
False (contributes to all 3 factors: abnormal flow, hypercoagulability, vascular endothelial damage)
True or false: Neoplasia contributes to abnormal blood flow only in Virchow's triad
Nephrotic syndrome, Cushing's, IMHA, thyombocytosis, cardiac diseases esp in cats, sepsis, DIC, HWD, neoplasia
What are the most common diseases that we see thrombus formation as a complication in?
True
True or false: antithrombin deficiency occurs in many of the diseases that predispose to thrombus formation
Inactivates thrombin and other clotting factors
What is the purpose fo antithrombin?
False (only takes about 60-70% left of normal levels to start having thrombus formation)
True or false: it takes a severe reduction in antithrombin levels (<20% of original) to lead to thrombosis, due to reserve levels
Decreased synthesis, increased consumption, loss from intravascular compartment, increased protein catabolism
What are the general causes of antithrombin deficiency?
HCM
What does feline ATE occur as a sequelae to in 10-48% of cats?
Intracardiac thrombusWhat is the source of the thrombus in feline ATE with HCM?Blood stasis and abnormal flow, hyperreactivity of platelets, LA stretch can lead to collagen exposure and TF activation (tissue factor)What causes the thrombus to form in the heart in feline HCM?Site of thromboembolismWhat does the clinical presentation of feline ATE depend on?Saddle thrombusWhat location of thrombus results in ischemic myopathy and neuropathy in 90% of cases?Gut, kidney, liver, spleen, ovaries, forelimb, heartWhat are some sites that feline ATE can embolus to?Loss of femoral pulses, cyanotic nail bed, no bleeding, cool extremity, painful firm gastrocnemius, pain, sometimes concurrent signs of CHFWhat are the clinical signs of saddle thrombus in cats?TrueTrue or false: it is important to differentiate open mouth breathing due to CHF vs. pain when an animal presents with open mouth breathing and ATEPain, pallor, pulselessness, polar (cold), paresis (or paralysis)What are the 5 Ps of feline ATE?UMN disease, cardiogenic embolism, pulmonary neoplasia, systemic diseaseWhat are the differential diagnoses for feline ATE presentation?Sudden end of dyeWhat is the appearance of feline saddle thrombus on angiography?Thrombus in LAWhat is present in this echo?No visible thrombus, just enlarged LAWhat is usually found in the heart on echo in cats with ATE?Smoke in LAWhat echo finding tells us the cat is at a higher risk of thrombus formation?Primary lung tumor with digit syndrome (tumor mets to toe)Other than cardiac disease as the top cause of feline ATE, what is a less common cause?Anticoagulants, analgesics, treat CHF is presenthat are some ways we can treat active ATE?Heparin/LMWH, clopidogrel loading doseWhat are 2 examples of anticoagulants we would use in active ATE?Unfractionated heparinWhat is the most common type of heparin used as an anticoagulant?Adjust dose until aPTT is 1.5-2x times baselineWhat is the best way to chose a dose for unfractionated heparin as an anticoagulant?False (no single method has been shown to work best for treatment)True or false: surgery is the best method to treat ATETreat underlying disease, anticoagulantsWhat are some ways to prevent feline ATE?Antiplatelets, irreversibly blocks ADP binding receptor on platelet surface, reduced degranulationWhat does clopidogrel target for anticoagulation?Moderate to marked LAE, prior to ATE, LAE with smokeWhen should clopidogrel be started as an anticoagulant to prevent ATE?Inactivates thrombin and activated factor XaWhat is the MOA of low molecular weight heparin?Longer duration of action, good safety profile, no routine monitoringWhat are the characteristics of low molecular weight heparin?