Diagnostic challenges and emerging therapeutic strategies for aortic Thromboembolism in cats

Abstract

Background/Objective: Aortic Thromboembolism (ATE) is a life-threatening event that can occur in cats and has a highly unpredictable outcome. This review aims to analyze the challenges related to diagnosis and to introduce innovative therapeutic strategies within the framework of this condition.

Methodology: The purpose of this systematic narrative review was to conduct a comprehensive search of the databases PubMed/Medline, Scopus, and Web of Science using relevant keywords between January 2019 and May 2024. Using a set of predetermined criteria, the eligible studies were selected, and the data were analyzed through a narrative synthesis.

Results: In conclusion, the diagnostic challenges of acute ischemic attack (ATA) include a wide range of clinical signs, from sudden hindlimb paralysis to nonspecific symptoms like shortness of breath. Additionally, current biomarkers have limitations, as seen with D-dimer's lack of specificity, which highlights the need for modern imaging techniques such as echocardiography, Doppler ultrasound, and CT angiography. Direct oral anticoagulants (DOACs), like rivaroxaban, are recognized as effective alternatives to warfarin in treatment. These DOACs have predictable pharmacokinetics, so regular monitoring isn't necessary. Clopidogrel has also demonstrated effectiveness as a first-line therapy to prevent recurrence. Conversely, aggressive treatments like thrombolysis offer limited benefits due to their high risk of side effects and low survival rates among patients.

Conclusion: Although ATE remains a significant therapeutic challenge, the combination of advanced diagnostic methods with innovative treatment approaches, especially DOACs, is promising and could lead to better clinical outcomes for cats affected by the condition. More research is needed to develop standard protocols and to evaluate clinical trials with larger sample sizes.