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Re: [FH] Saddle Thrombus - URGENT NEED HELP ASAP!!!!

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  • acrocat@rocketmail.com
    Re: the use of heparin etc. Just to clarify, heparin does not dissolve the clot. Its use (usually in a specific form called fractionated or low molecular
    Message 1 of 14 , Dec 8, 2012
      Re: the use of heparin etc.

      Just to clarify, heparin does not dissolve the clot. Its use (usually in a specific form called fractionated or low molecular weight heparin) in clot cats is meant to keep the clot from getting bigger, and to help prevent other clots from forming. Whether it works for this purpose is not definitively known.

      The only clot-busting agent used in these cases would be streptokinase. It is really almost never used in cats because it is expensive (too expensive to keep in stock) and quite high-risk. It breaks up clots indiscriminately (we make 'appropriate' clots all the time) and there is a high risk of reperfusion injury--what Kendra referred to in the below snippet. Unless one is there to witness the clot event and immediately transport the cat to the vet, there is a risk of fatal reperfusion injury if streptokinase is used. The treatment for saddle thrombus is mainly supportive -- pain meds, use of LMW heparin to help stave off further clot formation, treatment of CHF if it occurs at the same time, and monitoring for reperfusion injury. The body can break the clot down, and if it happens soon enough after the clot is formed, the leg(s) can be saved. However, a cat who throws one clot is extremely likely to have another, so the reprieve may be short-lived.

      Adriann


      --- In feline-heart@yahoogroups.com, Kendra DeSantolo <kdesantolo@...> wrote:
      > But what the vet said was that we found her too late with
      > this condition and once it becomes advanced the circulation has to be
      > reintroduced gradually rather than suddenly or else you flood the body with
      > toxins (gangrene? or dying tissue?) that could be a horrible trauma to the
      > cat even worse than now and cause sudden death of heart muscle and
      > kidneys. She felt strongly about this and said the herbs were strong
      > medicine, as aggressive as she could offer (I have seen her herbs work
      > miracles in the past). Challenge was getting enough of them into a nauseous
      > cat. And now since Plan A did not work, the limbs may be irreversibly
      > damaged. I will post later what the other vet tells me.
      >
      > Thanks again,
      > Kendra
      >
      >
      >
      > On Sat, Dec 8, 2012 at 10:18 AM, Banu Korgul <banukorgul@...> wrote:
      >
      > > **
      > >
      > >
      > > I am very sorry about your kitty.. I have heard Nattokinase (without vit
      > > K) has clot dissolving effects..
      > > Maybe you want to try..
      > >
      > > Best wishes..
      > > banu
      > >
      > >
      > > >________________________________
      > > > From: Lynn <mosaic.artist@...>
      > > >To: feline-heart@yahoogroups.com; Laurie Stead <kittykatwhiskas@...>
      > >
      > > >Sent: Saturday, December 8, 2012 6:36 PM
      > > >Subject: Re: [FH] Saddle Thrombus - URGENT NEED HELP ASAP!!!!
      > >
      > > >
      > > >
      > > >
      > > >
      > > >Kendra,
      > > >
      > > >My heart goes out to you. These are such difficult decisions!!!
      > > >
      > > >This is such a personal decision, but I have always wondered, did I do
      > > this too early or did I wait too long?
      > > >
      > > >It sounds like you are not sure; that you are going along with what the
      > > vets recommend. I've written to you about our success story on one of the
      > > other lists. I do think blood thinners could be important as well as seeing
      > > a cardiologist.
      > > >
      > > >But YOU know your cat. You are seeing positive signs. You could get
      > > something to inject for pain if you choose not to euthanize.
      > > >
      > > >Not being a vet, I don't know. My ki had been paralyzed in his back legs
      > > for a least a week when he had CHF. His leg pulses were weak. He was
      > > miserable. It was difficult. None of the doctors thought he would survive,
      > > but I was lucky none of them told me that, because he is here 8 years later.
      > > >
      > > >I do think if there is doubt, get a back up plan for pain and nutrition
      > > and give it more time until you are sure. So many people get the digest, so
      > > I worry they won't get your post in time. Do trying searching the archives.
      > > Perhaps you can find information there that may help you.
      > > >
      > > >All my best to you.
      > > >
      > > >Lynn
      > > >
      > > >--- On Sat, 12/8/12, Laurie Stead <mailto:kittykatwhiskas%40yahoo.com>
      > > wrote:
      > > >
      > > >From: Laurie Stead <mailto:kittykatwhiskas%40yahoo.com>
      > >
      > > >Subject: [FH] Saddle Thrombus - URGENT NEED HELP ASAP!!!!
      > > >To: mailto:feline-heart%40yahoogroups.com
      > >
      > > >Date: Saturday, December 8, 2012, 8:08 AM
      > > >
      > > >
      > > >
      > > >Kendra, I am so sorry about Indy. I don't have experience with treating
      > > this but I do know others in the group have been successful. I am
      > > surprised you were not given medications to dissolve the blood clot and to
      > > prevent future ones?? From my understanding it can be very painful and
      > > cats are known to cry in pain. It does not sound like that happened with
      > > Indy so perhaps she can recover.
      > > >
      > > >I am changing the subject with more urgency since you need more info
      > > right away.
      > > >
      > > >We will pray for Indy and keep pawsitive thoughts for her.
      > > >
      > > >Laurie
      > > >
      > > >--- On Sat, 12/8/12, kltds1 <mailto:kdesantolo%40gmail.com> wrote:
      > > >
      > > >From: kltds1 <mailto:kdesantolo%40gmail.com>
      > > >
      > > >Subject: [FH] Saddle Thrombus
      > > >
      > > >To: mailto:feline-heart%40yahoogroups.com
      > >
      > > >
      > > >Date: Saturday, December 8, 2012, 10:52 AM
      > > >
      > > >
      > > >
      > > >Hello,
      > > >
      > > >I am new to the group and writing because my 4 y.o. cat Indy developed a
      > > saddle thrombus. This happened some time Thursday and I found her late
      > > Thursday night. The emergency vet said my only option was immediate
      > > euthanasia. I took her to my regular vet the next day and we tried herbs to
      > > soften the clot, but the lower legs remain without measurable blood
      > > pressure at the 48 hour mark, so she, too has now recommended euthanasia.
      > > >
      > > >She said even if the clot now dissolves she fears the necrotic tissues
      > > will overwhelm the cat’s system. Parts of the leg muscles are getting
      > > "congested" (swelling with fluids) and she had no pain response in the back
      > > legs or tail. Yet when I got home an hour later, Indy started wagging her
      > > tail in fact thumping it angrily when I gave her subâ€"Q fluids. So some
      > > reanimation is happening in the â€Å"dead� limbs though not in the legs
      > > yet.
      > > >
      > > >The only reason I continue investigating is because of reading success
      > > stories despite the stats. Indy still has fight in her. I have been giving
      > > fluids (moderate due to the possible heart condition though she is very
      > > dehydrated), force feeding (just Nutrical and water) and Buprenex, but
      > > today she is very nauseous so the Buprenex and Nutrical will not stay down.
      > > I don’t want her to suffer â€" esp now that the pain meds may not be
      > > staying in her long enough to work. But if anyone has any useful advice, I
      > > would rather hear it before we make her final decision today in a few hours.
      > > >
      > > >Thanks so much,
      > > >
      > > >Kendra
      > > >
      > > >__.
      > > >
      > > >[Non-text portions of this message have been removed]
      > > >
      > > >[Non-text portions of this message have been removed]
      > > >
      > > >
      > > >
      > >
      > > [Non-text portions of this message have been removed]
      > >
      > >
      > >
      >
      >
      > [Non-text portions of this message have been removed]
      >
    • Lynn
      Kendra, Here is an article on Saddle Thrombosis.The prognosis may be better than your vet said according to this. My cat didn t have any necrosis and was
      Message 2 of 14 , Dec 8, 2012
        Kendra,

        Here is an article on Saddle Thrombosis.The prognosis may be better than your vet said according to this.
        My cat didn't have any necrosis and was paralyzed on and off for several weeks.

        Best of luck to you. A cardiologist  might be able to help through the ER, though I never get good care there.
         http://www.marvistavet.com/html/feline_aortic_thromboembolism.html

        Lynn

















        [Non-text portions of this message have been removed]
      • Lynn
        I reading this jogged my memory. When my cat had CHF, HCM and then saddle thrombosis, he was on daily aspirin as part of his medication.  I wonder if this
        Message 3 of 14 , Dec 8, 2012
          I reading this jogged my memory. When my cat had CHF, HCM and then saddle thrombosis, he was on daily aspirin as part of his medication.  I wonder if this would help? He regained use of his legs and is still here at 19 years old 8 years after this! 

          Praying for a miracle for Indy.

          Lynn

          --- On Sat, 12/8/12, acrocat@... <acrocat@...> wrote:

          From: acrocat@... <acrocat@...>
          Subject: Re: [FH] Saddle Thrombus - URGENT NEED HELP ASAP!!!!
          To: feline-heart@yahoogroups.com
          Date: Saturday, December 8, 2012, 5:10 PM
















           









          Re: the use of heparin etc.



          Just to clarify, heparin does not dissolve the clot. Its use (usually in a specific form called fractionated or low molecular weight heparin) in clot cats is meant to keep the clot from getting bigger, and to help prevent other clots from forming. Whether it works for this purpose is not definitively known.



          The only clot-busting agent used in these cases would be streptokinase. It is really almost never used in cats because it is expensive (too expensive to keep in stock) and quite high-risk. It breaks up clots indiscriminately (we make 'appropriate' clots all the time) and there is a high risk of reperfusion injury--what Kendra referred to in the below snippet. Unless one is there to witness the clot event and immediately transport the cat to the vet, there is a risk of fatal reperfusion injury if streptokinase is used. The treatment for saddle thrombus is mainly supportive -- pain meds, use of LMW heparin to help stave off further clot formation, treatment of CHF if it occurs at the same time, and monitoring for reperfusion injury. The body can break the clot down, and if it happens soon enough after the clot is formed, the leg(s) can be saved. However, a cat who throws one clot is extremely likely to have another, so the reprieve may be short-lived.



          Adriann






















          [Non-text portions of this message have been removed]
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