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The aorta is the widest artery in the body, and when it splits at this trifurcation, the iliac arteries are significantly smaller.
The thrombus (clot) normally forms in the heart and travels down the aorta without causing problems.
When it reaches the iliac arteries it gets stuck occluding the blood flow and this means the legs no longer have a blood supply. Vital supplies of blood and oxygen are abruptly halted, with no backup (collateral circulation).
Blood testing will assess general health and ability to tolerate medications.
Echocardiography to classify the heart disease. Begin treatment of the underlying heart disease when the patient is stable.
Treatment
Pain management! Intravenous heparin to attempt to dissolve the clot. Aspirin or Plavix Physical therapy Oxygen therapy as needed. Intravenous fluid therapy. Surgical intervention is associated with a poor survival rate.
Supportive Care
Nursing care involves managing the comfort of the affected limbs. The legs need to be kept warm. Physical therapy including passive range of motion. The care giver moves a joint through its entire range of motion without assistance from the patient.
Bladder support. The patient may not be able to urinate on his own and may need to have his bladder expressed.
Cats with a rectal temperature of 98.9F have a 50% or higher chance of survival.
25% of pet owners elect euthanasia without attempting treatment.
Median survival time of cats in heart failure is 77 days. Cats not in heart failure 223 days.
Be aware of the potential for pressure sores from sitting in one position for long periods of time, and scrapes from dragging the hind limbs around.
His bladder may or many not need to be expressed to allow him to urinate. Continued physical therapy at home will help keep the limbs flexible.
Prevention
There is no known way to predict which atrisk cat will develop a embolism. The best prevention is regular veterinary exams. If there are any signs of heart disease:
Heart murmur Change in rhythm Change in breathing patterns
References CVCA Cardiac Care for Pets (2013). Echocardiogram [Ultrasound Image]. Retrieved from http://www.cvcavets.com/felinearterial-thromboembolism.asp Drs. Foster & Smith Educational Staff (n.d.). Saddle Thrombi Diagram [Line Drawing]. Retrieved from http://www.drsfostersmith.com/images/articles/a_1463_Saddle_Thrombi.jpg The Merck Manual For Pet Health (2011). Thrombus [Line Drawing]. Retrieved from: http://www.merckmanuals.com/pethealth/cat_disorders_and_diseases/heart_and_blood_vessel_disorders_of_cats/blo od_clots_and_aneurysms_in_cats.html Nelson, R. W., & Couto, C. G. (2003). Aortic thromboembolism in a cat [Photograph]. Retrieved from http://www.answers.com/topic/aortic-3 Pavlina, S. (2013). Feline arterial thromboembolism: A terrible FATE. Veterinary Technician, E1-4. Retrieved from http://www.vetlearn.com/veterinary-technician/feline-arterial-thromboembolism-a-terrible-fate Ware, W.A. (n.d). Hypertrophic Cardiomyopathy [Drawing]. Retrieved from http://maxshouse.com/Illustrations/Hypertrophic_Cardiomyopathy-Dia.jpg