Thromboembolism

Sarcoma embolus (dog). Courtesy of T. Scase

Description

• As the name implies, a thromboembolism is a clot (thrombus) or foreign body that blocks vessels a distance away from its original site of origin.

• The most significant sites of thromboembolic formation are the following: lungs, CNS, terminal aorta, kidneys.

Requirements for thromboembolism formation:

1. Disruption of endothelial integrity

2. Disruption of flow

3. Disruption of blood haemostasis

4. Disruption of fibrinolysis

The incidence of thromboembolism greatly increases with certain diseases including:

-Heart Disease

-Neoplasia

-Blood Disorders

-Parasitic Diseases

-Hyperadrenocorticism

Diagnosis

History & Clinical Signs

5 P's:

-Pain

-Paresis

-Pallor

-Pulselessness

-Polar (cold extremities)

Long Term Effects:

-Necrosis

Specific Problems:

• Signs are dependant on site of thromboembolism

-Neurological problems (acute)

-Renal Failure (acute)

-Dyspnoea (acute)

Laboratory Findings

• Heavily dependent on thromboembolic site

-Hyperkalemia

-Acidosis

-Increased Lactate

-Azotemia

-Elevated serum creatine phospohokinase

Radiography, Echocardiography, Angiography

-Clots may be seen by the above methods

Treatment

-Treat underlying conditions

-Pain Relief (e.g. morphine)

-Support with IV fluids

-Anticoagulants:

1. Heparin

2. Aspirin

Prognosis

-Grave