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− | [[Image:sarcoma embolus.jpg|right|thumb|125px|<small><center>'''Sarcoma embolus (dog)'''. Courtesy of T. Scase</center></small>]] | + | [[Image:Sarcoma embolus.jpg|thumb|right|125px|<small><center><b>Sarcoma embolus (dog)</b>. Courtesy of T. Scase</center></small>]] |
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− | ===Description=== | + | == Introduction<br> == |
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− | *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.
| + | 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. |
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− | *The most significant sites of thromboembolic formation are the following: lungs, CNS, terminal aorta, kidneys.
| + | In order for a thromboembolism to occur, some changes in the vasculature need to occur. These include disruption of endothelial integrity, disruption of flow, disruption of blood haemostasis amd disruption of fibrinolysis. |
| + | The incidence of thromboembolism greatly increases with certain diseases including heart disease, neoplasia, blood disorders, parasitic diseases and hyperadrenocortiscm. |
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| + | <br> |
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− | '''Requirements for thromboembolism formation:
| + | == Clinical Signs<br> == |
− | '''
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− | 1. Disruption of endothelial integrity
| + | The '5 P's' are the characteristic clinical signs of thromboembolism. These are pain, paresis, pallor, pulselessness and polar (cold extremities). <span style="font-weight: bold;" /><span style="font-weight: bold;" /><span style="font-weight: bold;" /><span style="font-weight: bold;" />Long term clinical effects include necrosis of the affected area. Specific clinical signs relating to the thromboembolism being in a particular area include acute onset neurological problems, renal failure if clot in kidneys and dyspnoea if it is in the lungs.<br> |
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− | 2. Disruption of flow
| + | <br> |
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− | 3. Disruption of blood haemostasis
| + | == Diagnosis<br> == |
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− | 4. Disruption of fibrinolysis
| + | All findings and diagnostic procedures are heavily dependent on the site affected.<br> |
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| + | Blood tests may reveal hyperkalemia, acidosis, increased lactate, azotemia and elevated serum creatine phospohokinase. Radiography, Echocardiography and Angiography may also be used to diagnose a thromboembolism.<br> |
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− | '''The incidence of thromboembolism greatly increases with certain diseases including:
| + | <br> |
− | '''
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− | -Heart Disease
| + | == Treatment == |
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− | -Neoplasia
| + | It is important to treat the underlying conditions. Pain relief is vital and must be very strong, e.g. morphine. I.V. fluids will also need to be given as supportive treatment. Anticoagulants: Heparin or Aspirin should also be given. |
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− | -Blood Disorders
| + | <br> |
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− | -Parasitic Diseases
| + | == Prognosis<br> == |
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− | -Hyperadrenocorticism
| + | This is grave in most cases.<br> |
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| + | <br> |
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− | ====Diagnosis==== | + | == References<br> == |
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− | =====History & Clinical Signs=====
| + | Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company<br>Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)W.B. Saunders Company<br>Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier <br>Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial<br>Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier. <br> |
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− | '''5 P's:'''
| + | <br> |
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− | -Pain
| + | Literature Search |
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− | -Paresis
| + | [[Image:CABI logo.jpg|left|90px]] |
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− | -Pallor | + | <br> Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation). <br><br><br> [http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206605.pdf '''Feline thromboembolism.''' Moïse, N. S.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 229-232 - '''Full Text Article'''] |
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− | -Pulselessness
| + | [[Category:Arterial_Pathology]] [[Category:To_Do_-_Review]] [[Category:Vascular_Diseases_-_Dog]] [[Category:Vascular_Diseases_-_Cat]] |
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− | -Polar (cold extremities)
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− | '''Long Term Effects:'''
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− | -Necrosis
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− | '''Specific Problems:'''
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− | *Signs are dependant on site of thromboembolism
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− | -Neurological problems (acute)
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− | -Renal Failure (acute)
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− | -Dyspnoea (acute)
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− | ====Laboratory Findings====
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− | *Heavily dependent on thromboembolic site
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− | -Hyperkalemia
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− | -Acidosis
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− | -Increased Lactate
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− | -Azotemia
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− | -Elevated serum creatine phospohokinase
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− | ====Radiography, Echocardiography, Angiography====
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− | -Clots may be seen by the above methods
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− | ===Treatment===
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− | -Treat underlying conditions
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− | -Pain Relief (e.g. morphine)
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− | -Support with IV fluids
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− | -Anticoagulants:
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− | 1. Heparin
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− | 2. Aspirin
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− | ===Prognosis===
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− | -Grave
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− | ==Literature Search==
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− | [[File:CABI logo.jpg|left|90px]]
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− | Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
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− | <br><br><br>
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− | [http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206605.pdf ''' Feline thromboembolism.''' Moïse, N. S.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 229-232 - '''Full Text Article''']
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− | [[Category:Arterial_Pathology]][[Category:To_Do_-_Cardiovascular]] | |
− | [[Category:Vascular Diseases - Dog]][[Category:Vascular Diseases - Cat]] | |