Changes

Also Known As: '''''ATE'''''

Also Known As: '''''ATE'''''

==Clinical Signs==

==Clinical Signs==

The most common presenting signs are '''acute rear limb paralysis, depression, pain and [[Dyspnoea - Cat|dyspnoea]]'''. The paralysis may be unilateral or bilateral. On clinical exam there is an '''absence of femoral pulses''' in the affected limbs and the [[Canine Hindlimb - Anatomy & Physiology|cranial tibial and gastrocnemius muscles]] feel firm on palpation. The '''footpads are cold''' and '''discoloured''' and there is '''no response to noxious stimuli''' or '''movement''' in the lower limb. Additional findings include a lack of tone in the anal sphincter, bladder distention and abdominal pain. Pain and underlying cardiac disease can cause '''tachycardia and tachypnoea'''. Additional signs of cardiac disease may be detected on cardiac auscultation such as a '''[[Heart Murmur|murmur]], [[Arrhythimas|arrhythmia]]''' or gallop rhythm.

The most common presenting signs are '''acute rear limb paralysis, depression, pain and [[Dyspnoea - Cat|dyspnoea]]'''. The paralysis may be unilateral or bilateral. On clinical exam there is an '''absence of femoral pulses''' in the affected limbs and the [[Canine Hindlimb - Anatomy & Physiology|cranial tibial and gastrocnemius muscles]] feel firm on palpation. The '''footpads are cold''' and '''discoloured''' and there is '''no response to noxious stimuli''' or '''movement''' in the lower limb. Additional findings include a lack of tone in the anal sphincter, bladder distention and abdominal pain. Pain and underlying cardiac disease can cause '''tachycardia and tachypnoea'''. Additional signs of cardiac disease may be detected on cardiac auscultation such as a '''[[Heart Murmurs|murmur]], [[:Category:Arrhythmia|arrhythmia]]''' or gallop rhythm.

Reperfusion injury, which occurs several hours after clot formation may cause '''depression, [[Arrhythmias Overview|arrhythmias]] and cardiac conduction abnormalities'''. This can be fatal. Swelling and [[Oedema|oedema]] of the limbs is seen once reperfusion occurs.  

Reperfusion injury, which occurs several hours after clot formation may cause '''depression, [[Arrhythmias Overview|arrhythmias]] and cardiac conduction abnormalities'''. This can be fatal. Swelling and [[Oedema|oedema]] of the limbs is seen once reperfusion occurs.

==Diagnosis==  

==Diagnosis==  

====Echocardiography====  

====Echocardiography====  

Echocardiography is used to identify the underlying cardiac disease. It is possible to assess the level of [[Muscle Hypertrophy|hypertrophy]], systolic and diastolic dysfunction. Intra-atrial blood stasis and spontaneous contrast (clots) may also be evident on echo.  

Echocardiography is used to identify the underlying cardiac disease. It is possible to assess the level of hypertrophy, systolic and diastolic dysfunction. Intra-atrial blood stasis and spontaneous contrast (clots) may also be evident on echo.  

====Radiography====

====Radiography====

Thoracic radiography is useful to identify any [[Pulmonary Oedema|pulmonary oedema]] or pleural effusions caused by the underlying cardiac disease.

Thoracic radiography is useful to identify any [[Pulmonary Oedema|pulmonary oedema]] or pleural [[:Category:Effusions|effusions]] caused by the underlying cardiac disease.

====Biochemistry====

====Biochemistry====

==Prognosis==

==Prognosis==

'''Prognosis is entirely dependent on the level of ischaemic injury'''. Several features can give an indication of prognosis but ultimately only time will tell is the cat has the ability to regain function in the affected limb. Obviously less severe clinical signs on presentation suggests a ‘better’ prognosis. The type of cardiac disease present also affects prognosis, with a better prognosis in cases of [[HCM]] with minimal atrial enlargement and no congestive heart failure. It is reported that approximately one third of cats survive the initial thromboembolus and reperfusion injury. '''The condition is thought to recur in up to a quarter of cases'''.  

'''Prognosis is entirely dependent on the level of ischaemic injury'''. Several features can give an indication of prognosis but ultimately only time will tell if the cat has the ability to regain function in the affected limb. Obviously less severe clinical signs on presentation suggests a ‘better’ prognosis. The type of cardiac disease present also affects prognosis, with a better prognosis in cases of [[HCM]] with minimal atrial enlargement and no congestive heart failure. It is reported that approximately one third of cats survive the initial thromboembolus and reperfusion injury. '''The condition is thought to recur in up to a quarter of cases'''.  

==Prevention==

==Prevention==

Moise, NS (2007) '''Presentation and management of thromboembolism in cats''' ''In Practice 2007 29: 2-8''

Moise, NS (2007) '''Presentation and management of thromboembolism in cats''' ''In Practice 2007 29: 2-8''

[[Category: To Do - Siobhan Brade]]

 

[[Category:To Do - Manson review]]

 

 

[[Category:Vascular Diseases - Cat]]

[[Category:Expert Review - Small Animal]]