Prospective evaluation of tissue plasminogen activator in 11 cats with arterial thromboembolism

The purpose of this study was to evaluate the clinical response and side effects of tissue plasminogen activator (tPA) for the treatment of feline arterial thromboembolism (ATE). Previous reports of conservative and thrombolytic therapy were used to provide a historical control group of cats with ATE. The study was terminated due to a high frequency of adverse outcomes. tPA was administered to 11 cats with clinical signs of ATE for a median duration of 4.0 h (range 2-12 h) prior to treatment. Pulses were restored in 40% of limbs within 4 h and 53% within 24 h. Motor function was restored to 33% of limbs within 24 h. Adverse effects were seen in 11/11 cats following administration of tPA including azotemia (n = 5), neurological signs (n = 5), cardiac arrhythmias (n = 5), hyperkalemia (n = 4), acidosis (n = 2) and sudden death in one cat. Ultimately, three cats (27%) were discharged alive from the hospital. While signs compatible with thrombolysis were noted in many cats following tPA administration, a high rate of side effects and low rate of hospital discharge were noted in this study.