NAVLE Cardiovascular

Feline Thromboembolic Disease Study Guide

Feline aortic thromboembolism (FATE), also known as "saddle thrombus," is one of the most devastating complications of cardiac disease in cats.

Overview and Clinical Importance

Feline aortic thromboembolism (FATE), also known as "saddle thrombus," is one of the most devastating complications of cardiac disease in cats. This condition occurs when a thrombus, typically formed in the left atrium, dislodges and embolizes to the systemic arterial circulation. The most common site of embolization is the aortic trifurcation (where the aorta splits into the iliac arteries), affecting blood supply to the hindlimbs.

FATE represents a significant category on the NAVLE due to its dramatic clinical presentation, association with underlying cardiac disease, and the critical decision-making required for emergency management. Understanding the pathophysiology, recognition of clinical signs, and appropriate treatment protocols is essential for veterinary practice.

High-YieldFATE is almost always associated with underlying cardiac disease (approximately 90% of cases), most commonly hypertrophic cardiomyopathy (HCM). The first clinical sign of heart disease in many cats IS the thromboembolic event itself - 80% of cats with FATE had no previously recognized cardiac disease.
Cause Details and Prevalence
Cardiomyopathy Approximately 90% of cases; HCM is most common, followed by DCM, RCM, and UCM. About 25% of cats with HCM will develop FATE.
Neoplasia Second most common cause (approximately 6-10%); pulmonary neoplasia is most frequently associated
Hyperthyroidism Can cause thyrotoxic cardiomyopathy; some cats develop FATE even after becoming euthyroid
Other Causes Infection, inflammatory disease, corticosteroid or progesterone administration; approximately 3% have no identifiable cause

Etiology and Pathophysiology

Underlying Causes of FATE

Virchow's Triad in Feline Thromboembolism

Thrombus formation in cats with cardiomyopathy follows the classical principles of Virchow's triad, which describes three conditions that favor thrombosis:

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