Retrospective analysis of the use of tranexamic acid in critically ill dogs and cats (2018-2019): 266 dogs and 28 cats.

Abstract

To describe the signalment, dosing, adverse events, and patient diagnosis for dogs and cats admitted to the critical care unit (CCU) receiving tranexamic acid (TXA). Case series from 2018 to 2019. Private referral and primary care veterinary hospital. Two hundred and sixty-six dogs and 28 cats. None. Records of dogs and cats admitted to the CCU that received TXA were evaluated. A diagnosis was assigned to each patient based on the International Statistical Classification of Diseases system. "Neoplasia" ([most frequently] hemangiosarcoma) (89/226 [39%]) and "diseases of the blood and blood forming organs" (idiopathic hemoabdomen, pericardial effusion) (78/226 [34%]) were the most common disease processes for which dogs received TXA. In cats, "diseases of the blood and blood forming organs" (idiopathic hemoabdomen) (9/28 [32%]), "neoplasia" (hemangiosarcoma, mast cell tumor, carcinoma) (7/28 [25%]), and "injury, poisoning, or certain other consequences of external causes" (high-rise syndrome) (5/28 [17%]) were most common. One hundred and forty-eight dogs (65%) and 13 cats (46%) underwent an invasive procedure during hospitalization. Thirty percent (70/226) of dogs received a packed RBC (pRBC) transfusion. Administration of TXA before or after pRBC transfusion did not significantly affect median dose of pRBC administered (P=0.808). The median IV dose of TXA was similar for dogs and cats at 10mg/kg. One cat received a 10 times overdose of TXA and did not suffer any appreciable adverse effects. Adverse events were reported in 1.7% (4/226) of dogs including hypersalivation (3/226) and seizure (1/226) in a dog that received a cumulative dose of 280mg/kg of TXA. Hypersalivation was the only adverse event reported in 3% (1/28) of cats. TXA is primarily utilized in critically ill dogs and cats diagnosed with neoplasia, bleeding disorders, and trauma at this institution. Adverse events were infrequent and largely mild.