Abstract
A 7-year-old castrated male Pomeranian was evaluated on emergency for diagnostic work-up and treatment for acute nonpainful paraparesis. The neurologic examination suggested a L4-S3 myelopathy, but physical examination revealed lack of femoral pulses and rectal hypothermia, as well as a grade II/VI systolic heart murmur, so ischemic neuromyopathy was suspected. Clinicopathologic analysis revealed increased muscle enzymes and proteinuria. Abdominal ultrasonography confirmed aortic thromboembolism (ATE), and surgical histopathology diagnosed necrotizing pancreatitis. Surgical aortic thrombectomy was performed, and antithrombotic therapy was instituted. Pancreatitis was treated supportively. The dog was discharged to the owners after 10 days of hospitalization. Recheck examination 6 weeks after initial presentation revealed a normal neurologic examination and normal femoral pulses. The patient has had no further bouts of pancreatitis and remains neurologically normal 5 years after initial presentation. Canine ATE is relatively rare compared to the feline counterpart. Directed therapy for feline ATE is often not recommended, as underlying conditions are oftentimes ultimately fatal. Underlying etiologies for canine ATE include cardiovascular disease and endocrinopathies, but canine ATE secondary to pancreatitis has not yet been reported. Surgical removal of aortic thromboembolus should be considered as curative for pelvic limb dysfunction in the canine patient without a terminal underlying disease.
Highlights
Aortic thromboembolism (ATE) is a relatively rare occurrence in the dog
Follow-up phone call 5 years after the incident confirmed that the dog continues to do well. He ambulates normally and has not had any further bouts of pancreatitis. Though it frequently occurs in cats with hypertrophic cardiomyopathy, ATE is relatively uncommon in dogs
Rare cases of canine ATE have been associated with underlying conditions, such as hyperadrenocorticism, hypothyroidism, diabetes mellitus, cardiac arrhythmias and structural cardiac disease, various neoplasms, protein-losing nephropathy, protein-losing enteropathy, gastric dilatation/volvulus, and trauma [1,2,3,4,5,6,7,8]
Summary
Aortic thromboembolism (ATE) is a relatively rare occurrence in the dog. Compared to the syndrome in cats, it typically results in less severe clinical signs and is more enigmatic in etiology. Treatment approaches for canine ATE, including thrombolytic therapy and rheolytic thrombolysis, have been described; to the authors’ knowledge this report is the first description of open surgical removal of an aortic thrombus [1,2,3,4,5]. An additional novel feature of this report is the development of canine ATE secondary to pancreatitis
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