Veterinary medicine, like human medicine, can sometimes be disconcerting. Indeed, some diseases require a multitude of tests (blood tests, X-rays, ultrasounds, biopsies, etc.) without a precise diagnosis being able to be established. Conversely, some conditions, such as iliac embolism in cats, can be diagnosed through a simple physical examination.
Aortic thromboembolism, also known as iliac embolism, is a serious veterinary emergency that primarily affects cats. This condition requires immediate treatment. Unfortunately, it is often the result of an underlying heart condition. However, in many cases, the cat does not show any warning signs that suggest heart disease.
Causes and Mechanism of Iliac Embolism
Heart disease, with or without associated hyperthyroidism, is the main cause of aortic thromboembolism. A diseased heart, subjected to constant stress, increases in volume. Since it is a muscle, it gradually hypertrophies. As it enlarges, the walls of the heart cavities stretch, causing tiny cracks that lead to internal bleeding.
The body, seeking to stop these micro-hemorrhages, activates coagulation, which leads to the formation of blood clots. If one of them breaks off, it ends up in the bloodstream in the form of an embolus. As it travels through the arteries, this embolus ends up blocking the bifurcation of the iliac arteries, suddenly compromising blood flow to the hind limbs.
Symptoms and Diagnosis
Sudden interruption of vascularization results in marked clinical signs. The cat is often found motionless, panting, with its mouth open. Its mucous membranes may have a bluish tint (cyanosis). In addition, it appears paralyzed from the hindquarters and may express intense pain by plaintive meowing. It is imperative to consult a veterinarian urgently.
During the clinical examination, the veterinarian will look for characteristic signs such as:
- Coldness of the hind limbs
- Marked pain in the hind legs
- A blueish discoloration of the claws
- Muscle stiffness in the calves (gastrocnemius)
- Absence of pulse in the thighs
- The presence of a heart murmur on auscultation
Although the diagnosis is generally easy to make, the major difficulty lies in explaining the seriousness of the situation to the owner. The announcement of an advanced heart disease, often previously unrecognized, as well as the poor prognosis can be upsetting. The cat’s extreme pain and the high risk of recurrence make the decision difficult. Many owners, faced with these elements, choose euthanasia.
Treatments and Follow-up
If the owner opts for medical care, hospitalization is essential for several days. Treatment is based on several axes:
- Management of heart failure: oxygen therapy, diuretics, cardiac medications
- Pain management: strong painkillers (fentanyl patch, painkiller injections, vasodilators)
- Preventing future blood clots: anticoagulants
Once the cat’s condition has stabilized, additional tests are necessary to assess cardiac function (thoracic X-rays, echocardiography, electrocardiogram) and to adjust the medication.
If the animal survives, with or without locomotor sequelae, lifelong treatment will be essential for its heart as well as for the prevention of a recurrence. Rigorous veterinary monitoring will be essential in order to optimize its life expectancy.
Conclusion
Iliac embolism in cats is a serious condition that requires rapid response. As an owner, it is crucial to recognize the warning signs and consult a veterinarian as soon as the first symptoms appear. Early treatment and appropriate medical follow-up will improve the animal’s well-being and increase its chances of survival.
