Journal article
Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 3-Defining antithrombotic protocols
Journal of Veterinary Emergency and Critical Care, Vol.29(1), pp.60-74
2019
Abstract
Objectives
To systematically examine the evidence for use of a specific protocol (dose, frequency, route) of selected antithrombotic drugs, in comparisons to no therapy or to other antithrombotic therapies, to reduce the risk of complications or improve outcomes in dogs and cats at risk for thrombosis.
Design
Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence (LOE) and quality (Good, Fair, or Poor), and development of consensus on conclusions via a Delphi‐style survey for application of the concepts to clinical practice.
Settings
Academic and referral veterinary medical centers.
Results
Databases searched included Medline via PubMed and CAB abstracts. Eight different antithrombotic drugs were investigated using a standardized Patient, Intervention, Comparison, Outcome (PICO) question format both for dogs and cats, including aspirin, clopidogrel, warfarin, unfractionated heparin (UFH), dalteparin, enoxaparin, fondaparinux, and rivaroxaban, generating a total of 16 worksheets. Most studies identified were experimental controlled laboratory studies in companion animals (LOE 3) with only four randomized controlled clinical trials in companion animals (LOE 1).
Conclusions
Overall, evidence‐based recommendations concerning specific protocols could not be formulated for most antithrombotic drugs evaluated, either because of the wide range of dosage reported (eg, aspirin in dogs) or the lack of evidence in the current literature. However, clopidogrel administration in dogs and cats at risk of arterial thrombosis, notably in cats at risk of cardiogenic thromboembolism, is supported by the literature, and specific protocols were recommended. Comparably, aspirin should not be used as a sole antithrombotic in cats with cardiomyopathy. Using the available safety profile information contained in the literature, the panel reached consensus on suggested dosage schemes for most antithrombotics. Significant knowledge gaps were highlighted, which will hopefully drive novel research.
Details
- Title
- Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 3-Defining antithrombotic protocols
- Authors/Creators
- M-C Blais (Author/Creator) - Université de MontréalD. Bianco (Author/Creator) - Internal Medicine Department, Metropolitan Animal Specialty Hospital, Los Angeles, CA.R. Goggs (Author/Creator) - Cornell UniversityA.M. Lynch (Author/Creator) - North Carolina State UniversityL. Palmer (Author/Creator) - United States Army ReserveA. Ralph (Author/Creator) - MedVet New Orleans, New Orleans, LA.C.R. Sharp (Author/Creator) - Murdoch University
- Publication Details
- Journal of Veterinary Emergency and Critical Care, Vol.29(1), pp.60-74
- Publisher
- Wiley
- Identifiers
- 991005541759707891
- Copyright
- © Veterinary Emergency and Critical Care Society 2019
- Murdoch Affiliation
- School of Veterinary and Life Sciences
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.71 Cardiology - Circulation
- 1.71.193 Acute Myocardial Infarction
- Web Of Science research areas
- Veterinary Sciences
- ESI research areas
- Plant & Animal Science