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Diagnosis and treatment of platelet hyperactivity in relation to thrombosis in dogs and cats
Author(s) -
Wiinberg Bo,
Jessen Lisbeth R.,
Tarnow Inge,
Kristensen Annemarie T.
Publication year - 2012
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/j.1476-4431.2011.00708.x
Subject(s) - medicine , platelet , aspirin , thrombosis , etiology , antiplatelet drug , platelet activation , intensive care medicine , cats , clinical trial , drug , disease , pharmacology , clopidogrel
Objective To review the mechanisms of platelet activation and options for diagnosing and treating platelet hyperactivity in relation to thrombosis in dogs and cats. Data Sources Prospective, retrospective, and review articles, as well as textbook chapters in both human and veterinary medicine. Articles were primarily, but not exclusively, retrieved via M edline. Human Data Synthesis In people, platelets are known to play a key role in the development of arterial thrombosis in numerous disease states and antiplatelet drugs are the cornerstone in the treatment of acute events and for prevention in patients at risk. For many years, aspirin was used as the sole antiplatelet drug in people, but the introduction of adenosine diphosphate receptor antagonists and integrin α IIb β 3 inhibitors has significantly improved outcome in selective groups of patients. Veterinary Data Synthesis The understanding of platelet activation in disease states has increased dramatically over the past decade. Simultaneously, a host of new methods for evaluating platelet function have been developed, which enable primarily researchers, but also clinicians to monitor the activity of platelets. Many of these methods have been validated for research purposes, but few have found their way to the clinics. Not a single correctly randomized clinical trial has been carried out with any antiplatelet drug for any indication in dogs or cats, and consequently, treatment is empiric and largely based on expert opinion or data from experimental studies. Conclusions The pathogenesis of thromboembolic disease is complex and multifactorial and the role of hyperactive platelets in this etiology remains to be clarified in most of the diseases associated with thrombosis in dogs and cats. Until efficacy data from well‐designed studies are available, antithrombotic therapy should consist of close monitoring, good supportive care, and judicious empirical use of antiplatelet agents.