Retrospective Study of Streptokinase Administration in 46 Cats with Arterial Thromboembolism

A retrospective evaluation was performed on 46 cats with arterial thromboembolism (ATE) that were treated with streptokinase (SK). Significant heart disease was diagnosed in 45/46 cats, and 21/46 cats had congestive heart failure. Variable dosing schemes of streptokinase were administered within 1–20 hours following the onset of clinical signs (median = 5.5 hours). There was no difference between survivors (S) and non-survivors (NS), based on time of administration of SK after onset of clinical signs. Twenty-five (54%) of the cats had return of pulses within 2–24 hours of treatment. Fourteen (30%) of the cats had return of motor function between 9 hours and 6 days. Fifteen of the cats (33%) were discharged from the hospital, 18 (39%) died in the hospital, and 13 (28%) cats were euthanized due to complications or poor response to treatment. Four of 5 cats (80%) with single limb dysfunction survived to hospital discharge. Life threatening hyperkalemia was diagnosed in 16 cats (35%) after SK administration. Hyperkalemia was more likely to occur with the longer duration of SK infusion. Eleven cats (24%) developed clinical signs of bleeding following SK administration and 3 of these cats required a blood transfusion. Laboratory testing documented coagulopathy following SK administration in 11 out of 17 cats tested. Hypothermia and azotemia prior to SK administration and the development of hyperkalemia were negatively associated with survival.