PMID- 30654416
OWN - NLM
STAT- MEDLINE
DCOM- 20190305
LR  - 20190305
IS  - 1476-4431 (Electronic)
IS  - 1476-4431 (Linking)
VI  - 29
IP  - 1
DP  - 2019 Jan
TI  - Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care 
      (CURATIVE): Domain 3-Defining antithrombotic protocols.
PG  - 60-74
LID - 10.1111/vec.12795 [doi]
AB  - 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.
CI  - (c) Veterinary Emergency and Critical Care Society 2019.
FAU - Blais, Marie-Claude
AU  - Blais MC
AUID- ORCID: 0000-0003-0877-4425
AD  - Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de 
      Montreal, St-Hyacinthe, Quebec, Canada.
FAU - Bianco, Domenico
AU  - Bianco D
AD  - Internal Medicine Department, Metropolitan Animal Specialty Hospital, Los 
      Angeles, CA.
FAU - Goggs, Robert
AU  - Goggs R
AUID- ORCID: 0000-0001-7446-6987
AD  - Department of Clinical Sciences, College of Veterinary Medicine, Cornell 
      University, Ithaca, NY.
FAU - Lynch, Alex M
AU  - Lynch AM
AD  - Department of Clinical Sciences, North Carolina State University, Raleigh, NC.
FAU - Palmer, Lee
AU  - Palmer L
AUID- ORCID: 0000-0002-3849-1736
AD  - Lieutenant Colonel, US Army Reserve, Veterinary Corps, Chair K9 Tactical 
      Emergency Casualty Care Working Group, New Orleans, LA.
FAU - Ralph, Alan
AU  - Ralph A
AD  - MedVet New Orleans, New Orleans, LA.
FAU - Sharp, Claire R
AU  - Sharp CR
AUID- ORCID: 0000-0002-1797-9783
AD  - School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia.
LA  - eng
PT  - Consensus Development Conference
PT  - Journal Article
PT  - Practice Guideline
PT  - Systematic Review
PL  - United States
TA  - J Vet Emerg Crit Care (San Antonio)
JT  - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
JID - 101152804
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Animals
MH  - Anticoagulants/therapeutic use
MH  - Cat Diseases/*drug therapy
MH  - Cats
MH  - Clinical Protocols/standards
MH  - Critical Care
MH  - Dog Diseases/*drug therapy
MH  - Dogs
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Heparin/therapeutic use
MH  - Practice Patterns, Physicians'/standards
MH  - Veterinary Medicine/*standards
OTO - NOTNLM
OT  - CURATIVE
OT  - administration and dosage
OT  - anticoagulant
OT  - antiplatelet agents
OT  - veterinary
EDAT- 2019/01/18 06:00
MHDA- 2019/03/06 06:00
CRDT- 2019/01/18 06:00
PHST- 2018/12/07 00:00 [received]
PHST- 2018/12/10 00:00 [revised]
PHST- 2018/12/08 00:00 [accepted]
PHST- 2019/01/18 06:00 [entrez]
PHST- 2019/01/18 06:00 [pubmed]
PHST- 2019/03/06 06:00 [medline]
AID - 10.1111/vec.12795 [doi]
PST - ppublish
SO  - J Vet Emerg Crit Care (San Antonio). 2019 Jan;29(1):60-74. doi: 
      10.1111/vec.12795.