What does arterial thromboembolism (ATE) mean?

ATEs are clots that travel to other parts of the body through the circulatory system. They most often originate in the heart. When these clots reach the smaller blood vessels in the periphery, usually the back legs, they can occlude blood flow.

What are the consequences of ATE?

When blood flow is occluded, oxygen delivery to the tissues is compromised. If ATE affects the back legs, this results in loss of function. Pets with ATE may limp or drag their back legs, and they are usually very painful. When tissues are starved of oxygen they can die and release toxic products into the blood stream. These toxins can cause changes in electrolytes and dangerous abnormal heart rhythms which can cause sudden death.

Many patients with ATE experience acute congestive heart failure (CHF) due to the stress of the event. Please see the handouts on CHF for more information. CHF can make ATE harder to manage, as treatment for CHF can cause dehydration and kidney damage.

What causes ATE?

Severe underlying heart disease is the most common cause for ATE. There are many different types of heart disease. An echocardiogram (heart ultrasound) by a cardiologist is the best way to assess cardiac structure and function and make treatment recommendations.

How is ATE treated?

ATE is treated supportively while the clot dissolves. Limb function can gradually improve over weeks to months. Treatment plans will vary on an individual basis, but typical treatments include anti-platelet or anti-coagulant medications, pain medications, anti-nausea medications and appetite stimulants, and medications to help support the heart and control CHF. Unfortunately, despite medications, once a pet has had one episode of ATE they are at high risk for having another or developing refractory heart failure within the next 6-12 months. Periodic rechecks with a cardiologist will be recommended.

What should I monitor at home?

Monitor your pet’s affected limb(s) for pain, redness, swelling, ulceration, and discharge and contact a veterinarian with any concerns.

It is important to become familiar with your pet’s normal sleeping respiratory rate. Your pet’s respiratory rate should be less than 40 breaths per minute when sleeping. However, any consistent or progressive elevation from your pet’s baseline rate should be cause to alert a veterinarian. You should also monitor for cough, lethargy, fainting, or decreased appetite, and contact a veterinarian with any concerns.