The most likely cause of a saddle thrombus in cats (a blood clot that blocks arteries in the legs) is cardiomyopathy or congestive heart failure. Cardiomyopathy is a disease of the heart muscle that prevents the muscle from being able to pump effectively.
I spoke with Dr. Prueter, an internal medicine veterinary specialist here in Cleveland, to learn more and here is my summary of our conversation. Note that I've taken the liberty of summarizing our conversation in lay person's language (because that's what I am) and so any inaccuracies are all mine!
What happens to the cat's heart with cardiomyopathy and how is it caused?
In the case of hypertrophic cardiomyopathy (HCM), the left side of the heart thickens so much that abnormalities can occur where the blood exits the heart (the areas in red in the diagram). HCM is generally found to be hereditary, particularly in Persians and Maine Coon cats.
Restrictive cardiomyopathy occurs when the inner lining of the heart becomes stiff, causing the heart muscle to thicken to try to pump harder, setting the stage for blood clots as well. Not much is known about the cause of restrictive cardiomyopathy.
Dilated cardiomyopathy (DCM) occurs when the heart muscle weakens. DCM used to occur frequently before it was discovered that the lack of the amino acid Taurine in cat food caused the condition. Taurine is very heat sensitive and the taurine in meat was destroyed in the pet food processing. Now that we know better and pet food is supplemented by taurine after the heat processing, this condition is much less common than before.
How exactly is a blood clot caused by heart disease in the case of a saddle thrombus?
The abnormalities from cardiomyopathy cause turbulence or "swirling" of blood inside the heart instead of the usual flow of blood out into the artery (aorta), which creates prime conditions for blood clots to form.
If a clot does form and moves out of the heart, it very often goes down the aorta and gets stuck where the artery splits (bifurcates) into the iliac artery, which lead down into the legs.
But a clot can go anywhere: into one of the legs where the whole or part of the leg is blocked off; the front legs; the brain. None of it good although it's much easier to tackle a lower leg blockage with surgery than a total leg blockage. Once the thrombus blocks the artery, it is very hard for a cat to recover from the damage caused.
Treatment Options for Saddle Thrombus Once It Has Happened
Veterinarians used to recommend surgery after a dye study is performed to determine where exactly the clot is located but even if the clot was removed successfully, many times another clot would replace it, sometimes within minutes. Nowadays, vets are not very likely to take this course of action.
Current treatments use drugs to break down the clots and to keep the clots from forming such as Acepromozine, which dilates the blood vessels. But there are adverse effects of these drugs and they don't always work, certainly not in the time frame needed to recover the use of the cat's legs.
How can you tell if a cat has heart disease? What are the symptoms?
Cats are notorious for not showing their symptoms externally (see Dr Patty Khuly's discussion on the evolutionary aspects to this). It is quite possible for your cat to have advanced heart disease and appear completely normal. Heart disease usually occurs as a cat ages but it is possible for younger cats and even kittens can get heart disease.
The symptoms can be found internally through a veterinarian's examination. A heart murmur or gallop rhythm (arrhythmia) can indicate an issue with the heart that has the potential for a clot to form.
The good news is that a cat can have a heart murmur for several years without any issue so it's important you take your cat to the vet for her regular check up to catch issues early. Heart disease can be managed well for many years before any heart failure occurs.
Treatment of Heart Disease and Blood Clots in Cats
If your cat has signs of heart disease, your vet may take an X-Ray of your cat's heart for indications of an enlarged or weakened heart muscle. For more refined measurements, he/she may also do an ultrasound. It is possible to see a thrombus in the left atrium if it's there but it may not always be visible.
If there is evidence of a clot, the vet will usually prescribe aspirin immediately and maybe even heparin to prevent further growth of the clot and to encourage the body's own internal mechanisms to break down the clot.
In short, take your cat to your veterinarian regularly so you might catch the early signs of heart disease and be able to prevent a saddle thrombus before it happens.
As with any of your pet’s health conditions, if you are worried about your pet, talk to your vet.
Related Posts:
Saddle Thrombus in cats
Causes and signs of saddle thrombus in cats
Memories of Dave
Heart diagram courtesy of The Children's Heart Institute
X-Ray courtesy of VetGo Cardiology
Question:
I chose a plan with a $500 deductible as I truly am most concerned with the major problems (and I couldn’t afford the premiums for a lower level). However, I notice your instructions indicate that claims over $50 must be submitted within 60 days of the vet visit. Do I still have to submit all claims before I reach the $500 deductible?
What would make the most sense to me is to save all bills, and then if, and only if, I get past the $500 would I submit for reimbursement. I would want to be able to include any lesser bills incurred during the year that would contribute towards the $500, but by that point they would be past 60 days old. If I have to keep submitting claims all year that I’m not going to get reimbursed for (because I have not yet met the $500 deductible) then this plan sounds like too much work.
Please advise.
Answer:
You are absolutely right - saving them until you meet your deductible total makes the most sense and that's what we've unofficially been allowing behind the scenes. But no point hiding the good news and I'm glad you asked this so I can say that we won't enforce the 60 days when you haven't met your deductible total.
Do make sure to send your invoices in in a timely manner when you finally go over the deductible and certainly be sure to send them in within 60 days of the end of your policy year so we can wrap up things up for our underwriters in a timely manner.
Thanks for that excellent point - I'll make sure to update the instructions on the claims as soon as I can.
Our latest press release titled Embrace Pet Insurance Now Covers Chronic and Recurring Illnesses draws attention to the fact that it is important to have chronic and recurring illness coverage in your pet insurance policy as not every company does (and they aren't very upfront about that fact so you don't want to get caught out - always check).
"Owners of dogs and cats can be in for a shock when faced with a large vet bill after their pet is ill or gets in an accident. Many vets now offer diagnostic techniques, treatments and surgical procedures that used to be only available for humans -- but the costs can be in the thousands of dollars.
"Treatment for an incurable condition such as epilepsy, diabetes or hyperthyroidism can extend over the life of the pet, so pet owner needs to make sure their pet's insurance covers treatment over the course of many years," recommends Bennett."
At Embrace, we cover ongoing chronic conditions in our policy under our Continuing Care benefit and if you include our prescription drug and dental illness coverage, those are also included in your continuing coverage.
Currently, our maximum for continuing care claims is the same as whatever you chose for your policy maximum for the first year of the illness and then it drops to 25% of the maximum for years two and onwards (the drop only occurs for continuing conditions, not new conditions) but we are working on our underwriter, Lloyd's of London, to remove the 25% restriction. We shall see if we are successful on that - wish us luck :)
So with Embrace Pet Insurance, you don't need to worry that when your dog or cat gets sick while insured, the condition will become pre-existing after you've been insured for a while. Who'd want insurance that does that?
Here's an interesting fact about Embrace Pet Insurance's coverage:
We cover hereditary diseases with no dollar or time limits per condition. The only limits that apply to your payouts are your annual maximum and possibly your annual continuing care maximum (if applicable). But once your policy renews, your maximums reset and you start afresh.
Note that we have no per incident limits, no per body system limits, and no per lifetime limits.
Now, isn't that good news?
There are many different types of maximums a pet insurance product can have. I talk about many of them in this article here. In summary, maximums usually include a selection of per incident, per annum, per body system, and per lifetime maximums.
Here's what you need to know about Embrace Pet Insurance maximums:
Note that we have no per incident limits, no per body system limits, and no per lifetime limits.
Here are some examples. Please forgive me if they are confusing - let me know how I can do better and I'll tighten them up.
Example 1: annual maximum is after deductible and copay
Policy has $100 annual deductible, 10% copay, and $2,000 annual maximum
Claim 1: $900 for a serious infection.
Payout = [$900 - $100 annual deductible = $800] x (1 - 10% copay) = $720
This is less than the maximum of $2,000 so pay out $720
Claim 2: $1,500 for an ultrasound, hospital stay, and other diagnostic work
Payout = [$1,500 - 0 because you have paid your deductible for the year] x (1 - 10% copay) = $1,350
Previous payout is $720. Add current proposed payout to get $2,070. This is more than the maximum for the year so the latest payout is capped so that the total payout is $2,000 i.e.$1,280.
Total payout is $2,000.
At the end of the year, the claims total resets to zero and the calculation starts again next year.
Example 2: annual maximum is before deductible and copay
Policy has $100 annual deductible, 10% copay, and $2,000 annual maximum
Claim 1: $900 for a serious infection.
Check claim is less than annual maximum of $2,000, which it is.
Payout = [$900 - $100 deductible = $800] x (1 - 10% copay) = $720
Claim 2: $1,500 for an ultrasound, hospital stay, and other diagnostic work
Check the running total of claims ($900 + $1,500 = $2,400) is less than annual maximum of $2,000, which it is not. Need to reduce latest claim by $400 to keep within limit of $2,000.
Payout = [$1,500 - $400 - 0 deductible] x (1 - 10% copay) = $990
Total payout for the year is $720 + $990 = $1,710, not $2,000
Here are your time saving tips:
store your claims form for each pet in their file at the vet's office. That way, you don't have to remember to bring it with you when you go for your vet visit
Paperwork - I'm sure it's one of the biggest bugaboos out there, not just in pet insurance, but for many other businesses. Nobody likes it and we'd all love to avoid it, particularly our vets, so we've done our best to minimize what we require from your vet as best we can.
So what does the vet need to do?
It's simple. All your vet has to do is jot down the condition and diagnosis per invoice attached to the claim form, the date of the invoice and how much it is, and give us a few words on the situation.
Why do we ask the vet to get involved in a claim?
So that your claim is processed faster. If the vet helps us understand what the claim is about and confirms the invoice amounts and times, we can write you a refund check much sooner. It saves us bugging them later to ask the same thing.
