Use of rivaroxaban for treatment of cranial vena cava syndrome secondary to transvenous pacemaker lead thrombosis in a dog

Publication date: Available online 25 July 2019Source: Journal of Veterinary CardiologyAuthor(s): B.L. Miranda, R. Walton, D.N. LeVine, A. Blong, W. Ware, J. WardAbstractA six-year-old Brussels griffon was presented for cervical swelling three months after implantation of a transvenous pacemaker. Transthoracic echocardiography demonstrated a thrombus associated with the pacemaker lead, partially obstructing right atrial inflow. The laboratory findings were consistent with protein-losing nephropathy. Initial medical therapy consisted of rivaroxaban (0.68 mg/kg PO q 24 hr), clopidogrel (2.5 mg/kg PO q 24 hr), and enalapril (0.5 mg/kg PO q 12 hr). Resolution of cervical and thoracic edema was noted within two weeks of initiating therapy. Recheck echocardiography two months and one year later revealed decreasing thrombus size despite worsening proteinuria. To the authors' knowledge, this is the first documented use of rivaroxaban for successful medical treatment of cranial vena cava syndrome caused by intracardiac pacemaker lead thrombosis in a hypercoagulable patient.
Source: Journal of Veterinary Cardiology - Category: Veterinary Research Source Type: research