A.K. McManamey, M. Womble, P.R. Fox
Background
This case report describes an unusual presentation of proximal aortic thrombosis in a dog, a condition rarely documented in veterinary medicine. Aortic thrombi in dogs are typically distal, and proximal obstruction is not well characterized. The study aims to detail the clinical, imaging, and pathological findings of this unique presentation and highlight its diagnostic and clinical implications.
Methods
A 12-year-old mixed-breed dog presenting with persistent tachypnea underwent clinical evaluation, including thoracic radiography, echocardiography, Doppler blood pressure measurements, abdominal ultrasound, and computed tomography angiography. Following clinical deterioration and euthanasia, a full postmortem examination with gross and histopathologic analysis was performed to characterize the aortic lesion and associated systemic effects.
Results
Diagnostic imaging revealed a non-contrast-enhancing lesion extending from the ascending aorta through the aortic arch, causing near-complete luminal occlusion. Marked differential blood pressure was observed, with severe cranial hypertension and caudal hypotension. Postmortem findings confirmed a chronic, organizing thrombus within the proximal aorta, accompanied by mild arteritis. Secondary findings included left ventricular hypertrophy, myocardial fibrosis, pulmonary edema, and hypoxic injury to the liver and kidneys. No definitive underlying cause of the thrombus was identified.
Limitations
As a single case report, the findings are not generalizable. The etiology of the thrombus and associated arteritis remained unresolved despite extensive evaluation. Additionally, the lack of therapeutic intervention beyond supportive care limits conclusions regarding optimal treatment strategies.
Conclusions
This report documents a rare case of proximal aortic thrombosis in a dog, associated with severe hemodynamic disturbances and multi-organ consequences. The findings emphasize the importance of considering aortic thrombus as a differential diagnosis for proximal aortic masses and differential blood pressure presentations. Advanced imaging, particularly computed tomography angiography, proved valuable for diagnosis, though treatment options remain unclear in such cases.
Sagittal section of the computed tomography post contrast administration. There is a non-contrastenhancing
lesion extending from the ascending aorta through the aortic arch (arrowhead) and proximal descending
aorta. The lesion nearly occludes the entire lumen of the aorta and has some extension along the brachycephalic and
left subclavian arteries (arrow).
How did we do?
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