Dual antithrombotic therapy gains attention in high-risk cats

A recent VETgirl podcast published March 23, 2026, spotlights a 2022 retrospective case series examining dual antithrombotic therapy with clopidogrel and rivaroxaban in cats with thromboembolic disease. The underlying study, from investigators at the University of California, Davis, reviewed 32 outpatient cats treated over five years, most with hypertrophic cardiomyopathy or remodeled HCM, and found that the combination was associated with a low reported rate of clinically significant adverse events and a 16.7% recurrence rate among cats treated after an arterial thromboembolism event. No cat started on dual therapy for spontaneous echocardiographic contrast or intracardiac thrombus developed a new arterial thromboembolism while on treatment. (podcasts.apple.com)

Why it matters: For veterinary professionals, the study adds some much-needed clinical support to a strategy that has already been reflected in ACVIM consensus guidance for very high-risk cats: using clopidogrel as the foundation of thromboprophylaxis, with consideration of adding an oral factor Xa inhibitor such as rivaroxaban in selected cases. The evidence is still limited, retrospective, and from a single center, but it helps fill a gap between guideline recommendations and real-world feline cardiology practice, especially for cats with prior arterial thromboembolism, intracardiac thrombi, or marked spontaneous echocardiographic contrast. (academic.oup.com)

What to watch: The key next step is stronger prospective evidence, because current support for dual therapy in cats remains based on retrospective data, while earlier controlled evidence established clopidogrel, not combination therapy, as superior to aspirin for secondary prevention after feline arterial thromboembolism. (sciencedirect.com)