静脈血栓塞栓症を合併した2頭の犬におけるリバロキサバンによる治療と凝固プロファイルのモニタリング

Treatment with rivaroxaban and monitoring of coagulation profiles in two dogs with venous thromboembolism.

• Mona Uchida
• Aki Ohmi
• Reina Fujiwara
• Kenjiro Fukushima
• Akihiro Doi
• Kazushi Azuma
• Hajime Tsujimoto

抄録

免疫介在性溶血性貧血に血栓塞栓症を合併した2頭の犬を紹介した。2頭とも当初は免疫抑制療法としてダルテパリンとクロピドグレルを併用した。免疫抑制療法は有効であったが，経過中に血栓塞栓症による腹水が認められた．リバロキサバン投与開始後，D-ダイマー，アンチトロンビン（AT），トロンビン-アンチトロンビン複合体（TAT）の正常化と並行して，腹水は直ちに減少した。本剤投与後の有害事象として，血便，皮膚出血，血尿が1例に認められた。リバロキサバンは免疫介在性溶血性貧血に続発する血栓塞栓症のコントロールに有効であり，D-ダイマー，AT，TATは犬の血栓塞栓症の状態をモニターするのに有用であった。

Two dogs with immune-mediated hemolytic anemia complicated with thromboembolism were presented. Both of the dogs were initially treated with immunosuppressive therapy in conjunction with dalteparin and clopidogrel. Although the immunosuppressive therapy was effective, peritoneal effusion due to thromboembolism was observed during the course of the disease in these dogs. After initiation of rivaroxaban treatment, peritoneal effusion decreased immediately in parallel with the normalization of D-dimer, antithrombin (AT), and thrombin-antithrombin complex (TAT). Hematochezia, cutaneous hemorrhage, and hematuria were observed as adverse events after administration of rivaroxaban in one case. Rivaroxaban was effective for the control of thromboembolism secondary to immune-mediated hemolytic anemia, and D-dimer, AT, and TAT were useful to monitor the status of thromboembolic disease in dogs.