Thromboembolic disease remains a major contributor to morbidity and mortality in small animal practice. Dogs with immune-mediated haemolytic anaemia (IMHA), protein-losing nephropathy or neoplasia, and cats with cardiomyopathy are all at significant risk of life-threatening clot formation. Antithrombotic therapy has advanced considerably in the last five years, guided by expert consensus and growing clinical evidence. Veterinary nurses and technicians play a central role in implementing these protocols; selecting the right drug, monitoring patients for efficacy and complications, and supporting clients with long-term therapy.
The ACVECC CURATIVE Consensus (2019) provided the first structured recommendations across five domains: identifying at-risk patients, initiating antithrombotic therapy, designing treatment protocols, monitoring and refining therapy, and determining when to discontinue. These were updated in 2022, with additional guidance on risk stratification and the introduction of Domain 6, focusing on thrombolytic therapy. The ACVIM consensus on IMHA (2019) also strongly emphasised thromboprophylaxis in dogs, reinforcing the importance of antithrombotic care in critical patients. Together, these guidelines highlight clopidogrel as the first-line agent for cats at risk of arterial thromboembolism, while combinations of antiplatelets and anticoagulants (including aspirin, unfractionated heparin, low molecular weight heparin, and rivaroxaban) may be considered for dogs depending on the clinical scenario.
For veterinary nurses and technicians, this area of medicine demands not only pharmacological knowledge but also confidence in protocol implementation and patient monitoring. Key responsibilities include: ensuring correct dosing and administration, recognising signs of bleeding or clotting, interpreting laboratory monitoring where available (e.g., aPTT, anti-Xa assays), and adapting care protocols in consultation with clinicians. Nurses are also essential in educating clients, particularly when pets are discharged on long-term clopidogrel or rivaroxaban therapy.
This presentation will provide a practical, nursing-focused update on antithrombotic therapy in small animals, framed around the CURATIVE consensus domains. Case examples will illustrate how evidence-based recommendations translate into real-world care for dogs with IMHA and cats with hypertrophic cardiomyopathy. Attendees will leave with the ability to identify high-risk patients, understand drug selection and combination strategies, apply structured monitoring, and support safe, effective long-term management. By bridging consensus guidelines with hands-on nursing practice, this session aims to improve patient outcomes and empower nurses and technicians to take an active role in thrombosis prevention and care.