Thanks for sharing Liz.
I think rivaroxaban is a super interesting drug. Based on the ACVIM consensus for the treatment of immune mediated haemolytic anaemia (IMHA) in dogs and cats, the jury is still out regarding the best drugs to use regarding the risk of thromboembolic disease.
Considering the underlying mechanisms of venous thromboembolism commonly seen in dogs with IMHA, it is proposed that a treatment strategy incorporating anticoagulants may be the favoured approach for thromboprophylaxis, especially within the initial two weeks following diagnosis. In cases where the use of anticoagulants, along with the necessary monitoring, is not accessible or practical, recommendations lean towards administering antiplatelet drugs as a preferable alternative to not utilizing any form of antithrombotic medication. Insufficient evidence is available to make strong recommendations on the choice of anticoagulant in IMHA. The strongest evidence supports the use of individually dose‐adjusted UFH. Other anticoagulants including enoxaparin and rivaroxaban appear to be safe and may be efficacious. It is important to emphasize that UFH should not be administered without individualized dose adjustment. In situations where this isn’t possible or practical, the use of injectable low-molecular-weight heparins or direct oral Xa inhibitors like rivaroxaban is suggested.
In short, I have been using a combination of rivaroxaban and clopidogrel for my IMHA cases, particularly in the early stages of treatment.
Thanks again for sharing.
Scott 🙂
