Clopidogrel vs aspirin after feline arterial thromboembolism (FAT CAT) — POSSIBLE

In cats that have survived a first cardiogenic arterial thromboembolism, does clopidogrel vs aspirin delay or prevent recurrence?

Shelf #211 · gate-verified and displayed under the developer's blinded-trial rule

POSSIBLE: Clopidogrel reduces the likelihood of recurrent cardiogenic arterial thromboembolism (CATE) in cats compared with aspirin. In FAT CAT, a multicenter, double-blind, randomized, positive-controlled study of 75 cats that had survived a CATE event, clopidogrel was associated with a significantly reduced likelihood of recurrent CATE compared to aspirin (p = 0.024) and a longer median time to recurrence (443 days, 95% CI 185-990, vs 192 days, 95% CI 62-364); both drugs were well tolerated. The claim on this shelf is recurrence prevention only — the trial also reported a composite of recurrent CATE or cardiac death (p = 0.033), but it did not demonstrate a standalone survival benefit, and this pack claims none — so the pack is not Tier C. The stamp is POSSIBLE, not higher, because the evidence is a single trial of 75 cats with wide confidence intervals. Drafted Nov 10, 2026 (VetMed build, topic #211); all figures from abstracts fetched and verified at drafting.

FAT CAT (Hogan 2015): clopidogrel cut the likelihood of recurrent CATE vs aspirin and extended median time to recurrence to 443 vs 192 days

Multicenter, double-blind, randomized, positive-controlled study (FAT CAT)

Who: Cats: 75 cats that survived a cardiogenic arterial thromboembolism (CATE) event, at multiple centers; mean age 8.0 +/- 3.5 years, 57/75 (76%) male, 62/75 (83%) mixed breed (remainder included Persian, Abyssinian, American Shorthair, Bengal, Birman, Himalayan, Maine Coon, Ragdoll, Snowshoe, and Sphynx); only 15% (11/75) had a history of heart disease recorded prior to the CATE event. Assigned to clopidogrel (18.75 mg/cat PO q 24 h) or aspirin (81 mg/cat PO q 72 h).

Result: Clopidogrel administration was associated with significantly reduced likelihood of recurrent CATE compared to aspirin (p = 0.024) and had a longer median time to recurrence [443 (95% CI 185-990) days vs. 192 (95% CI 62-364) days, respectively]. Clopidogrel was also associated with a significantly reduced likelihood of the composite endpoint of recurrent CATE or cardiac death (p = 0.033) with a longer median time to event [346 (95% CI 146-495) days vs. 128 (95% CI 58-243) days]. Both drugs were well tolerated.

Watch out: The composite endpoint bundles recurrence with cardiac death; the record does not report a standalone survival difference, and this shelf claims recurrence prevention only. The trial appeared in the Journal of Veterinary Cardiology (2015;17 Suppl 1:S306-17), not the Journal of Veterinary Internal Medicine as the topic draft stated. With 75 cats, the confidence intervals around the median times are wide.

Hogan DF, Fox PR, Jacob K et al. Secondary prevention of cardiogenic arterial thromboembolism in the cat: The double-blind, randomized, positive-controlled feline arterial thromboembolism; clopidogrel vs. aspirin trial (FAT CAT). J Vet Cardiol. 2015;17 Suppl 1:S306-317. PMID: 26776588. Registry ID: none in the record. MeSH: Animals · Aspirin · Cat Diseases · Cats · Clopidogrel · Double-Blind Method · Male · Platelet Aggregation Inhibitors · Thromboembolism · Ticlopidine

Synthesis: a single small double-blind randomized trial supports clopidogrel over aspirin for recurrence prevention

Synthesis

Who: Synthesis of the card above: FAT CAT (Hogan 2015), the single trial on this shelf — a multicenter, double-blind, randomized, positive-controlled study of 75 cats that had survived a CATE event.

Result: This shelf rests on one trial, stated on its face. FAT CAT was double-blind and randomized against an active comparator and found clopidogrel significantly reduced the likelihood of recurrent CATE versus aspirin (p = 0.024), with median time to recurrence 443 vs 192 days. That is a genuine hard clinical endpoint, but a single 75-cat trial with wide confidence intervals (185-990 days around the clopidogrel median) supports POSSIBLE, not a stronger stamp. No survival benefit is claimed: cardiac death appears only inside a composite endpoint, so tierC is false.

Watch out: All cats had already survived a first CATE event — the trial says nothing about primary prevention in cats with heart disease who have never embolised, and nothing about anticoagulant or dual-therapy strategies, which are separate shelves.

Synthesis of Hogan DF et al. PMID: 26776588. Registry ID as on the individual card.

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