From the Research
Apixaban is not recommended for use in cats to prevent recurrent venous thromboembolism (VTE). While apixaban is an oral direct factor Xa inhibitor used in humans for this purpose, there is insufficient evidence supporting its safety and efficacy in cats. For cats at risk of thromboembolism, the current standard of care includes low-dose aspirin (typically 1-5 mg/kg every 72 hours) or clopidogrel (18.75 mg per cat once daily) 1. These medications have more established safety profiles in feline patients. The pharmacokinetics of apixaban in cats is poorly understood, and appropriate dosing regimens have not been established. Additionally, cats metabolize drugs differently than humans, raising concerns about potential toxicity. If thromboprophylaxis is needed for a cat with a history of VTE, consultation with a veterinary specialist is strongly recommended to determine the most appropriate anticoagulant therapy based on the individual cat's underlying condition, risk factors, and overall health status.
Some key points to consider:
- The provided studies focus on human patients, with no direct evidence for the use of apixaban in cats 2, 3, 4, 5.
- The most recent and highest quality study, published in 2025, discusses the use of apixaban in humans with active cancer and venous thromboembolism, but does not provide any information on its use in cats 1.
- The lack of evidence on apixaban's safety and efficacy in cats, combined with the potential risks of toxicity and the differences in drug metabolism between humans and cats, make it essential to prioritize caution and avoid using apixaban in feline patients.
- Instead, established treatments like low-dose aspirin or clopidogrel should be considered, and veterinary specialists should be consulted to determine the best course of treatment for each individual cat.