Managing hypertension in your dog or cat
The following was written by Doris Garcia, pharmacy student at Nova Southeastern University College of Pharmacy:
Most of my adult life, I’ve spent being the bad cop towards my hypertensive father.
“Dad, I don’t think it’s a good idea for you to have pumpkin pie for lunch”
“Don’t you think water would be better for you than a shot of espresso?”
“Those crackers are very high in sodium; why not try these unsalted whole grain crackers instead?”
It is truly tiresome, and sometimes you must pick your battles…
Growing up in a family with very little consumption of vegetables and a long history of heart disease, I too am at high risk for developing hypertension. As a pharmacy student who faces long hours of studying, I would frequently sip on espresso and energy drinks in order to cram. In my third year of pharmacy school, signs of pre-hypertension forced me into taking my own advice, the advice my father still neglects to take. I cut out all caffeinated beverages and lowered my sodium intake. Luckily my blood pressure readings stabilized.
It was to my dismay, when again someone near and dear to me was diagnosed with hypertension—Cookie, my 8 year-old German shepherd. Unlike my father, I could control exactly what Cookie was able to ingest, and would be responsible for giving him his medications as prescribed by his veterinarian.
Just like humans, your pet can be diagnosed with hypertension. Yet, unlike humans, hypertension in pets is usually secondary to another illness. This is called secondary hypertension. It can be caused by diabetes, chronic kidney disease, hyperthyroidism or an alteration of hormonal balance which may occur due to an overactive adrenal gland. Treating the underlying illness usually resolves the secondary hypertension. However, if your pet continues to have elevated blood pressure (systolic reading >160) the following medications have been proven to be effective.
- The most common medication to treat high blood pressure in your pet is Enalapril/Benazapril. This is a drug in the ACE- Inhibitor class. This is a preferred anti-hypertensive for dogs.
- When an ACE- Inhibitor is not enough to control the elevated blood pressure, Amlodipine is also prescribed. This medication is a Calcium Channel Blocker. It is the preferred anti-hypertensive medication in cats. Kidney function should be monitored in your pet if they are taking this medication. Amlodipine may reduce potassium levels; therefore, your pet’s potassium levels should be monitored and supplementation given as necessary. Amlodipine may also have an interaction with certain medications that control stomach acid, such as Cimetidine. Ranitidine may be a better alternative in pets concomitantly taking acid suppressants and amlodipine.
- Beta Blockers, such as propanolol/atenolol may also be an option. They decrease blood pressure by decreasing the heart rate.
- Hydralazine may help to reduce blood pressure by dilating vessels in the body.
- Diuretics, such as furosemide/spironolactone, may help to decrease blood pressure by decreasing blood volume.
- Sodium nitroprusside can be used in cases of acute hypertension to quickly decrease a dangerously elevated blood pressure in an emergency situation.
Initiation of medications is crucial to prevent end organ damage (i.e. kidneys, eyes). Follow up with your veterinarian after initiation of treatment should occur approximately every 3 months. During follow up visits, your pet’s blood pressure will be assessed to determine the need for necessary changes in medications or possible dose adjustments. Other tests will be performed by your veterinarian biannually, such as a complete blood count, blood chemistry panel and a urinalysis.
Possible symptoms your pet may display when associated with hypertension:
*****Note: Most commonly, pets are asymptomatic*****
- Confused/ Circling/ Disoriented
- Vision Problems/ Cataracts/Dilated pupils/ Sudden Blindness
- Ruptured vessels in the eye
- Blood or Protein in the urine (due to failing kidneys)
- Bleeding from the nose
- Irregular Heartbeat/ Heart murmurs
- Weakness in the limbs
- Palpable thyroid gland- (occurs in hyperthyroidism, which is more common in cats)
Remember, this information is not a substitute for veterinary care. If you have questions about your pet’s health. please consult your veterinarian. If you have questions about medications, don’t hesitate to contact your 1800PetMeds Pharmacist who is more than happy to assist you.