Managing feline hypertension isn't always straightforward, especially when we consider that we frequently have to manage systemic hypertension alongside comorbidities. We've all been there, the hypertensive case in front of us, and they've got an underlying condition. There's a lot going on.
And choosing the most appropriate anti-hypertensive agent is one of the first decisions that you'll need to make. And it's a significant challenge. You want a drug which is going to be well tolerated and effective, but also compatible when managing common concurrent diseases.
I've found that we can cut through some of the complexity. And the good news is that expert and consensus guidelines offer us clear direction. Here's what ACIM say in their consensus materials.
Amlodipine besylate has been the first choice antihypertensive treatment because of established efficacy in cats with idiopathic hypertension or in those with chronic kidney disease. And ISFM guidelines echo this too, where it states amlodipine besylate is the drug of choice for the management of hypertension in cats. If you want to know why this is, here are some key reasons why amlodipine is recommended as the first line treatment for feline hypertension.
So it typically reduces systolic blood pressure by between 30 to 70 millimetres of mercury, with 60 to 100% of hypertensive cats suitably managed on monotherapy, making it the most efficacious drug for managing systemic hypertension in cats. It's also the only anti-hypertensive that has demonstrated efficacy in managing cats with severe hypertension, that is, those individuals with systolic blood pressures greater than 200 millimetres of mercury. This is clinically relevant as epidemiological studies on feline hypertension have shown that a reasonable proportion of cats are severely hypertensive at diagnosis.
There's strong clinical evidence supporting its role in reducing the risk of target organ damage to organs such as the eyes, the heart, the brain and central nervous system. This is important to note, as it demonstrates that appropriate treatment helps mitigate the negative consequences of uncontrolled hypertension on vital organs, improving feline health and welfare. Despite its ability to have a profound effect on blood pressure, hypotension tends not to occur, and it's well tolerated, even in cats with common comorbidities such as chronic kidney disease and hyperthyroidism.
As covered earlier in the course, amlodipine is particularly well suited for hypertensive cats with chronic kidney disease, irrespective of their iris stage. Its effectiveness as an anti-hypertensive combined with its mode of action at the level of the nephron offers specific advantages to cats with concurrent chronic kidney disease, hypertension, and hypertension-induced proteinuria. This is why amlodipine is recommended as the first line therapeutic agent for feline hypertension.
So, the next challenge was developing a formulation that was safe and effective for cats. This ambition was shared by International Cat Care, who'd had a safe and effective cat-specific anti-hypertensive on their wish lists for over 10 years. Amadit, the first felines specific formulation of amlodipine, was created to fulfil this unmet need in feline health and welfare.
What's good about it is it addresses some of the challenges of accurate dosing and palatability. The flavoured and chewable tablets make it easy to administer with 80% voluntary acceptance, even winning an ISFM Easy to Give award. The 1.25 milligramme tablets align with consensus dosing guidelines, and the fact that it can be divided into two means you can easily dose a wide range of cats of different weights and sizes.
Over the past decade, SIA has played a leading role in raising awareness of feline hypertension. We have a sustained commitment to education, quality improvement and clinical guidance, which has helped bring much needed attention to this under-recognised welfare issue. Encouraging earlier diagnosis and more proactive management within the veterinary community.
Now, if you're looking to deepen your understanding, our ophthalmology CPD module looking hypertension in the eye, offers practical bite-sized learning designed to build confidence in performing ophthalmic examinations. It focuses on differentiating normal from abnormal findings and identifying ocular target organ damage with helpful tips for capturing retinal images using your phone. And if you're planning a feline hypertension initiative in your practise, we've created a QR resource sheet linking to a wide range of materials for vets and nurses, a dedicated page with consensus statements, clinical papers and CPD opportunities.
For client engagement, ready to use social media content, client leaflets, blood pressure diaries, and a public facing website designed to raise awareness and educate cat owners. You can download a digital copy of the QR sheet using the code provided. We hope you have found the course valuable and thought provoking and useful to develop how you approach cats with hypertension in your practise.
Thank you for listening.
