Hypertension

Hypertension, more commonly known as high blood pressure, is fairly common in older cats, but can be found in younger cats as well.

Diagnosis:

Just like in people, we will attach a blood pressure cuff to your cat, either at the base of the tail or on a foot and get blood pressure readings in a similar manner.

A normal blood pressure reading in a cat at home at rest is the same as people, 120/70.

We will generally take multiple readings of your cat's blood pressure at the clinic until we are confident that your cat is as relaxed as possible so that we have the lowest readings that we can get. We may also average several readings together to get the best overall idea of your cat's blood pressure.

• A normal blood pressure reading for a cat at home at rest is the same as yours - 120/70.
• At the clinic, we will routinely add 50 points to the systolic to account for stress, so if your cat's systolic is 170 or less, we consider that normal.
• If your cat's systolic is between 170-190, we consider that the grey range, and will factor your cat's behavior and stress level during the blood pressure readings to determine whether to start medication.
• If your cat's systolic is greater than 190, unless your cat was fighting, growling, and striking out during the entire process, we will consider that to be high blood pressure, and may want to start your cat on medications.

Causes:

Hypertension in cats can be primary or secondary to another disease process. Because of this, if we diagnose hypertension in your cat, we may want to look for another disease which may be causing the hypertension.

• Primary. This can be congenital, or it can also be idiopathic, which is a medical term that means we have absolutely no idea of the cause.
• Secondary. This is a result of a disease process in your cat that is causing hypertension as a side effect. In some cases, if we treat the underlying disease process, the hypertension may resolve on its own, but for most cats, they will need to be on medication for life after diagnosis. Some of these disease processes are:
  • Kidney disease
  • Hyperthyroidism
  • Diabetes
  • Obesity
  • Heart disease

Most of these disease processes can be diagnosed through blood work or x-rays. If we cannot find a medical cause, then we will diagnose primary hypertension by default.

Treatment:

We use some of the same medications that are used in people to get your cat's hypertension resolved. If there is another disease process causing the hypertension, we may also want to treat that as well.

The most common medications that we will use for hypertension are:

• Amlodipine. This is a calcium channel blocker and by far the most common medication we will use, and our first line of defense. In some cases though, we may need to add additional medications if amlodipine is not effective enough.
• Atenolol. This is a beta blocker that can also have some slight blood pressure lowering effects.
• Enalapril or benazepril. These are in a class of drugs called ACE inhibitors that can also have some slight blood pressure lowering effects.

All of these medications are available in pills that are very small and easy to hide in food or treats, but for cats that are a little too smart for their own good, and who are not pillable, all of these medications can also be compounded into flavored liquid, and as a last resort, ear pastes, although none of them are as effective in an ear paste formulation.

Why treat? If your cat has uncontrolled hypertension, that can in itself cause disease in your cat, as the high blood pressure is very hard on your cat's organs. Some of the more common diseases that can be caused by hypertension are:

• Kidney disease
• Blindness from retinal detachment
• Heart disease
• Stroke
• Dementia like symptoms

All of these diseases when caused by hypertension can be prevented, but only if we can keep your cat's blood pressure in a normal range consistently.

Cats with hypertension can live normal good quality lives with proper treatment and medications.

If you have any questions regarding any of the information given here, please feel free to contact us at info@allfelinehospital.com

This handout was written by Dr. Shelley Knudsen, DVM

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