Managing chronic diseases in cats - DVM
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Managing chronic diseases in cats
Help your feline patients live longer, healthier lives.


DVM Best Practices


Several devices using technologies such as oscillometry and Doppler ultrasonography measure systemic blood pressure. It takes patience to get accurate blood pressure readings in cats. Train your technicians to perform these time-consuming measurements. Use a quiet room, have the owner present, and allow five to 10 minutes for acclimation. Perform a minimum of five to seven measurements. It's important to use the correct cuff width (30% to 40% of the circumference of the leg) and place the cuff at heart level.14

Patients with systolic blood pressure elevations above 170 mm Hg recorded on more than one occasion should be treated for hypertension. It is important to identify and treat any underlying diseases first, such as hyperthyroidism. The most effective drug is the calcium channel blocker amlodipine (0.625 to 1.25 mg/cat orally every 12 to 24 hours).15 If improvement doesn't occur after 48 to 72 hours, increase the dose.15 If you reach the dose's upper range without controlling blood pressure adequately, add an ACE inhibitor such as benazepril (2.5 mg/cat orally every 24 hours for cats weighing 2.5 to 5 kg). In hyperthyroid cats, consider beta-blockers such as atenolol (6.25 to 12.5 mg/cat orally every 24 hours) as first-line therapy instead. Once stabilized, cats with hypertension should be re-evaluated at least every three to four months, or as dictated by any concurrent diseases. At each visit, measure systolic blood pressure in addition to performing a complete physical examination. Depending on the existence of concurrent diseases, serum chemistry profiles and other diagnostics may also be re-evaluated at least every six months.

Conclusion Make sure all staff members help care for patients with chronic diseases. Everyone needs to deliver the same message of high-quality care. In addition to performing blood pressure measurements, technicians can also teach clients how to administer insulin, perform blood glucose readings, and give subcutaneous fluid therapy at home. A team approach will help you offer more efficient care and make staff members feel involved in delivering high-quality care.

Susan Little, DVM, DABVP, received her BSc from Dalhousie University, Nova Scotia, in 1983 and her DVM in 1988 from the Ontario Veterinary College, University of Guelph, Ontario. She co-owns two feline specialty practices in Ottawa, Ontario, and serves as vice president of the Winn Feline Foundation.

References

1. U.S. Pet Ownership and Demographics Sourcebook. Schaumberg, Ill: AVMA, 2002.

2. Zoran DL. The carnivore connection to nutrition in cats. J Am Vet Med Assoc 2002;221:1559-1567.

3. The path to high-quality care: Practical tips for improving compliance. Lakewood, Co: AAHA, 2003:61.

4. Center SA, Harte J, Watrous D, et al. The clinical and metabolic effects of rapid weight loss in obese pet cats and the influence of supplemental oral l-carnitine. J Vet Intern Med 2000;14:598-608.

5. Greco DS. Diet and feline diabetes mellitus: The carnivore connection, in Proceedings. Atlantic Coast Vet Conf 2002.

6. Bennett N, Greco DS, Peterson ME. Comparison of a high fiber vs low carbohydrate diet for the treatment of diabetes mellitus in cats (abst). J Vet Intern Med 2001;15:297.

7. Marshall RD, Rand JS. Comparison of the pharmacokinetics and pharmacodynamics of glargine, protamine zinc and porcine lente insulins in normal cats (abst). J Vet Intern Med 2002;16:358.

8. Rand J, Marshall R. Insulin glargine and the treatment of feline diabetes mellitus, in Proceedings. ACVIM Forum 2004.

9. Marshall RD, Rand JS. Insulin glargine and a high protein-low carbohydrate diet are associated with high remission rates in newly diagnosed diabetic cats (abst). J Vet Intern Med 2004;18:401.

10. Kley S, Casella M, Reusch CE. Evaluation of long-term home monitoring of blood glucose concentrations in cats with diabetes mellitus: 26 cases (1999-2002). J Am Vet Med Assoc 2004;225:261-266.


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