Small Animal Clinical Pharmacology - CYF MEDICAL DISTRIBUTION

CHAPTER 17 DRUGS USED IN THE MANAGEMENT OF HEART DISEASE AND CARDIAC ARRHYTHMIAS
Table 17.4b Feline cardiovascular medication chart
Drug Class Dose (per cat) Dose (mg/kg)
Enalapril* or benazepril* ACEI PO: 1-2.5 mg q.12-24 h PO: 0.2-0.7 mg/kg q.12-24 h
1. Diltiazem
Calcium channel blocker
1. PO: 7.5 mg q.8 h
2. PO: 10 mg/kg q.24 h
2. Cardizem CD
3. Dilacor XR
3. PO: 30-60 mg q.12-24 h
Atenolol* β-blocker PO: 3.125-12.5 mg q.12-24 h PO: 1.1-2.5 mg/kg q.12-24 h
Atenolol, low dose* β-blocker PO: 1-3.125 mg q.24 h
Uptitrate if well tolerated
Furosemide* Diuretic PO: 3.125-12.5 mg q.12-48 h PO: 1-2 mg/kg q.12-48 h
IV/IM/SQ: 0.5-2 mg/kg PRN
Hydrochlorothiazide* Diuretic PO: 6.25-12.5 mg q.12 h PO: 2-4 mg/kg q.12 h
Spironolactone* Aldosterone antagonist PO: 6.25 mg q.12 h PO: 1-2 mg/kg q.12 h
Digoxin Cardiac glycoside PO: 0.031 mg q.24-48 h
/ 4 of 0.125 mg tablet
Aspirin NSAID PO: 81 mg q.3 d PO: 25 mg/kg q.3 d
Sotalol*
Antiarrhythmic
PO: 10 mg q.12 h
β-blocker
Nitroglycerin paste Vasodilator Topical: 1/8-1/4 inch q.6-8 h
Low molecular weight heparin Antithrombotic SQ: 100 IU/kg q.12-24 h
Butorphanol Anxiolytic IV/IM/SQ: 0.2 mg/kg PRN
Taurine Amino acid PO: 250-500 mg q.12 h
Clopidogrel (Plavix) Thienopyridine 18.75-75 mg PO q.24 h
Can be formulated as a suspension by a formulation pharmacy.
Echo sedation medetomadine 20 µg/kg IM.
Note: Therapeutic recommendations reflect the authors’ opinion and are based on review of available data.
or reduce congestion can be expected to reduce euthanasia-associated
mortality.
Prolong survival
1. Inhibition of the RAAS
a. ACE inhibitors
i. Enalapril, benazepril
b. Aldosterone antagonism
i. Spironolactone
2. Inhibition of the sympathetic nervous system
a. β-Blockers
i. Atenolol and metroprolol (selective),
propranolol (nonselective; unproven in dogs
and cats)
b. Adrenergic blockers (α- and β-blockade)
i. Carvedilol
3. Improve diastolic function
a. Feline hypertrophic cardiomyopathy (HCM)
i. Calcium channel blocker such as
diltiazem
ii. β-Blocker such as atenolol (prolongs diastolic
filling period)
4. Other
a. Modulation of cytokine maladaption
i. Pimobendan
b. Prevention of thrombosis in heart diseases
associated with increased risk
i. Feline hypertrophic cardiomyopathy
Antiplatelet agents such as clopidogrel
Anticoagulants such as coumadin, heparin
(IV, SQ) and low molecular weight
heparin (IV, SQ)
c. Antioxidants
i. Carvedilol
ii. Omega 3 fatty acid supplementation
d. Complementary therapy
i. Taurine
ii. L-carnitine
Therapeutic approach for preclinical
heart disease
Agents in this class target primarily mechanisms involved
in the progression of heart disease. However, to date,
no therapeutic agent has been demonstrated to delay the
progression of any canine or feline preclinical heart
disease and thus agents listed in this section are candidate
therapies.
Prolong preclinical stage of disease
1. Inhibition of the RAAS
a. ACE inhibitors
i. Enalapril, benazepril
b. Aldosterone antagonism
i. Spironolactone
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