? Yum's cardiologist visit and enalapril prescription

The cardiologist said Yum's heart looked pretty normal, with the wall thickness at the upper end of normal.
He said the heart drops in older cats and these physiologic changes can cause murmurs.
She had her BP measured for the first time. It was high. He said "180".
He prescribed the ACE inhibitor enlapril, 2.5 mg once a day. He gave me tablets, which I will try crushing into her food. I think I can get a liquid version.
I see @Marje and Gracie ,@Barbara & Uncle , and maybe @Wendy&Neko might have experience with the drug.
Oddly google says in some places it is used for CRF and in other places it can cause kidney failure.
The cardiologist didn't think her kidney disease was very bad at this point.

 

Glad that Yum's heart looks normal and that her kidney disease isn't very advanced.

 

I have used it as steroids caused Gracie to have a transient heart issue. However, she was only on it three days before she crossed.

It can be used in CKD cats for proteinuria (kidneys leaking protein). Wendy used benzapril (same class of drugs) as Neko had proteinuria due to the acro. She could give you more info on it but in the short time Gracie was on it, it rally stabilized her heart and she had no side effects.

 

It is used for high BP. Doodles was on it for the HCM 2.5 mg twice a day without any side effects. Diamondback Drugs compounded it into sugar free chewables. I still had to open Doodles mouth and insert but then he'd chew and swallow. They could probably compound it into a liquid.

Very glad to hear Yums heart is in good shape.

 

Great news on the heart. Neko had the age related murmur for a couple of years before it got worse. We didn't do anything about it. How stresssed was Yum at the vet? Neko's first BP check was very stressful (delays, barky dogs) and she was around 220. On the second BP check a puppy jumped her kennel in the waiting room and she was about 185. At her dental, in a quiet darkened room by herself with Feliways going, she was 140, She registered about there the rest of her life. The only side effect of benazapril is that it can increase the creatinine some. Not enough to bother us, but I did notice a bit of a a difference in her CREA the couple time she was off benazapril.

Neko's benazapril, 2.5 mg, was a chewable that I had to hide in a pill pocket, until her mouth got so she didn't want to eat anything that large, so I put it into gelcap. I knew other cats on this chewable, called Fortekor, and not a single one ate the "chewable", obviously designed for small dogs.

 

I had to ask him the BP number. He didn't offer it to me. And when I asked if she was stressed out he waved that off. They used doppler, if that makes any difference. I had read I should insist on being present for the BP measurement (as a calming influence), but I did not do that. She behaved pretty well. Her first ever 40 minute car ride, each way. I brought her brush along and brushed her as we waited.
I just called them to ask if I could break her pills in half and give them twice instead of once a day. They said no. I thought she might not notice the taste of the pill ground up in her food if it was smaller. I read I can get an ear paste or drops.

 

I posted this for another member:

My vet uses Doppler.

 

Yes, Uncle is getting a half of a 2.5 mg tab twice a day. His brother was on it too. He could taste it when I tried to crush up and put in in his food. So I've been putting Uncle's into a little ball of pate style food and he eats it right up without detecting it or spitting it out!
Glad to hear Yum's heart looks pretty good

 

Makes more sense to break it in two and give it twice a day. I didn't get to ask the cardiologist my question about that strategy, just a tech or maybe a tech through a receptionist. No idea why they said no. Yum has just discovered RadCat Lamb. I crushed the pill and mixed it with that. She inhaled the lamb as usual. It's amazing.

 

I think I will take her in tomorrow to our regular vet for another BP measurement. I will decide whether or not to give her another enalapril dose tonight, before that test. I believe the drug has to work a while to produce a BP change, so I will probably give it to her. Then we will go in again for a BP check next week. I get the feeling my vet doesn't believe in BP measurements. She said they would try the Doppler but might fall back to oscillometric.

 

Today at the regular vet Yum's BP was 142 and 150. My vet still says to put her on enalapril. I have a call in to the cardiologist. I brushed her while they took her BP today, and I let her hide her face in my sweater. 142 and 150 seem kind of in the normal range for a vet visit to me.

 

Her number was 180 at the cardiologist visit on Monday, when he prescribed the medicine.

 

That's wonderful brushing helps relax Yum.

 

Good news with the heart.

Don't you wish they could do the BP while she is home and you would know if it were a reliable number?

 

Like you said, I would wait for the cardio vet's opinion on the drug given the new BP data. Glad to see she came back down with you loving on her.

 

The cardiologist said to wait on the medication and check her BP again next week. I think the rule of thumb is do not medicate if the BP is below 160. However, feline BP should be below 120, just like ours. I think they build in a 40 point white coat bias in calculating 160. I don't want to make her lethargic, or hurt her with unnecessary medication. I will wait for MORE DATA. They tried the tail first this morning, then switched to a front paw---which worked immediately.

 

Yes! The CRF web pages recommend asking to rent your vet's doppler BP device overnight to check your cat at home. They cost about $1000. The vet tech was afraid to do it himself, and even the vet wasn't sure it would work. But we had a success!

 

My vet used 170 as the white coat syndrome cutoff.

I also sprayed the carrier with Feliway and gave Rescue Remedy the morning of the vetty visit. It seemed to help. But ECID of course.

 

Maybe I will pick up some Feliway. Good idea, although it hasn't calmed her before in a different circumstance. Hope dies last.

 

So sorry about the recent news on Yum's health. Sending hugs and wishes for a healthy and happy Yum!

 

Thanks. She's not doing badly, nothing has been as bad as I feared. I feel so lucky compared to so many on this forum.