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The Honolulu Advertiser
Posted on: Saturday, September 23, 2006

Pets get high blood pressure, too

By Dr. Marty Becker
McClatchy-Tribune News Service

Blood pressure measurements have been a standard in human medicine for many years and due to recent advances in blood pressure measurements for our pets, it may not be the first thing done, but it is becoming more common for routine, annual, pet health checkups. As a result, hypertension (i.e., high blood pressure) is being diagnosed more frequently.

Your pet's blood pressure may be measured using a Doppler flow detection system or oscillometic method; both are similar techniques to those done in your doctor's office. Initial readings may be high due to stress and anxiety in unfamiliar surroundings — affectionately termed "white coat hypertension."

Hypertension in our pets usually indicates: kidney or heart disease, Cushing's disease, anemia, obesity, diabetes or feline hyperthyroidism. Blood and urine tests help determine the underlying cause of hypertension but there are a growing number of cases, particularly in cats, where no underlying cause is found.

Veterinarian Dr. Anthony Carr stresses that blood pressure should be checked routinely on all geriatric cats as well as dogs and cats at risk for hypertension due to a previously diagnosed disease such as kidney failure.

"Some patients will show obvious signs of hypertension but often hypertension is silent," said Carr, associate professor at the Western College of Veterinary Medicine, University of Saskatchewan in Canada.

Hypertension alone damages vital organs including the eye, brain, heart and kidney. Owners with pets experiencing hypertension may report sudden loss of vision and/or widely dilated pupils. Possible neurological signs of hypertension may include circling, a tilt of the head or seizures. Signs associated with an underlying disease like heart and kidney disease are subtler and may include lethargy, depression, difficulty breathing, increased thirst and urination, weight loss, and increased or decreased appetite. Bleeding from the nose may also occur.

Dr. Christine Wilford, a private-practice veterinarian at Cat's Exclusive Veterinary Hospital in Shoreline, Wash., sees hypertension in almost one quarter of the geriatric cats she treats. "I'd say maybe 20-25 percent of those kitties over 13 years of age, those with unexplained dilute urine, renal failure and hyperthyroidism have mild to severe hypertension when I determine their pressures," she said.

One such case from Wilford's practice was Samantha, a 15-year-old female spayed grey tabby cat who was brought in by her owner because she was howling. On a hunch, Wilford measured her blood pressure and as suspected, Samantha's blood pressure was high. She was sent home on amlodipine, an antihypertensive medication commonly used for cats. Samantha's owner reported that after taking amlodipine, not only had Samantha stopped howling but she was playing like a kitten again. Her blood pressure was normal four days later.

Wilford has seen positive results in other geriatric cats treated with amloidipine for high blood pressure.

"My own cat Fuzzy, a 16-year-old calico kitty, had kidney disease and was losing her hearing," explained veterinarian Dr. Sandy Wright. "I did not want her losing vision due to hypertension with kidney failure." Wright consulted with Dr. Jerry Woodfield, a Seattle veterinarian specializing in cardiology. "We measured her blood pressure and she was hypertensive. Fuzzy also was placed on amlodipine and her hypertension resolved without a negative affect on her kidney function."

Your pet may be referred to a veterinary ophthalmologist or cardiologist if diagnosed with hypertension. In addition to treating the underlying cause, veterinarians have an array of new antihypertensive medications to control hypertension. Special diets may be required and treats high in salt should be avoided. As in humans, blood pressure will need to be monitored to tailor the medications to the individual pet and lifestyle is a factor.

Prognosis is good for treating hypertension if caught early and pets that experience a loss of vision may have their vision return. Occasionally, high blood pressure will return to normal if the underlying disease is successfully treated and then use of antihypertensive medications may no longer be needed.

Cats are not the only pets to experience high blood pressure. Dogs experience it, too.

Dr. Diane Levitan, diplomate, American College of Veterinary Internal Medicine, and director of The Center of Specialized Veterinary Care in Westbury, N.Y., detected hypertension in Sadie, a 4-year-old terrier. Sadie sustained kidney damage due to a kidney infection. The infection was treated with antibiotics; however, the kidneys began to lose function resulting in worsening blood tests, protein loss in the urine and high blood pressure.

Sadie is now 9, and by managing her diet, blood pressure and infection recurrence, she has survived several years beyond all expectations with a great quality of life. "Early detection of hypertension in pets with kidney disease is very important," Levitan said. "Studies show that dogs with kidney failure and hypertension can have up to four times higher risk of crisis than those without hypertension."

The key to her success was the teamwork of pet owner, family veterinarian, and Levitan — the specialist.

For more information on blood pressure measurement and your pet's risk for hypertension, consult your family veterinarian and www.acvim.org.