Feline Hypertrophic Cardiomyopathy – Therapy
For therapeutic purposes, it is primarily important to distinguish between primary and secondary cardiomyopathy as a consequence of other pathologies.
It should also be remembered that in cardiac patients, it is very important to evaluate and monitor renal function, starting with a urine test to determine the PU/UU ratio.
In general, for cardiogenic pulmonary oedema, the SO-FINE approach (Bonagura, 2014) is recommended:
- Sedation (butorphanol 0.2-0.3 mg / kg)
- Furosemide/ Positive inotropic agents (Dobutamine in case of cardiogenic shock and Pimobendan in case of systolic dysfunction)
- Extra (Additional) therapy (toracentesis)
Then, in chronic therapy, furosemide (0.5-2 mg/kg PO da SID a TID) at a dose as low as possible by monitoring the respiratory rate at home by the owners of e Ace-inibitori (benazepril 0.5 mg/kg SID/BID).
The use of β-blockers, such as atenolol, is controversial; studies from 2013 showed that atenolol did not contribute to prolonging the life of HCM cats in 5 years of observation compared to the control group of cats that were not treated with B blocker.
In the case of severe SAM, it appears that Atenolol continues to reduce the amount of regurgitation.
It is even more contraindicated in patients with heart failure because it reduces the survival time compared to patients treated only with diuretics.
In patients who also present a systolic deficit (as DCM), in addition to the above-mentioned therapy, Pimobendan 1.25 mg /2x daily Pimobendan dosed 1.25 mg/cat of BID along with taurine integration if a deficiency occurs is recommended.
Another therapy to be considered is anticoagulation therapy, which sometimes must be implemented even in asymptomatic patients.
In order to assess whether to begin such a therapy, it is important to validate the patient’s risk.
If the cat shows left atrial enlargement, the risk of thromboembolic complications is high and it is therefore advisable to start treatment to prevent it from occurring.
eparin e clopidogrel
Acetylsalicylic acid (5 mg/cat every 72 h), heparin and clopidogrel (1/4 pills 75 mg SID) are drugs.