Page 317 - Feline Cardiology

Measure BP
Identify TOD &
Concurrent diseases

BP < 150/95 mmHg BP ≥ 150/95 mmHg

Minimal risk of TOD Ocular/CNS TOD present No ocular/CNS TOD present
Re-evaluate in 3-6 months

Candidate for Re-measure BP
initiation or escalation of within 7 days
antihypertensive therapy

BP < 150/95 mmHg BP 150-159/95-99 mmHg BP 160-179/100-119 mmHg BP ≥ 180/120 mmHg

Re-measure BP Evidence of TOD? Evidence of TOD Yes:
in 1-3 months or cause of Candidate for
secondary hypertension? initiation or escalation of
anti-hypertensive therapy

Yes: No: Yes: No:
Candidate for Manage causes of Candidate for Clnical judgement: Candidate for
initation or escalation secondary hypertension. initiation or escalation of anti-hypertensive therapy -or-
of anti-hypertensive therapy Re-measure BP in 1-3 months anti-hypertensive therapy re-measure BP in 1 month

Figure 21.1. The recommended approach to patient evaluation is based on reliable measurements of blood pressure (BP). However,
Systemic Hypertension those causing secondary hypertension), and the categorization of risk for further TOD form the basis for treatment decisions. Algorithm
the identification and characterization of pre-existing target organ damage (TOD), the recognition of concurrent conditions (especially
from ACVIM Consensus Statement.

*

*

*
*

*

Figure 21.3. Fundus photograph of a geriatric cat with systemic
hypertension. Notice the multifocal intraretinal and subretinal
hemorrhages (black and white arrows, respectively) and the peri-
papillary and dorsal tapetal retinal detachments (black and white
Figure 21.2. Normal feline fundus, for comparative purposes. asterisks, respectively). Photo courtesy of Cheryl Cullen, DVM,
The tapetal fundus is seen throughout the image, with normal MVSc, DACVO.
retinal vessels radiating from the optic nerve head in the lower
region of the image. Courtesy of Christa Robinson, DVM, MS.

326