Page 425 - Feline Cardiology

Generic Name Indications/Drug Dosage and Comments Available sizes
(Brand Name) Type Possible Routes
of Admin.

Furosemide Loop-type diuretic 0.5–4 mg/kg Indicated for congestive heart failure (esp. 50 mg/ml
(Lasix [H], PO q 12–48h cardiogenic pulmonary edema; adjunct to Inj VM
Salix [V], (chronic CHF); delay recurrence of pleural effusion, ascites, 10 mg/ml
Disal [V]; up to 3–4 mg/ and other cardiogenic fluid retention). Onset Inj HM
frusemide) kg PO q 8h for of action ≤1 h after IV use, peak at 2–3 h. 12.5,50 mg Tab
chronic Typically used in conjunction with an ACE VM
refractory CHF; inhibitor and low-sodium diet (to minimize 20,40,80 mg Tab
2–6 mg/kg diuretic dose, but only if palatable to cat). HM
+
−
+
2+
+
IV once, then Promotes excretion of Na , K , Cl , H , Ca 10 mg/ml
PRN (acute via blockage of Na/K/2Cl cotransporter in thick Liq
CHF) segment of ascending loop of Henle in renal VM
tubule. Effect occurs intraluminally, after drug
has been excreted into tubule. Larger volume
+
of urine (and less K wasting) than equivalent
natriuresis-inducing doses of thiazide
diuretics. Higher dosages usually in acute
congestive heart failure (hours/days of use),
lower doses and addition of other drugs (ACE
inhibitor, Na restriction, others) with chronic
(weeks–years) treatment. Cats usually dislike
oral syrup formulation. Drug is plastic- and
light-sensitive; do not store or dispense in
syringes for more than several hours. For CRI,
calculate total dosage for 24h and administer
in small volume (e.g., 50 ml) 5% dextrose in
water, protecting administration set from
light.

Heparin- Anticoagulant Dalteparin: Low molecular weight heparins (LMWH) Dalteparin:
low molecular 150 IU/kg produce a more consistent, longer-lasting, and 2500 IU/0.2 ml,
weight SC q 4h more effective level of anticoagulation in 5000 IU/0.2 ml,
(Enoxaparin Enoxaparin: humans and possibly in cats compared to 7500 IU/0.3 ml,
[Lovenox]; 1.5 mg/kg unfractionated heparin. Considered safer than 10 000 IU/1 ml,
Dalteparin SC q 6–8 h warfarin (lower incidence of excessive 25 000 IU/3.8 ml
[Fragmin] [H]) bleeding). May be administered without Inj HM
monitoring coagulation parameters, although Enoxaparin:
optimal anticoagulation may be achieved in 100, 150 mg/ml
the cat with serum antifactor Xa Inj HM
activity = 0.5–1 IU/ml.

Heparin- Anticoagulant 200–300 IU/kg Aortic thromboembolism (acute management). 1000,
unfractionated IN q 6h Mechanism of action is antithrombin (AT) 2000,
(“regular”) potentiation; therefore, contraindicated 2500,
(ineffective) in AT-deficient states, e.g., 5000,
protein-losing nephropathy (suspicion if 10 000,
proteinuria) or enteropathy. Not thrombolytic; 20 000,
reduces rate of formation of thrombus but no 40 000
IU/ml
active lysis of existing thrombus. Unproven
Drug Formulary (variable) efficacy in cats; may be monitored Inj
via aPTT measurements (should be 1.5–2.5×
HM
baseline) but such values may occur despite
subtherapeutic serum heparin levels; antifactor
Xa activity (levels of 0.35–0.7 U.ml) has been
recommended as a target for heparin
anticoagulation in dogs.

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