Page 436 - Feline Cardiology

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

Spironolactone Aldosterone 1–2 mg/kg PO Associated with prolonged survival in human 25,
(Aldactone [H]) antagonist q 12h heart failure patients, both via diuretic effects 50,
diuretic and tissue anti-aldosterone effects (e.g., 100 mg
reduction of formation of fibrous tissue in Tab
myocardium). Also K-sparing and synergistic HM
diuretic effects with long-term furosemide
therapy, improving hypokalemia and lessening
effects of diuretic tolerance by using
sequential nephron blockade, respectively. No
such benefits shown in cats. Cats with
asymptomatic HCM given spironolactone
2 mg/kg PO q 12h × 4 months showed no
improvement in hypertrophy compared to
placebo and 31% of cats (all Maine coon)
developed severe facial ulcerative dermatitis
requiring termination of treatment.
Streptokinase Thrombolytic 90,000 IU IV, Aortic thromboembolism of recent onset 250,000 IU,
(Kabikinase, then 45,000 IU (<8 h); emboli that have been present for >8 h 750,000 IU,
Streptase IV CRI are less likely to be lysed, increasing risk of 1,500,000 IU
[both H]) adverse effects compared to beneficial effects. Inj
Absolute contraindications include intracardiac HM
thrombus (risk of detachment and
embolization), unconfirmed embolic disease (if
a reasonable possibility exists that clinical
signs are due to trauma, neoplasia, or other
nonembolic disorder), and existing or
expected bleeding tendency. As with other
thrombolytics, the proportion of cats that
benefit from greater return of pulses (superior
to anticoagulation alone, e.g., heparin) is
negated or outweighed by the number of
severe adverse reactions, including
hyperkalemia and hemorrhage (manifesting as
overt blood loss—hematuria, epistaxis,
ecchymoses—or internal bleeding—
neurologic dysfunction, dyspnea due to
pulmonary hemorrhage, weakness and pallor
due to GI bleeding). Requires intensive
24-hour critical care and monitoring. Overall
survival to discharge = 33%.
Taurine Essential amino 125–250 mg Supplementation for chronic treatment of 250 mg
acid PO q 12h taurine-deficient systolic dysfunction/dilated Tab
cardiomyopathy. Indicated when whole blood OTC
and/or plasma taurine levels are low, which may
occur with a nutritionally balanced or unbalanced
diet. Reversal of cardiomyopathy occurs in many
cats, with improvement in clinical signs during
the first 2 weeks of taurine supplementation and
radiographic/echocardiographic improvement Drug Formulary
in the next 2–4 weeks.
Tenormin—see
Atenolol
Continued

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