4/5 Trixie PMPS 67 +1.5 72 - BP...Ace inhibitor?

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Amy&TrixieCat

Amy&TrixieCat

Member Since 2011
Yesterday

Trix decided to get another early start in the lagoon today. Hopefully she'll start surfing this lovely number!

She has given BFF Tuna and Salmon Soulmates 2 paws up. I can say that because, unlike Fowl Ball which got rejected after 1.5 feedings, we have now successfully had three enthusiastic meals that included Soulmates served side-by-side with her PLC. I wouldn't invest in a whole case, but I will be buying a few more cans - woohoo!

I also saw that Ann, John & Tess and Rachel & Chyna did some fabulous research and found that Wild Callings should be good for our FD/CKD kitties...huge wooohooo on that one since it gives us more possible fuds options! I'm going to try and track some down and pray that Trix loves it. Very, very exciting!!

Trix gets her BP rechecked later this morning. Unfortunately I have to work so DH has to take her by himself. I always like to talk to the vet, but now we are stuck in the realm of having to be there are a very specific time because of when she takes her pill (vetty likes to check her BP at "amlodapine +6"), and I have to teach this morning so I couldn't get out of work. I am sure all will be well, and I'll post an update when I have it. We still have just over 2 months before we recheck her BW.

Sending many safe travel prayers for Sienne as she and the kitties make the big move to Ohio today! I am sure everyone will be thrilled with their new home once the dust settles.

I have to do human fuds shopping after work today...I may not have time to post, but I'll be checking in on and thinking about my LL family. Have a great day!

Amy
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP check today

Morning Amy ~O) ~O) ~O)

WOW, I think you gave found the right dose and the rights fuds to make this all work for Trixie. The numbers have been so great. AWESOME! Surf well today Trixie. Good luck too with your BP check at the vetty today. I am sure you will nail it. :-D :cool:

How wonderful to have another fuds for her. WOO HOO!! I too am grateful to people like Ann and Rachel that take the time to research and track down the values in these fuds. THANKS guys!

Have a great day today. I hope all goes well.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP check today

Morning, gang! ~O)

Oh, that food option sounds VERY exciting, indeed! I do hope that it works for Miss Trixie.

Wishing for a very good BP check today!

I hope that she gives you a very lovely surf today. She's already starting to show you what she can do. :mrgreen:

Have a great day, and please be safe! :YMHUG:
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP check today

Hi, Amy, I'm so glad to hear that there's an additional option for LC/low-phos. food. :-D I know all too well about the limited options ;-) .
Sending good BP-check vines to Miss Trix today.
Her numbers are looking so GREAT! :thumbup
Have a good day at work!
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP check today

Morning Amy, sending many good Vetty vines for Trixie today for her b/p check-up. Yay on the fuds you're finding are good for Trixie. Nice on the Wild Callings, too, which means more choices for the kitties.
Our Mom and Pop store that used to sell BFF changed ownerships, and I've been meaning to visit the new one.
Trixie girl is doing amazing lately which is a lot owed to you.
Hope all goes well with the teaching classes today. Hugs and scritches from us.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

I'm at work so I apologize for this being quick and scattered. Plus, I didn't go to the vet with DH, so I have to call at some point and get more info.

Trix's BP is better but still a little high at 179. I am really frustrated and stressed that we are making no progress. She was at 170 BEFORE we started meds. Now, twice a day amolodapine, and we are HIGHER.

Anyway, vetty suggested adding an Ace Inhibitor to help lower it a bit and possibly help her kidney values. She did say there is an small chance it could WORSEN her kidney values. At this point, giving the ace inihibitor is up to us, so I want to do some reasearch and gain more info before commiting to it.

Does anyone have any experience or knowledge? Any and all thoughts are appreciated!

Trix is also keeping DH busy with somewhat dropping numbers...last I heard, she was at 61 when they got home (+6.5ish). She is happy, radiant, and asking for fuds...apparently she CPCed the Soulmates he gave her :-D .

With that...back to work.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Hi Amy - No clue on the ace inhibitor and kitties. I have a friend though that did go that route to lower her BP. It was effective, but there were times too that she just went too low. She could tell, I wonder how one would know with a cat. She had to constantly monitor her BP. I have no clue how this would work in cats. Wise I think to research it before going that route. I think I'd be leery of going that route if there is any chance of kidney issues, Bummer that the BP was basically the same. maybe it was just one of those days for her. I dunno... it is so difficult to get really good BP readings with cats. Maybe wait a few and retest the BP? Wish I had an answer for you, but know to you've been through the BP ride before too.

AWESOME on the BG. and the soulmates! I will have to smile - I found two cans of that in the kitty fuds cupboard, left over from Mannie, when I was cleaning out and taking inventory of the Fuds stash. ;-)
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Thanks for the info Michelle ...

Since I forgot to mention before... Her first reading when all this started was 170; we started Bp meds once west. Next check she was 190 and above so we increased her meds to twice a day. Now she's st 179, so better that last time but still not better thane her first reading before she started meds .


Back to work again....
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

I so remember going through the same scenario, well similar, with Mannie. We started out at 200 or thereabouts, got it down to 150/160 (I think, and that as the only "good reading" we ever got), back up to 180/200, then 220 when other health issues and meds were added to the mix. The past few months we were at and in the 180 range, with him on the amlodopine twice a day too. I just never could get it any better. I so feel your frustration. We all just do the best we can do. He was content and happy.... the bean however was stressed. ;-)
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Amy

What dose is she on? I know you are giving it bid but what is the dosage? The typical dose is 0.625 mg/day but it can be increased to 1.25 mg/day. So I'm not sure if she started Trix at 0.625 mg sid and then increased to 0.625mg bid which would then put her at the upper limit. However, you are giving it bid now and I wonder if it should only be dosed sid at the higher dose? That would be a question for the vet. I don't know if it would make a difference or not. Amlodipine can be less effective if Trix is getting any glucosamine or sups like cosequin. I don't remember that she is but thought I'd ask.

Enalapril is the ace inhibitor typically used but it is often not as effective as amlodopine. Tanya's suggests using them both if amlodipine is not effective on its own.
However, for really severe cases of hypertension which do not respond to amlodipine alone, it may sometimes be necessary to give ACE inhibitors in addition to the amlodipine. I had to do this for my non-CKD cat with hypertension. But in most cases, you can try amlodipine by itself first. If your vet is reluctant, you may wish to print out some of the links above.
Click to expand...

I also found this for you on Tanya's on hypertension

Some vets also like to use ACE inhibitors to control systemic blood pressure. They may wish to do this simply because they think it is the best treatment, but they may also want to do so because of something known as the renin-angiotensin-aldosterone system or RAAS.
If blood flow to the kidney is reduced, the kidneys are stimulated to produce hormones called renin and angiotensin. The adrenal gland is stimulated to produce another hormone called aldosterone. This is known as the renin-angiotensin-aldosterone system (RAAS). These hormones make the blood vessels in the body constrict, which in turn leads to hypertension.

The RAAS can be activated by CKD, and may also be activated by the use of calcium channel blockers (such as amlodipine, the recommended treatment for hypertension in cats) to treat general hypertension. In contrast, since ACE inhibitors work by preventing the conversion of angiotensin I into angiotensin II, they not only do not activate the RAAS, they may reduce the risk of activation.

There is some debate as to how common activation of the RAAS is in CKD cats. In Feline hypertension: risks, diagnosis and management (2007) Atkins CE, Presentation to the World Small Animal Veterinary Association World Congress 2007, Dr Atkins states "several studies have indicated that the renin-angiotensin-aldosterone system (RAAS) is probably abnormally activated in many or, perhaps, most cats with systemic hypertension, particularly with concurrent renal disease." However, in Heart disease in the older cat (2006) Simpson K Presentation to the FAB Conference, Ms Simpson states that ACE inhibitors "appear fairly unreliable at decreasing blood pressure. A possible explanation for this may be that the hormonal axis which these drugs target (the reninangiotensin-aldosterone system (RAAS)) is not activated to the same degree in cats as in humans."
Click to expand...

Perhaps this is why she wants to try enalapril? I just wonder if the suggestion to add enalapril to the amlodipine is perhaps a good one? I have absolutely no idea but it would provide you something to ask the vet and there are some good links on Tanya's about doing this.
BTW, I did a drug interaction check between amlodipine and lantus and there is no known interaction. Just thought it would be worth a search.

Paws crossed. I was really hoping she would respond to the increased amlodipine dose.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Super quick reply again...still in the middle of teaching....

She is on 1/4 amlodopine tablet twice a day....since I'm at work, I don't know what the actual strength is but I'm pretty sure it comes in just one standard strength, right?

Vetty wants to ADD an ace inhibitor Benazepril 5mg - 1/2 tablet twice a day (so I think that works out to 2.5mg BID - again, I'm at work so I don't have the bottle in front of me and I wasn't with DH at the vetty). It would be in addition to the current BP meds. The choice is up to us, though. I know vetty said that there is some controversy about using Ace inhibitors, and she knows I like to research things. I do plan on calling her tomorrow for more details, but I know there is lots of experience here, too.

Trix is not any sort of joint supplements - no cosequin, etc.

ETA: Originally, vetty did suggest 1/2 amplodapine once a day instead of what we decided to do with the BID dosing. The BID dosing worked well with Mario, so that was why I decided to try that route. So I will ask her about SID higher dosage, too.

Pardon my language, but we just had a bat-**** crazy customer in here, too, so now I'm even more rattled. Trix is feeling awesome....that's all that matters.

Back to work.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

I'm sending un-rattle vines your way! It's hard to deal with people like that, on top of your worrying about Trixie. I'm glad that some people can give you insight on this :YMHUG: .

I really hope that the fuds go over well! I still find it hard to believe that they can be that low but it's what the chart said that he gave...I guess I am ever the pessimist :? . We tried the WC duck last night to mixed review and some scratching so that one (and any duck) may be off the market. We tried the beef today. Chyna ate it and seemed interested but she isn't up on appy much today so far and is now hiding under the bed :sad: . I'm glad that Trixie is eating so well today, though, and feeling good :-D

I hope the rest of your day goes well, and fast! (PS, love the expression on the customer :lol: )
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

The typical strength is 5 mg but it does come in 2.5 mg so she's either getting 1.25mg bid or .625 mg bid. I found it really hard to chop evenly for a consistent dose so I had it compounded. If you decide to go that route, I'd be sure they do not use any sweeteners at all including maltodextrin. They can still flavor it without sweeteners.

Sorry I missed that you did say "ADD" initially. We had a pj party last night so I'm still sucking down coffee :lol:

Well....the way I think you have to look at it is that the high BP could also be what has her kidney values up there. If you try to add the benazepril, I'd ask the vet what the shortest response time you could expect would be and then get Trix right back in to see if the combo is helping to lower the BP. That way you could perhaps catch it before it does worsen kidney values.

I've always been of the opinion that you seem to have a pretty savvy vet. You do a great job of research and she seems to be very good about discussing that with you. It's just too darn bad that dopplers to check kitty BP are so darn expensive.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Max gets 1.25 mg of amlodipine every morning. His BP was high on .625 and has been high since increasing. I think it is really hard to get a true reading at the vet's due to stress. Furthermore the doppler is supposedly better for cats but my vet doesn't use it so Max's BP could be higher at the vet's. I considered buying a machine of my own but they are expensive. Someone on one of the CRF lists was purchasing an inexpensive one. This reminds me to ask if it works. JMHO but just like BG tests at the vet's I think we don't get good BP checks either unless you have a really laid back cat. My Max is afraid of his shadow.

Elise
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Hi Amy,
This is a "support" post, because I don't know anything about the topic! But I'm so glad that Trixie is enjoying her new fuds.
i hope you all will have a more relaxing evening than the day has been.

Rusty says, surf those greens, Trix!

Ella & Rusty
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

Sorry about the crazy customer and the BP frustration. I hope things are better this evening. :YMHUG: :YMHUG:

I hope you find a good dose of the BP meds for Trixie. That's great she likes the Soulmates. I hope she likes the Wild Calling too when you get a chance to try it.
 
Re: 4/5 Trixie AMPS 128 +2.25 86 - BP...Ace inhibitor?

not my area of expertise either, but just want to add a little moral support while you're figuring things out for your sweet trixie. :YMHUG:

Her BGs sure look great!
 
Ok, I'm home but between work, the BP readings, and food shopping (big stock up), my brain is officially FRIED. But, she currently gets 1.4 if a 2.5mg tablet twice daily.

Thanks for all the feedback and support...I so appreciate all of it.

My vetty does consider 170 high enough to cover white coat syndrome, but ECID. Trix seems pretty mellow in general, including at the vet, but who knows for sure what is going inside her little body when she's there.

I'm going to call the vet tomorrow with a couple questions before starting the Ace Inhibitor, just to be sure we're on the right track. One thing I wonder is if she would do better on the half tablet once a day, rather than 1/4 tablet twice a day. Mario did well on the BID dosing, but again, ECID.

I don't feel as anxious as I did with her second round of BW that showed no kidney improvement because she is so darned radiant :-D ...but it is stumping my brain that her BP is HIGHER on meds than it was without! I'm tired of kitty puzzles now!!

Time for a dinner and a big glass of vino....
 
Adding in my support - for both Trixie and you! Whatever you need - patience pants, un-rattle vines, bp vines - they're coming your way. Despite all of the issues you're facing right now, it is wonderful to hear that Trixie is feeling great.

Surf safely tonight, little one! :mrgreen:
 
We have the same problem. Since our cat, Balki, started treatment for hyperthyroidism, his BP has been worse. We increased Amlodipine to 2.5mg daily (1.25mg BID)! This is because I refused to add the ACEI, and have refused it for 2 years now. His BP was sometimes better (and sometimes worse, despite the increase), but he looked truly odd and worrying.

We went back to his original dose of 1.25mg SID and are now going to add Telmisartan (Micardis). You might be interested to research this drug. It is also mentioned on Tanya's CRF site. It was recently released for cats in Europe - a product called Semintra. Vets there are now recommending it over Benazepril. It is an angiotensin II receptor antagonist and supposedly safer than ACEI. I can't recommend it yet, as we have only just had it compounded, ready to start.
 
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