Conscious Cat

April 2, 2012 11 Comments

High blood pressure in cats

Posted by Ingrid

cat_veterinary_clinic_exam

Feline hypertension, the medical term for high blood pressure, is usually seen in older cats, and is most often secondary to an already existing disease such as kidney failure, heart disease, or hyperthyroidism. Accurate diagnosis and treatment are important to prevent serious consequences.

Symptoms

High blood pressure is known as the silent killer, because by itself, it has no symptoms. High blood pressure causes wear and tear on the heart and kidneys. It can cause small blood vessels to leak and rupture. If this happens in the eye, it can lead to blindness. If it happens in the brain, it can lead to a stroke.

Diagnosis

Obtaining an accurate blood pressure measurement on cats can be challenging. Most cats are stressed when they visit the vet, and stress elevates blood pressure. There’s even a name for this in human medicine: “white coat syndrome.” This is a phenomenon in which patients exhibit elevated blood pressure in a clinical setting, but not in other settings, and it applies to cats as well.

Blood pressure in cats is measured the same way it is measured in humans: with an inflatable cuff and an ultrasonic listening device called a Doppler. In order to minimize stress during this non-invasive test, it helps if it is done in a quiet room, away from barking dogs and other noises. Usually, having the cat’s guardian present can help calm the cat. The vet will take several readings, to rule out the above mentioned white coat effect as much as possible.

If blood pressure is consistently  high after taking several measurements, additional tests will be necessary, including, at a minimum, a complete bloodcount, blood chemistry, and urinalysis.

Risk Factors

Cats who have one or more of the following conditions are at risk for elevated blood pressure:

  • Hyperthyroidism
  • Chronic renal failure and other kidney disease
  • Diabetes

Treatment

The decision whether to treat hypertension should be based on reliable, repeatable blood pressure readings, and will be influenced by any concurrent disease. Vets must take the cat’s temperament and anxiety level into consideration when interpreting blood pressure test results. Normal cats often have transient elevated blood pressure due to the stress of being at the vet’s and the exam itself. The treatment decision will also depend on an individual cat’s risk factors.

Treatment will first target the underlying disease. Medications that can exacerbate hypertension, such as steroids, will need to be eliminated or reduced. Excessive sodium in the diet should be avoided, but a low salt diet is not necessarily indicated. Maintaining normal potassium levels is important, and a low salt diet can lead to loss of potassium without any beneficial effects on blood pressure.

If treatment is indicated, the type of drug used will depend on the overall diagnosis. The goal of treatment is to reduce blood pressure into a range that minimizes organ damage. Once blood pressure is controlled, it should be rechecked every three months.

Cats in a hypertensive crisis (severe neurological symptoms or sudden onset blindness) will need emergency treatment and will usually require hospitalization and careful monitoring. The prognosis for these cats is variable. Some cats with sudden onset blindness will recover some of their lost vision if treatment is initiated soon enough.

The American Association of Feline Practitioners recommends blood pressure monitoring as part of a regular bi-annual senior cat exam in their Senior Care Guidelines.

Photo Flickr Creative Commons

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11 Responses to “High blood pressure in cats”

  1. mikken says:

    We took in my hyperthyroid cat to check his blood pressure. They shaved the underside of his tail, tried to put alcohol on it (! – I stopped that), and then slapped some cold gel on the shaved area. Then the vet came in, speaking VERY LOUDLY in the small, echoing room, and used large, sweeping gestures as she spoke…

    Needless to say, they decided that my cat had very high blood pressure.

    I was so dissatisfied with the whole procedure, I complained and my regular vet (who didn’t have the equipment, which is why we went to the ER to do this in the first place), set us up to test again. This time, the gel was warmed before it came anywhere near the cat, the cat was given time to settle, we had brought his favorite treats and warm towels for him to sit on (instead of the metal table), the vet came in (different one who knew the story and was trying to do it right this time), spoke very quietly, introduced himself to the cat, talked to him a while, then gently went through the procedure.

    Blood pressure was completely normal.

    So, yeah. Sometimes “whitecoat syndrome” is really “whitecoat not thinking the whole thing through from the cat’s point of view syndrome”.

    • Ingrid says:

      These kinds of stories make my blood pressure go up, Mikken! Some vets just don’t get cats. I’m so glad you had your kitty rechecked again under better circumstances, and that everything was normal.

  2. Nina says:

    Urgh! That makes my blood pressure goes up too! I can only imagine her to be some old deaf woman! Glad your furbaby is fine, though. :)

  3. Darla says:

    I’m cat sitting my brothers two cats near Seattle, one of which is older & was diagnosed with hyperthyroidism 6 months ago at his vet in Chicago. Sunday night she was fine but I woke up at 6 am Monday morning & noticed she hadn’t moved & her posture was troubling. She was very weak, unresponsive to movement & when I tried to see if she could stand she couldn’t. She has had zero appetite, as well. After explaining to the new vet what happened & how quickly the first thing she did was check her BP. We all sat quietly on the floor with warm towels (she is a very spirited cat around strangers to begin with) & waited about 15 minutes for her to calm down. They then took 7 different BP rates before coming to a HIGH BP conclusion. They were all well over 200 & averaged out to 210. Very high, even for a stressed cat. She proceeded to check the eyes for retinal damage (negative), found the heart to have a galloping rhythm, took a full CHEM & CBC panel. I started her on the BP medicine about two hours later & she is already feeling better tonight & looks a whole lot better. She is eating again & drinking, walking better & looks much more like herself. We believe she may have had a small stroke.
    My big issue is that even with the thyroid disease diagnosed at the vet in Chicago, they never bothered to check her BP? This is something we all need to ask them to do while getting our bi-anual or at least annual check-ups. Please share this info on checking your cats blood pressure. After some reading on it, I am shocked that it is not done regularly.

    • Ingrid says:

      Thanks for sharing your experience, Darla. Thank goodness you noticed the change in this cat so quickly – her family is very fortunate to have a cat sitter like you! I agree that not enough vets check blood pressure routinely – it should be part of an annual or bi-annual check up, especially for senior cats.

  4. helene Los Banos says:

    I just noticed my 19 yr old cats pupils were huge even during the bright sunny days…a few days later she started bumping into furniture and walking around in circles…i took her to the vet this morning and her BP was 217/ 90….very high for a cat!!!!! My vet took it three times and it went down a little bt never under 200….HYPERTENSION!!! i never know cats get high blood pressure and unfortunately it will be rare if her eyesight comes back…he perscribed a BP medication that is also used for people but a much lower dose of course. One of her kidneys is shrunken so we are testing for kidney, thyroid and liver fuctions withh blood tests. I am hoping the medication helps her feel better and less lethargic…she sleeps all day ..she still eats and drinks well and useds the litter box. Central Maui animal Clinic is so great with animals….i trust them completely with all seven of my animals…the vet said i should check her BP at least twice a year, especially for her age and get xrays which can show other things tht blood tests do not….they are very thourough

  5. Karen says:

    I appreciate this article! My orange son had hyperthyroid, resulting in extremely high blood-pressure. I feel it might have caused some type of small stroke. His front paw was a bit numb for some weeks, causing him to stumble when it curled under as he walked. Over time that went away. But the damage to his vision remains. He had the i13i radiation treatment after the medication got his BP & thyroid lowered. But I still wish I had realized his condition sooner so his vision was better and also spared him prolonged illness.

  6. marcia pyle says:

    my cat is 18+ and has super hypothrois for some years with a resulting tumor. he also has some heart issues. But he is or was a happy cat eating, drinking, using cat box, playful and very impish such as hide and seek. We go out every day and go for long exploring walks. 2 days ago we were outside and he suddenly went blind. I rushed him to the vet and another vet looked at him and took his bp and said it was over 200 and that was what caused the blindness which is irreversible. I asked what his last bp reading was and she told me he had never had it taken. After reading up on this on the internet looking at many reputable sites I found out that any cat over 7 should have regular bp checks, especially if they have hyperthyroid which he has had for 4 years. I am so mad about this. How could a vet not know this or worse yet not care enough to follow well known procedures. My cat is now hiding in the closet and I am heartbroken. He cannot enjow any of his favorite activities. I consider this as close to malpractice as you can get. I am not a vet. I should’t have to sook on the internet to see what should be done to treat my cat. That is why I go to the vet in the first place. I have called several other vets to ask them what they would do and all of them say they would be checking bp regularly. I am devestated and can’t stop crying.

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