Veterinary care center "Elitevet" Systemic arterial hypertension in cats Signs of pathology are

Antihypertensive drugs have various side effects, such as excess excretion of sodium and water, leading to dehydration and depletion of body fluid volume; systemic hypotension, which leads to weakness, syncope and renal dysfunction; kaliuresis leading to hypokalemia with corresponding clinical symptoms. Therefore, the veterinarian must be completely sure of the diagnosis before initiating treatment for hypertension. Regular blood pressure measurements are needed to diagnose and check the effectiveness of treatment for systemic hypertension (see previous article).

Hypertension disorders

Systemic hypertension can have damaging effects on various tissues. In dogs and cats, there is a strong association between ocular lesions and systemic hypertension. However, most other adverse effects of systemic hypertension in dogs and cats are theoretically inferred by extrapolation from clinical studies conducted in humane medicine or experimental studies in laboratory rodents and dogs.

The eyes are the organ most often affected in dogs and cats by hypertension. Hypertensive disorders most often include: hemorrhages in the retina, vitreous body or anterior chamber; retinal detachment and atrophy; retinal swelling; perivasculitis; curvature of retinal vessels and glaucoma.

Kidney function is highly susceptible to the adverse effects of hypertension. But in this case, when pressure increases, the preglomerular arterioles usually contract and protect the glomeruli themselves from the harmful effects of hypertension. In dogs and cats with kidney failure, these arterioles are dilated and do not respond well to changes in blood pressure. Thus, the increase in blood pressure is directly transmitted to the glomerular bloodstream. This increase in glomerular capillary pressure is considered glomerular hypertension, which can lead to glomerular damage and progressive decline in renal function unless the hypertension is effectively treated.

The heart works against increased blood pressure (afterload), so left ventricular hypertrophy and secondary valve insufficiency may occur. Tachycardia is rarely seen in hypertension, although there are a number of primary diseases that lead to secondary hypertension, such as hyperthyroidism, which increases the heart rate. With antihypertensive therapy, left ventricular hypertrophy may regress.

If these symptoms are observed along with cerebral hemorrhage (head tilt to one side, depression, seizures) in dogs and cats with uncontrolled hypertension, the prognosis for these animals will be poor.

Selection of animals for treatment

Due to the uncertainty of results and the difficulty of measuring blood pressure in dogs and cats (see previous article), only animals with demonstrably elevated blood pressure (measured by indirect methods), clinical signs and abnormalities consistent with hypertension should be considered patients for antihypertensive therapy. Given the clear association between ocular disease and systemic hypertension, the authors believe that antihypertensive therapy should be used in all dogs and cats with documented systolic blood pressure greater than 200 mmHg. Art. or diastolic pressure more than 120 mm Hg. Art. regardless of other clinical symptoms. For all patients with systolic/diastolic pressure greater than 170/100 mmHg. Art. and symptoms identified by clinical evaluation (retinal lesions, chronic kidney disease, left ventricular hypertrophy) that may cause or aggravate systemic hypertension, antihypertensive therapy should also be used. The situation remains uncertain for animals with elevated blood pressure (systolic/diastolic pressure greater than 170/100 mmHg) and no clinical signs of systemic hypertension. Some doctors recommend treating such animals, others do not.

1. Animals with clearly elevated blood pressure (systolic pressure greater than 200 mmHg and/or diastolic pressure greater than 120 mmHg) are considered patients for antihypertensive treatment.
2. Animals with elevated blood pressure (systolic pressure 170-200 mmHg and/or diastolic pressure 100-120 mmHg) and symptoms of systemic hypertension are also patients for antihypertensive treatment.
3. Treatment options may also be considered for asymptomatic animals with elevated blood pressure (systolic pressure 170-200 mmHg and/or diastolic pressure 100-120 mmHg).
4. Animals without clinical symptoms and slightly elevated blood pressure (systolic pressure 120-170 mmHg and/or diastolic pressure 80-100 mmHg) should not receive antihypertensive therapy.
5. Animals with normal blood pressure or those whose blood pressure has not been measured should not be treated with antihypertensive drugs.

Duration of treatment

If the diagnosis reveals that hypertension is associated with chronic kidney disease, then antihypertensive therapy should continue throughout the life of the animal with periodic changes in dosage depending on the results of blood pressure measurements.

Hypertension caused by hyperthyroidism and hyperadrenocorticism can be eliminated after 1-3 months of treatment of the underlying disease, if there is no concurrent chronic renal failure. But sometimes dogs with controlled hyperadrenocorticism remain hypertensive.

For other patients, it is impossible to predict the duration of treatment, but sometimes they need to be treated for life. Periodic changes in dosage are shown depending on the results of pressure measurements.

Goal of therapy

It is usually not possible to restore normal blood pressure values ​​when treating hypertension. The veterinarian's goal is to reduce blood pressure by 30-50 mmHg. Art. With oscillometric methods of measuring pressure, systolic, mean or diastolic pressure is taken into account to assess the effectiveness of therapy. Doppler blood pressure methods use systolic blood pressure to measure the effectiveness of treatment. In general, Doppler sensors are most suitable for measuring blood pressure in both cats and dogs (see previous article).

Antihypertensive therapy

General provisions
Systemic arterial blood pressure is the result of cardiac output and total peripheral resistance, so antihypertensive therapy is primarily aimed at reducing cardiac output or total peripheral resistance, or both. Treatment can be roughly classified as dietary therapy and pharmacological therapy.

Treatment is mainly carried out using the method of sequential trials. Changes in dosage and regimen of medications should occur at least once every 3 weeks, unless severe hypertension and severe clinical symptoms require emergency assistance. When using pharmacological agents, a wide range of dosages should be used, in which the initial dose of the drug is less than the lowest limit. If a drug or combination of drugs is not effective enough, you can increase the dosage or add several other drugs. Often, especially for dogs, multiple medications are prescribed at the same time.

Diet
The first recommendation would be a low sodium diet, that is, no more than 0.25% on a dry matter basis. A diet low in chloride and relatively high in potassium may further reduce blood pressure. However, it should be noted that dietary changes alone are unlikely to reduce blood pressure to safe levels in animals with overt hypertension. Dietary sodium restrictions are often used to enhance the effects of drugs. For animals with chronic kidney disease and hypertension, it is more important to maintain calorie intake than to limit sodium content.
Obesity contributes to high blood pressure in humans and in dogs, and possibly also in cats. Therefore, it is desirable for hypertensive and obese animals to reduce body weight. The effect of obesity on blood pressure is relatively small, but it interferes with accurate blood pressure measurement by indirect methods. Weight loss has some benefit and should be considered as a long-term treatment goal for dogs and cats with hypertension and obesity.

Pharmacological drugs
Until recently, drug treatment of hypertension in dogs and cats was extrapolated from medical protocols. Recommendations for drug therapy included the use of diuretics, vasodilators and beta blockers, these drugs were prescribed in parallel with sodium restriction in the diet.

Vasadilators
Some drugs are classified as calcium ion antagonists, which reduce total peripheral resistance, which leads to a decrease in blood pressure. Amlodipine besilate is a long-acting dihydropyridine calcium antagonist that has been used successfully to treat cats with hypertension at a dose of 0.625 mg per cat orally every 24 hours. (Henike et al., 1994). Large cats and animals with severe hypertension may require a higher dose of 1.25 mg twice daily. It should be determined very carefully, guided by constant pressure measurements. During treatment with amlodipine, a significant decrease in blood pressure occurs, and side effects (azotemia, hypokalemia and weight loss) are rarely reported. Amlodipine has a delayed action, so side effects such as hypotension and anorexia can be avoided. In dogs with chronic liver disease, amlodipine 0.05-0.1 mg/kg orally once daily reduced blood pressure in initial pharmacokinetic tests. But for most dogs, amlodipine was less effective even at doses above 0.25 mg/kg 2 times a day.

Angiotensin-converting enzyme inhibitors (ACEIs) (0.5 mg/kg enalapril or benazepril orally every 12 hours) lower blood pressure; higher doses may be required in cats, but results are less predictable than with amlodipine. The simultaneous administration of ACE inhibitors and calcium ion antagonists may be effective when monotherapy in lowering blood pressure is not effective.

Alpha blockers such as prazosin (1 to 4 mg orally every 12 to 24 hours) and phenoxybenzamine may lower blood pressure by decreasing peripheral vascular resistance. But these drugs are rarely used.

There is increasing concern regarding the adverse effects of calcium ion antagonists. It is based on studies conducted in humane medicine and diabetic dogs in which renal dysfunction and/or proteinuria increased during calcium antagonist therapy. There are also theoretical reasons to prefer ACE inhibitors to other antihypertensive agents in animals with pre-existing kidney disease. However, co-administration of calcium antagonists and ACE inhibitors works well to block any side effects of calcium antagonists alone, at least in dogs with diabetes. (Brownetal., 1993). Because calcium antagonists are very effective in cats with systemic hypertension, they should be used in these animals until more reliable information is available about their long-term effects.

Beta blockers
Beta blockers have an antihypertensive effect by decreasing cardiac output and decreasing renin release. It is better to give a cardiac-specific (6eTat) antagonist such as atenolol at an initial dose of 0.5 mg/kg orally every 12 to 24 hours. These drugs can be combined with vasodilators and/or diuretics. Beta blockers may also be used for hypertension associated with hyperthyroidism in cats.

Diuretics
For dogs and cats with hypertension, diuretics such as thiazides (1 mg hydrochlorothiazide/kg orally every 12 to 24 hours) may be used. These drugs reduce extracellular fluid volume and cardiac output. Hypokalemia may occur with the use of loop diuretics and thiazides, so constant monitoring of potassium concentrations is necessary in all animals with chronic kidney disease treated with diuretics. Addition of the potassium-sparing diuretic spironolactone (1–2 mg/kg orally every 12 hours) helps reduce potassium losses.

Urgent care for hypertension
Animals with neurological signs or severe ocular damage from hypertension, such as retinal detachment or intraocular hemorrhage, require intensive treatment. Sodium nitroprusside, an arterial and venous vasodilator that acts as a donor of nitrate oxides within vascular smooth muscle cells, can be used for the initial treatment of hypertensive crises in animals. This drug is administered by infusion at a constant rate. Its dose must be carefully calculated according to fluctuations in blood pressure so that it does not cause reflex tachycardia.

If the veterinary clinic cannot provide a constant rate of infusion and intensive monitoring, then use hydralazine in combination with furosemide and diltiazem (0.5 mg/kg orally every 6 hours), or only the latter drug. If the blood pressure does not fall within 12 hours, a beta blocker (atenolol) is added.

Regardless of the initial therapeutic choice in the treatment of acute hypertensive crisis, the main drug for long-term treatment of systemic hypertension (atenolol for cats and ACE inhibitors for dogs) is prescribed almost immediately to facilitate the transition to long-term maintenance treatment.

Aftercare and additional medications
Routine evaluation in the treatment of all animals with systemic hypertension should include: fundus examination, evaluation of any underlying medical conditions, measurements of weight, blood pressure, and serum creatinine and electrolyte concentrations. The owner should be aware of the toxicity of drugs that can cause ataxia, anorexia, drowsiness or increase sleep duration. Animals receiving multiple drugs are significantly more likely to experience side effects than animals receiving a single drug. Once blood pressure is under control, the animal is assessed every 3 months. Detailed clinical and biochemical blood tests and urine tests are performed every 6 months.

Many animals with hypertension also have kidney damage. If possible, antihypertensive therapy should be accompanied by renal treatment. Cats with chronic liver disease need potassium supplements. Animals with renal dysfunction typically have an impaired ability to quickly adapt to sudden changes in sodium intake, so administration of electrolyte solutions to animals with renal failure may result in fluid overload, worsening clinical signs of systemic hypertension, and pleural effusions (or peripheral edema). Such problems are complicated by moderate or even severe anemia, which depletes cardiac reserve. These clinical findings may be difficult to differentiate from right-sided congestive heart failure. Similarly, acute reductions in sodium intake in animals with renal failure may result in extracellular fluid volume depletion. Some prescriptions, such as the administration of recombinant erythropoietin to increase hematocrit, may increase systemic hypertension and should not be used until the latter is controlled.

Hypertension is quite common among older animals (8 years and older). As a rule, hypertension in dogs and cats develops secondary to the underlying diseases (renal failure, endocrine disorders, etc.). There is also an inverse relationship - high blood pressure negatively affects glomerular filtration in the kidneys, disrupts the nutrition of the retina, and also increases pre- and afterload on the heart. Therefore, hypertension must be treated.

Blood pressure over 180/95 mmHg is considered elevated. Art. But obtaining accurate and reliable blood pressure readings in small pets is challenging. There is a deviation in blood pressure readings caused by fear, pain or excitement. Clinically, hypertension can be asymptomatic to a certain extent or accompanied by shortness of breath, cough, and impaired coordination of movements. In cats, hypertension is often diagnosed only after the appearance of hyphema (bleeding in the anterior chamber of the eye), blindness, or incoordination.

The prognosis for hypertension depends on the primary disease, but hypertension itself is dangerous due to the risk of developing symptoms of chronic heart failure, congestion in the form of edema, dropsy and the formation of intracranial hematomas (hemorrhagic stroke). Exacerbation of hypertension in the form of a hypertensive crisis can manifest itself in the form of dyspnea (rapid, heavy breathing), restlessness of the animal, and dilated pupils. As symptoms progress in the case of a stroke, the dog may suddenly whine, lose consciousness or show sudden general weakness, after which, as a rule, nystagmus (vertical or horizontal involuntary movements of the eyeballs), impaired coordination of movements - ataxia and tilting of the head to one side appear. In cats, symptoms of ataxia and blindness, as well as inappropriate behavior, predominate. In particular, a cat may constantly strive to climb somewhere, hide, or may simply stand with its forehead resting against a wall or corner. Dyspnea and cough are not typical in cats with hypertension.

First aid in such cases is to pour Corvalol or Valoserdin through the mouth in an amount of 3-5 drops per cat and 5-25 drops per dog, diluted randomly with water, calm the animal and limit physical activity to a minimum. If possible, you need to inject furosemide into the muscle (1-4 ml) or give it in tablets (1/4-2 tablets), make an intramuscular injection of a 25% solution of magnesium sulfate in an amount of 1-5 ml and urgently call a veterinarian. In the absence of these drugs, you can use any antispasmodic (baralgin, spasmalgon, no-spa in a dose of ¼-1 tablet).

In general, animals at risk for hypertension, especially those with renal and heart failure, should be closely monitored by their healthcare provider and receive a special salt-restricted diet or commercially prepared food for animals with kidney and heart disease. Fluctuations in atmospheric pressure make hypertensive patients sensitive to weather conditions - be especially vigilant during sudden changes in weather. And, of course, protect your pets from stress and conflicts with other animals, try to avoid transportation, and do not leave the animal for a long time in a stuffy room or a closed car in hot weather. If hypertension is confirmed, the doctor will prescribe a long course of antihypertensive drugs in combination with diuretics to the sick animal. Follow all the recommendations of your doctor and stay healthy!

It would seem that problems with blood pressure are unique to humans, but this is not so. Our pets can also suffer from this type of pathology, even if it happens much less frequently. A good example is hypertension in cats.

Nowadays, veterinarians officially recognize that high blood pressure in cats is an unpleasant reality. If this pathology is not dealt with in any way, it can even lead to the death of the animal. Hypertension almost never occurs as an independent disease: more often it is caused by acute or chronic renal failure and/or. Statistics show that blood pressure problems affect 60% of cats with kidney failure and approximately 90% of cats with hyperthyroidism. Thus, the causes of hypertension in cats in most cases are serious functional disorders in the endocrine system and urinary organs.

Less commonly, pathology develops with inflammation of the adrenal glands, as well as with their tumors. There are also cases of idiopathic arterial hypertension, the causes of which remain a mystery. We must not forget that increased blood pressure can be a logical response to severe stress. For example, after a veterinarian’s visit, it is useless to measure a cat’s blood pressure, as it will be greatly increased.

Arterial hypertension severely injures four main systems: the kidneys, eyes, central nervous system and cardiovascular system. In some cases, the pressure is so great that small capillaries begin to burst en masse. The lungs are especially susceptible (“pulmonary” hypertension in cats). The result may be retinal detachment, pulmonary fibrosis, hemothorax, or stroke. Since hypertension hits the kidneys hard, in case of renal failure a vicious circle is formed when one pathology contributes to the development of the second. In most cases, this disease is diagnosed in older animals.

Symptoms of arterial hypertension

Unfortunately, the symptoms of hypertension in cats are very vague and uncharacteristic. Since this pathology is almost always secondary to diseases of the thyroid gland and kidneys, the clinical picture will largely correspond to the primary disease. The main features are:

• Loss of appetite.
• Increased thirst and urination (polydipsia and).
• Weight loss (can be rapid if the cat has severe weight loss).

Read also: Diarrhea in a kitten: a complete list of possible causes, treatment, nutrition, prevention

Sometimes blood pressure problems are indicated by heart murmurs or serious eye problems. These signs help to understand that the animal has serious functional disorders in the body. This is one of the reasons why it is extremely important to regularly take your pet for a complete preventive veterinary examination.

In the case when the pressure rises suddenly and sharply, a very characteristic symptom will be sudden blindness and disorientation in space. The blood vessels in the eye will rupture and the retina will detach. In this case, vision is lost partially or completely. The cat's pupils dilate greatly. Cats panic, cannot move, and often bump into furniture, doors and corners when trying to run.

Less commonly, chronic hypertension can cause cerebral hemorrhage. When walking, the cat leans heavily, falls to the side, it is disoriented, there may be sudden attacks that strongly resemble epilepsy. But much more often the animal simply falls into a coma and quickly dies.

Diagnostics

The most reliable method for detecting hypertension is... a regular tonometer, the cuff of which is placed on the paw or base of the tail. The procedure itself is absolutely painless, and in balanced animals reliable results can be obtained already from the second or third time. But such “prudent” cats are very rare. Much more often you can observe real hysteria, accompanied by attempts to scratch and bite both the veterinarian and his own owner.

If so, you will have to try to calm your pocket tiger. Sit with the cat and pet him. Some foreign forums even advise using aromatic oils and other homeopathy. These medications do not reduce blood pressure, but may help calm the cat. As a rule, pressure must be measured several times to obtain reliable results.

How to treat this disease?

So how is hypertension treated in cats? It all depends on the primary disease that caused the increase in pressure. The sooner it is detected and the sooner effective treatment is prescribed, the greater the chance that hypertension will not develop at all.

Hypertension can be primary due to the pathology of the vessels themselves (idiopathic or essential) and secondary, arising from problems with some organ or system (for example, the kidneys or hormonal system), and sometimes can arise due to the use of certain drugs. Secondary hypertension in cats and dogs is more common than primary hypertension. AH develops more often in animals of older age groups (After 6-7 years).

How is blood pressure regulated in dogs and cats and why does hypertension occur?

Blood pressure (BP) depends on two quantities: the volume of blood that the heart pumps per unit time (varies depending on the heart rate and cardiac output) and general vascular resistance (elasticity of the vascular walls).

Simply put, the pressure of a liquid in any pipe system is regulated by the pumped volume of this very liquid and the diameter of the pipes through which it flows. An increase in the volume of liquid and/or a decrease in the lumen of the pipe (vessel) leads to an increase in pressure.

The mechanisms of blood pressure regulation are complex. Normally, the relative constancy of blood pressure is maintained due to the coordinated work of the nervous (central and peripheral) and hormonal systems.

One of the main organs that influence blood pressure is the kidneys. The kidneys perform several functions that help regulate blood pressure: they filter salts and water, and also take part in the functioning of the renin-angiotensin-aldosterone system (RAAS).

One of the endocrine glands that influences blood pressure is the adrenal glands (due to catecholamines and aldosterone).

Scheme of operation of the renin-angiotensin-aldosterone system (RAAS)

An example of the participation of the nervous system in the process of blood pressure regulation is shown in the figure below: impulses from baroreceptors (which respond to changes in pressure and are located in the vessels) along the afferent nerve fiber go to the central nervous system to the centers that process these impulses (vasomotor) and return along the efferent nerve fiber to receptors/tissues/organs responsible for changes in pressure.

Scheme of the participation of the nervous system in the process of blood pressure regulation

The main mechanisms leading to the development of hypertension

• impaired filtration of sodium salts by the kidneys and their retention in the body (i.e., an increase in the amount of sodium salts leads to an influx of water into the bloodstream, which is necessary to maintain a stable concentration of the latter, which increases the total blood volume and pressure);
• disruption of the sympathetic nervous system;
• disruption of the RAAS;
• disruption of the functioning of endothelial cells (cells lining the vessels from the inside, take part in the expansion and contraction of blood vessels, which directly affect elasticity);
• vascular hypertrophy (thickened walls, unable to react mobilely and expand the lumen of the vessel to changes, for example, blood volume or increased cardiac output).

Diseases that can cause secondary hypertension

• kidney disease (comes first in both cats and dogs);
• hyperthyroidism (more common in cats);
• hyperadenocorticism;
• diabetes mellitus;
• hypothyroidism;
• acromegaly;
• pheochromacytoma;
• hyperaldesteronism;
• cardiac hyperkinesis and arrhythmias;
• intracranial problems (for example, increased intracranial pressure);
• hyperestrogenism.

The mechanisms of development of primary hypertension in cats and dogs (as, in general, in humans) are currently not fully known and understood. That is, what causes the thickening of the walls of blood vessels or leads to disruption of the endothelium (in the absence of other causes of hypertension) has not been fully studied.

Why is AG dangerous?

Any disease has its target organs (those that suffer the most during the development of pathology). In hypertension these are: kidneys, heart, brain, eyes.

• Kidneys: with constantly high blood pressure in the vessels of the nephron, a gradual change in the structure of the tissue of this kidney unit occurs (an increase in the number of fibrous fibers), leading first to a disruption and then to a complete loss of the ability to filter urine. When such nephrons become more than 75%, irreversible renal failure occurs.
• Heart: Constantly increased pressure forces the heart muscle to work harder, this leads over time to its thickening, complicating the nutrition of the heart muscle and increasing the risk of arrhythmias.
• Brain: trophism (nutrition) of certain parts of the brain is disrupted as a result of tissue edema (due to high pressure, part of the liquid component of the blood “sweats” into the surrounding tissues) or hemorrhages (as a result of vascular ruptures). In some cases, these changes can lead to irreversible changes in the functioning of the central nervous system. Hydrocephalus (stagnation of fluid in the ventricles of the brain) also sometimes develops.
• Eyes: due to increased pressure in the vessels of the eye, hemorrhages may occur in different parts of the eyeball, retinal detachment, and glaucoma may develop. These changes often lead to partial or complete loss of vision.

As a rule, in the presence of hypertension, not one, but all of the listed organs suffer. And it doesn’t matter for what reason the hypertension arose. It is important how long and how strongly the pressure rises.

What are the symptoms of hypertension in cats and dogs?

Symptoms of hypertension vary in manifestation and strength. They depend, of course, on what, and how badly, the target organ was damaged. Symptoms that owners of animals with hypertension usually pay attention to:

• vision impairment/loss (more often in cats);
• pendulum eye movements;
• hemorrhages (redness) in the anterior chamber of the eye;
• causeless vocalization (in cats);
• dyspnea;
• fainting;
• epileptiform seizures;
• lethargy, apathy;
• disturbance of appetite and water consumption;
• Manege movements (movement in a circle).

Symptoms of high blood pressure in cats and dogs (changes) that can only be identified using specific methods in a veterinary clinic

• proteinuria and hematuria (urinalysis);
• concentric hypertrophy of the left ventricle of the heart (only by echo kg);
• arrhythmia (using ECG);
• systolic murmur (during auscultation);
• retinal detachment or hemorrhage in the fundus of the eye (ophthalmoscopic);
• changes in the structure of the central nervous system (according to CT or MRI).

The listed symptoms are nonspecific and often occur with other diseases. And this significantly complicates the early diagnosis of hypertension.

How to detect high blood pressure?

There are not many options for measuring pressure: these are direct methods when placing sensors directly into the central vessels (a traumatic method), but they are more accurate than indirect ones. In humane medicine and veterinary medicine, it is used in the intensive care unit and during complex operations.

The indirect method is measuring pressure with the tonometers we all know. However, in veterinary medicine, conventional medical tonometers often give too great an error or it is not possible to use them at all, for example, in cats and toy breeds of dogs.

In small animal veterinary medicine, it is recommended to use devices operating on the Doppler principle - one of them is PetMAP. The pressure is measured by placing a cuff on the paw or tail. It is recommended to make up to 3-5 changes at one place and display the average.

At the Sozvezdie veterinary center you can measure the blood pressure of cats and dogs using such a device. The price for measuring blood pressure in dogs and cats is indicated in the corresponding section.

For dogs, blood pressure norms range from 100/65mmHg - 160/100mmHg (systole/diastole). For cats - 110/70 - 180/110mmHg. Systolic pressure close to 200 always requires drug correction, and above 280 may require emergency measures.

However, in some pets, a pressure of 185/110 may already require therapeutic intervention. Unfortunately, finding out the presence of high blood pressure is not enough; it is important to understand primary or secondary hypertension. And this always requires additional studies, which are prescribed by the doctor based on the clinical symptoms noticed by the owner and abnormalities identified during examination.

This is important, because in the presence of secondary hypertension, therapeutic correction (if possible) of the primary disease removes the symptom of hypertension. If this is not possible, the doctor selects a drug to lower blood pressure. Dose adjustment of the drug often occurs during the first 1-2 weeks of treatment and is then applied for life.