Important Considerations
● Anatomy – horizontal orientation; lack of collarbone
● Drug administration barriers
● More acidic GI and urinary pH compared to humans
● Olfactory system – 4x more neurons than humans; olfactory memory
● Limited metabolic capacity – toxicity and efficacy concerns
● Common toxicities – acetaminophen, azo dyes, benzoic acids, enrofloxacin, permethrin
● Compounding reminders – flavors, 3% rule, salt conversions, lack sweet genes
Common Disease States
Hyperthyroidism
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- Etiology: oversecretion of T4 and T3; usually caused non-neoplastic hyperplasia of thyroid gland or thyroid carcinoma
- Symptoms: weight loss, vomiting, diarrhea, polydipsia, unkempt hair coat, high GFR
- Treatment options: radioactive iodine ablation, thyroidectomy
- Pharmaceutical treatment: methimazole (most common), carbimazole
- Important to maintain check-up appointments
- Must apply to pinna, apply with gloves and clean ears
- Counsel on handling precautions for transdermal gel
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Diabetes Mellitus
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- Prevalence: Usually T2DM; good prognosis if adherent to medication and diet
- BG Goal: 120-300 mg/dL; hypoglycemia = < 60 mg/dL; control is not as tight as in human patients
- Want to prevent hypoglycemia and make sure pet parents have glucose on hand
- Treatment: insulin (most common: insulin glargine)
- Pen device may be more economical option compared to vial
- Administered after meals
- Don’t substitute insulins without consulting veterinarian
- U-40 vs U-100
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Feline Asthma (Feline Chronic Bronchitis)
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- Focus on non-pharmacological treatment first: remove triggers (e.g., perfumes, aerosols, dust)
- Treatment: prednisolone (NOT prednisone) and fluticasone inhaler (anti-inflammatory drug of choice)
- Albuterol may increase airway exposure
- Use of spacer – acclimate pet to spacer before using it to administer medication
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Feline Lower Urinary Tract Disease
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- FLUTD = conditions affecting urinary bladder or urethra
- Obstruction – surgical therapy
- Non-obstructive – pharmacological therapy
- Urinary antiseptics and analgesics (used in humans) can be toxic to felines
- Amitriptyline, fluoxetine (commonly used), antispasmodics (little efficacy), analgesics
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Pain Management in Felines
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- No acetaminophen products
- Buprenorphine – used quite often; oral transmucosal formulation administered to gum line; ceiling effect; mild-to-moderate acute pain management
- Robenacoxib – decrease in bioavailability when given with food; treatment limited to 3 days; dose dependent on weight; mild-to-moderate chronic pain management
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Infectious Disease
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- Itraconazole – don’t use bulk powder as source of API (compounding consideration); FDA approved products: Itrafungol, Sporonox
- Ronidazole – not used often; narrow therapeutic index (patient dependent)
- Metronidazole benzoate – benzoic acid toxicity considerations
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Common Cardiovascular Therapeutics
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- Enalapril (ACEi) – reduce dose by 50% in cats with renal insufficiency (SCr > 2.3 mg/dL)
- Clopidogrel (anticoagulation) – don’t use transdermal formulation; compounding considerations depending on dose
- Diltiazem (anti-arrhythmic) – commonly causes vomiting; formulation must match dosage; extended-release tablets within commercial capsules
- Pimobendan – may be difficult to administer approved dosage form; stability and bioavailability concerns with compounding
- Meloxicam – use cautiously for chronic pain
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