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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


  • 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


 Diabetes Mellitus

  • 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


 Feline Asthma (Feline Chronic Bronchitis)

  • 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


 Feline Lower Urinary Tract Disease

  • 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


 Pain Management in Felines

  • 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


 Infectious Disease

  • 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


 Common Cardiovascular Therapeutics

  • 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