Associated Veterinary Specialists - Advanced Veterinary Care - St. Louis, MO
AVS Veterinary News


Hypertensive Encephalopathy

Muki Muki is a 17 year old, female spayed, domestic short hair cat who is known to be in stable IRIS Stage 2 chronic kidney disease. Muki is normally very social. The night before presentation to Dr. Hause she not interactive which is abnormal for her. That morning she was standing in the kitchen staring at the refrigerator. She went behind the dryer which is abnormal. She was not lying in her normal spot. She was not vocal where she normally would be. She was not crying for her treats. . On physical examination, Muki had grade 2 mitral and tricuspid insufficiency murmurs. Neurological examination found a dull attitude, normal pupillary light responses, no menace response in either eye, diminished conscious proprioception in all 4 feet and diminished voluntary motion. The historical and physical findings suggested an abnormality of the cortex of Muki’s brain. Her workup consisted of performing routine laboratory work which showed persistent azotemia and a blood pressure evaluation. Muki’s systolic blood pressure with the Doppler method was recorded to be 220 mmHg. The normal range is 130 to 160 mmHg in cats. The diagnosis was hypertension and hypertensive encephalopathy as a complication of the previous diagnosis of IRIS State 2 Chronic Kidney Disease. Muki was started on amlodipine at 0.625 mg once daily to be given a dose as soon as the medication was obtained, the following morning then once daily thereafter. The owners were instructed to bring her back in 5 days. At reexamination, the owners reported that the day after release from the hospital, Muki started to improve. She has progressively returned to normal. Her blood pressure was 135 mmHg. Hypertensive encephalopathy occurs commonly in humans with very high blood pressure. This a rare complication of high blood pressure in cats in that none of the AVS internal medicine specialists have previously seen a cat with this syndrome nor read about it in the veterinary literature. .