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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 32803
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I would appreciate your advice about the proposed treatment

Customer Question

Hello. I would appreciate your advice about the proposed treatment of my cat who is a 5 year old male cat with hypertrophic cardiomyopathy ( diagnosed at 1 year). He is currently stable and is treated with Furosemide (10mgs twice a day) as well as benefotin ( once a day) and Vetmedin ( half a tablet x2 daily). My lovely vet has suggested moving him on to torasemide rather than furosemide to improve QOL for longer but has said this is a relatively new approach to a stable cat and has not used this with any cat before. I was keen to seek a second opinion as to dosage, impact of changing medication. I do appreciate any advice you may be able to offer.Thank you . Melinda
Submitted: 1 month ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 1 month ago.

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Expert:  Dr. Michael Salkin replied 1 month ago.

Melinda, torsemide is a loop diuretic similar to furosemide but there's marginal information available on clinical use in veterinary medicine. What we do know is that it's ~10X more potent (dosed at 10% of furosemide dose), has a longer diuretic action, and is more potassium sparing (at least in dogs) than furosemide. The adverse effect profile for cats hasn't been fully established due to lack of use in that species but similar to furosemide, it can induce fluid and electrolyte abnormalities. It has a wide safety margin; in dogs, the oral LD50 (the dose that kills 50% of test subjects) is a whopping 2,000 mg/kg of body weight. There's no information concerning the LD50 in cats but it should be similar to that in dogs.

Based on results from limited studies and clinical usage, a starting dose of 0.2 - 0.3 mg/kg every 8-24 hours (usually twice daily) could be considered. Please note that use of doses that are, in terms of mg/kg, approximately 1/10th the daily furosemide dose typically requires halving or quartering the 5 mg tablet and so accurate dosing of cats (and small dogs) can be difficult. Please respond with further questions or concerns if you wish.

Customer: replied 1 month ago.
Thank you!
My vet has written Sasha up for once a day and in terms of practicality I assume it would be half a 5mg tablet .
Slightly concerned your dosage would have been twice a day. Do you think we will run into difficulties once a day?
also, he is on benefortin to manage his blood pressure ( which has always been fine)....would you reduce or take him off this if using Thanks again!
Expert:  Dr. Michael Salkin replied 1 month ago.

You're quite welcome. The smallest dose given as infrequently as to keep Sasha well is the correct dose. You can always give it twice daily if once daily doesn't suffice. The dose of benazepril (Benefortin) shouldn't change with a change in diuretic but may be increased or decreased predicated upon Sasha's blood pressure. Please continue our conversation if you wish.