Imidapril vs benazepril in proteinuric CRF cats

Re: Imidapril vs benazepril in proteinuric CRF cats

patrick murphy — Wed, 10 Oct 2012 13:14:33 GMT

at LVS last year great speaker from RVC said that they used the same research to get the Fortekor license, that he uses to prove it's ineffectiveness, but to tie it in with the new vet thread, if I don't dare have the branded product on the shelf, dear or dear, what a dinasour.

Re: Imidapril vs benazepril in proteinuric CRF cats

Rob Loxley — Wed, 10 Oct 2012 00:05:22 GMT

[quote user="David Mills"]I suggest you recheck the data sheet.[/quote]

OK, 77 days (shows how little Prilium we use!) mea culpa. But for anything much under 4kg, even with the 75mg bottle, you'll still struggle to use it all in that time.

Re: Imidapril vs benazepril in proteinuric CRF cats

David Mills — Tue, 09 Oct 2012 19:51:42 GMT

[quote user="robloxley"]

[quote user="David Mills"]Imidapril can be purchased in higher concentrations and can work out significantly cheaper than benazepril[/quote]

Unless you go by the 28 day discard for prilium once made up?

[/quote]

I suggest you recheck the data sheet.

http://www.noahcompendium.co.uk/V_AOk-toquinol_UK_Ltd/Prilium_75mg_150mg_and_300mg_Powder_for_Oral_Solution_for_Dogs/-32046.html

Re: Imidapril vs benazepril in proteinuric CRF cats

Rob Loxley — Tue, 09 Oct 2012 19:26:11 GMT

[quote user="David Mills"]Imidapril can be purchased in higher concentrations and can work out significantly cheaper than benazepril[/quote]

Unless you go by the 28 day discard for prilium once made up?

Re: Imidapril vs benazepril in proteinuric CRF cats

David Mills — Tue, 09 Oct 2012 17:16:40 GMT

[quote user="Martin Atkinson"]

There are those however on this forum who believe you might as well piss in its ear as give a cat with renal failure ACEi.

[/quote]

In the interests of balance, all the evidence currently available - some at a high level, most peer reviewed and rigorously assessed - points to only a very small benefit to ACEi in proteinuric cats in some studies, and it has not been shown to increase survival time; if there is any benefit, it is likely to be very small. If there is no proteinuria then there is absolutely no evidence for its use and in using it, it is essentially experimental and the owner should be made aware of that.

For cardiac reasons there is similarly no evidence it increases survival time of cats with CHF, or time to CHF from subclinical disease, or imporvement of subclinical disease for a wide range of parameters.

Imidapril can be purchased in higher concentrations and can work out significantly cheaper than benazepril. Enalapril is the cheapest of the lot.

[quote user="Martin Atkinson"]

Most likely profit reasons.

[/quote]

Hmmm...pot and kettle?

Re: Imidapril vs benazepril in proteinuric CRF cats

Martin Atkinson — Tue, 09 Oct 2012 16:42:01 GMT

[quote user="emma_j"]unsure if the prev vet was thinking of the imidapril for cardiac or renal reasons.[/quote] Most likely profit reasons.

If you are to follow the cascade on this then the cat should be on a licensed benazepril, if they can pill it then it's a no-brainer. There are those however on this forum who believe you might as well piss in its ear as give a cat with renal failure ACEi.

Re: Imidapril vs benazepril in proteinuric CRF cats

emma_j — Tue, 09 Oct 2012 12:50:40 GMT

Probably should give more detail! The specific case I'm dealing with is already on imidapril from previous vet and has been for years - g1-2 heart murmur, but no cardiac workup or concern re cardiac-related symptoms on the history I have, previously diagnosed early stages of renal failure on bloods but wasn't put on diet, no UPC measurement, so unsure if the prev vet was thinking of the imidapril for cardiac or renal reasons.

Presented recently for weakness and inappetance, workup showed azotaemia, hyperphosphataemia, hypokalaemia, anaemia, hypertension.....after a few days of fluids and medical management we have a renal failure iris stage 3, bp 150 and a normal potassium, is being discharged on renal diet, kaminox, renalzin and amlodipine, as the UPC is 0.7 I would normally add in benazepril as well, but obviously the cat is already on imidapril - cat is actually fine to tablet as owner has already been giving codeine tablets bid for a while.

Re: Imidapril vs benazepril in proteinuric CRF cats

Martin Atkinson — Tue, 09 Oct 2012 12:37:13 GMT

There's a current thread similar to this running already. I have used imidapril in cats which the owners weren't able to give Fortekor to for love nor money and there was no obvious difference in expected response but the case numbers are so low it is impossible to be completely objective. I would favour imidapril over enalapril as an ACEi substitute for benazepril as it is, like the latter, part metabolised in the liver before excretion which is an advantage in an animal with renal disease. Just don't forget to double the dog dose for a cat.. While on the subject has anyone had any experience with Nelio, Alstoe's version of benazepril? It is supposed to be more palatable than Fortekor but most of my feline patients have voted against it so far and the clients are going back to Fortekor even though it is more expensive.