Is there an alternative to Hypercard?

RE: Is there an alternative to Hypercard?

Richard Carter — Thu, 06 Dec 2018 13:18:26 GMT

Summit make an atenolol tablet and tenormin is the liquid formulation of atenolol if that is any help?

RE: Is there an alternative to Hypercard?

David Mills — Wed, 05 Dec 2018 23:18:47 GMT

Diltiazem can improve rate control in AF by slowing transmission through the av node. Whether this improves outcome, no one knows.

I think the OP has two options.

1. Use the (very cheap) human form, of which there are several forumalations. Some are standard, others are sustained release. It doesn't matter really if you're splitting them, they are all essentially standard once split.

2. Choose an alternative. Amiodarone is a great option in AF (it has been shown to reverse it in some cases), and it seems the side effects have been overstated in the past. It's a drug that potentially can affect both rate and rhthym.

Another potential is sotalol, as suggested above.

RE: Is there an alternative to Hypercard?

Charlotte Marshall — Wed, 05 Dec 2018 23:04:27 GMT

I had a dog that was prescribed diltiazem by a cardiologist and they used the human tablets. The dog was on 3/4 of a tablet each dose so they were splitting them.

I think it was on three times a day dosing. It was a generic version and I don't think it was long acting.

RE: Is there an alternative to Hypercard?

Andrew Henfrey — Wed, 05 Dec 2018 13:03:09 GMT

[quote user="Martin Atkinson"]Is this causing a significant ventricular arrhythmia?[/quote]

It's AF is causing a significant reduction in ventricular output for a dog already on high doses of pimobendan, cardalis and upcard. I think the dog would be better with good rate control to minimise the output reduction, hence digoxin and diltiazem combo to slow the rate.

There was no "smoke" on echo so it' not on an anticoagulant. I've never read of a high enough incidence of embolism to warrant use of anticoagulants routinely.

RE: Is there an alternative to Hypercard?

Martin Atkinson — Wed, 05 Dec 2018 08:50:52 GMT

[quote user="Andrew Henfrey"] I have a 10kg CKCS with atrial fibrillation.[/quote]Is this causing a significant ventricular arrhythmia? If not I would question the need to treat it, the diltiazem will do nothing to control the AF. I know you can't anthropomorphise this but I have AF and although I'm on diltiazem to control the VPCs/palpitations I get I could live happily without it, the cardiologist's main concern is the risk of clots forming in the atria so I'm on an anti-coagulant - genuine question: we give these to cats with atrial enlargement so should we be routinely prescribing them for AF? I presume you have Pimobendan in as part of the cocktail?

RE: Is there an alternative to Hypercard?

Andrew Henfrey — Tue, 04 Dec 2018 19:44:43 GMT

Beats - thank you for the idea. Supply against prescription may be a good option. 4 boxes are only 30 days for this dog though. Anyone else with hypercard sitting on the shelf that is not needed?

RE: Is there an alternative to Hypercard?

Yantha Smyth — Tue, 04 Dec 2018 17:26:05 GMT

Doesn't appear that Summit do diltiazem, but they do Sotalol in small sizes...would that be of any use as an alternative? Not that familiar with it myself, so not sure how suitable or not it would be.

RE: Is there an alternative to Hypercard?

Beats — Tue, 04 Dec 2018 16:33:24 GMT

I have 4 x boxes of 30tablets each of 10mg hypercard that I believe could be supplied to a client of yours if you issue a prescription?