Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

RE: Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

Sara Ramsey — Thu, 20 Feb 2020 21:37:51 GMT

Thanks for the replies. I spoke to Boerhinger again today. In their trials the pcv fell between 3 and 9% in some cats but was not "clinically relevant" but they probably weren't anaemic to start with. My issue with this guy is that I would prefer not to drop his PCV 9% when it is only 23%. I know they can tolerate low PCVs but I would prefer not to start darbopoetin. His temperament and the finances would be a challenge with this treatment.

They reminded me that the ARB drugs block the undesirable parts of the RAAS (hypertension and vasoconstriction) and spare the desirable parts like vasodilation. Where as the ACEi don't do this. This is why I believed it to be "safer" rather than "better" at reducing proteinuria.

Also the ARBs prevent "ACE" escape...but it is not clear how this is clinically relevant in cats.

I will have a chat with the owners and we can make decision together

RE: Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

Kate Richardson — Thu, 20 Feb 2020 17:24:22 GMT

I've never seen anaemia in renal cats that I could defintely say was due to Semintra- a lot of renal cats obviously do become steadily anaemic- this one sounds like the typical kidney anaemia/anaemia of chronic disease. I would start semintra for the proteinuria and monitor the anaemia as you would anyway for a cat wth kidney disease. Definitely better in my experience for proteinuria than benazepril

RE: Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

Anthony Dennison — Thu, 20 Feb 2020 16:21:20 GMT

How is the cat clinically? I wouldn't be chasing to improve the anaemia if the cat is ok - risks of thrombocytosis or embolisms using EPO products IIRC. Cats can cope pretty well with a low PCV.

[quote userid="7002" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/28908/using-semintra-in-a-ckd-with-sub-device-cat-with-a-pcv-of-23/219657"]I think I was thinking along the lines that Semintra had replaced Benazapril in cats with CKD as more targeted in it's mode of action and "safer"....but then I haven't been thinking about it from an anaemia perspective [/quote]

I think it's just different mode of action and in liquid form so better compliance

RE: Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

Rob Loxley — Wed, 19 Feb 2020 21:40:30 GMT

10mg/kg sounds like fun trying to get multiple 20mg tablets into a cat!

Not sure semintra is necessarily better bestbetsforvets.org/.../389

RE: Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

Sara Ramsey — Wed, 19 Feb 2020 21:14:21 GMT

Hmm..that's an option. Thank you. They do mention erythrocytes in the data sheet:

FORTEKOR reduced erythrocyte counts in normal cats when dosed at 10 mg/kg body weight once daily for 12 months and in normal dogs when dosed at 150 mg/kg body weight once daily for 12 months, but this effect was not observed at the recommended dose during clinical trials in cats or dogs.

I think I was thinking along the lines that Semintra had replaced Benazapril in cats with CKD as more targeted in it's mode of action and "safer"....but then I haven't been thinking about it from an anaemia perspective

RE: Using Semintra in a CKD (with SUB device) cat with a PCV of 23%?

Rob Loxley — Wed, 19 Feb 2020 20:30:52 GMT

what about benazepril?