Systemic hypertension in cats: amlodipine and ocular damage
15-year-old cat with sudden-onset blindness. Bilateral mydriasis and retinal detachment with fundic haemorrhages. Systolic blood pressure (Doppler) 210 mmHg on several calm measurements. Creatinine 2.3 mg/dL (0.8–2.0); total T4 pending.
What is the most appropriate action?
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A. Repeat the measurement in 4–8 weeks to confirm hypertension before treating
Measurements repeated over weeks are used when there is no target organ damage. With acute ocular lesions and pressure ≥ 180 mmHg the consensus recommends treating the same day.
B. Benazepril monotherapy
In cats, ACE inhibitors lower pressure only modestly and are not enough for severe hypertension with ocular damage. They can be added later, e.g. if there is proteinuria.
C. Amlodipine immediately and investigate the causes: chronic kidney disease and hyperthyroidism
Correct. Amlodipine is the first-choice antihypertensive in cats and usually lowers pressure effectively. Almost all feline hypertension is secondary, mainly to chronic kidney disease and hyperthyroidism, which must be diagnosed and treated.
D. Atenolol, because the hypertension is usually thyroid-related
It is not yet known whether the cat is hyperthyroid, and atenolol is a poor antihypertensive in cats. It only controls the tachycardia of hyperthyroidism and does not replace amlodipine.
lightbulb Key takeaway
The target organs of hypertension are the eye, kidney, brain and heart. The goal is a systolic pressure < 160 mmHg (ideally < 140) without hypotension. Telmisartan is a licensed alternative in cats. Treating hyperthyroidism may lower pressure or, conversely, unmask hypertension, so measure it again.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.