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ASA questions??

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  • taclea
    Hello Yesterday my vet recommended I start my 4 yr old on asa 81mg every 3 days. (mild L ventricle and atrium enlargement, mild mitral insuff, asymptomatic -
    Message 1 of 7 , Mar 4, 2009
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      Hello

      Yesterday my vet recommended I start my 4 yr old on asa 81mg every 3 days. (mild L ventricle and atrium enlargement, mild mitral insuff, asymptomatic - caught after hearing murmur at routine exam). I have also started him on an omega 3 supplement. My question is about anyones experiences/info w/ asa. I know that too much asa can be very dangerous for a cat but I dont know how why or how that would manifest (ie liver/kidney problems, bleeding problems????). I am also wondering if I should give him the enteric coated or regular asa. My vet said it wouldnt matter, but I would hate for it to cause him stomache upset or problems. I am not sure if there are other reasons to choose one or the other.

      thanks very much.
    • Carol
      Did your vet say to give a whole 82mg tablet? That seems like a lot. Can someone tell us what the usual dose is for a cat if you know? I personally don t
      Message 2 of 7 , Mar 4, 2009
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        Did your vet say to give a "whole" 82mg tablet? That seems like a lot. Can someone tell us what the usual dose is for a cat if you know?

        I personally don't like to use aspirin. It can be very toxic to cats and even cause liver failure. Here's some good info about
        aspirin written by a vet. He talks about aspirin staying in the
        system for 40 hours before it's cleared by the liver, so if the liver
        is at all compromised, that will take even longer.
        http://www.2ndchance.info/pain.htm

        Many of the folks here give their kitties Nattokinase instead of aspirin. Here's one info from the "Files".
        http://pets.groups.yahoo.com/group/feline-heart/files/Nattokinase/

        You might look in to the Nattokinase as an alternative.

        hugs,
        Carol and Snowball and the gang
      • taclea
        Ok, now I am worried. Yes she even wrote it down 81mg every 72 hrs.
        Message 3 of 7 , Mar 4, 2009
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          Ok, now I am worried. Yes she even wrote it down 81mg every 72 hrs.
        • Jean
          My cardiologist prescribed 1/4 of an 81 mg tablet twice a week (simpler and I suppose slightly less frequent than every three days), and if he tolerated it
          Message 4 of 7 , Mar 4, 2009
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            My cardiologist prescribed 1/4 of an 81 mg tablet twice a week (simpler and
            I suppose slightly less frequent than every three days), and if he tolerated
            it after a month to up it to 1/2 of an 81 mg tab twice a week. (He was
            starting ASA after not tolerating plavix in November.) I was considering
            replying to your initial email about a whole baby aspirin every three days,
            because it sounded like a lot to me as well (and I think I most commonly see
            1/4 of an 81 mg mentioned), but then I came across the following (pasted
            below message) from http://www.vetinfo4cats.com/catmed.html . My impression
            based upon this is that an entire 81 mg tablet IS on the high end, but not a
            complete anomaly in prescribing.

            I think the most common issue with ASA (and plavix) is that it's hard on the
            stomach. ASA seems to be better in this regard than plavix, probably in part
            because it's dosed every three days instead of daily. I believe it can also
            cause kidney/liver issues, just like most other heart meds; for plenty of
            cats, that's not an issue. (My boy's ALT, a liver enzyme, went through the
            roof after a week and a half on enalapril; it's part of the reason for
            regular bloodwork.) Uncontrolled or internal bleeding is a risk with any
            blood thinner, I think (in researching Patches' condition, I've heard
            infrequent stories of internal bleeding in cats on both ASA and plavix, but
            overall it seems more frequent with plavix.); the alternate risk of not
            being on ANY blood thinner is the risk of clotting (which blood thinners
            don't guarentee won't happen regardless, it's just thought to lower the
            risk).

            The nattokinase that Carol mentioned sounds like doesn't have the same risk
            of stomach side effects as ASA or plavix, and it certainly doesn't have the
            toxicity of ASA if not dosed or metabolized properly. If you and your vet (I
            forget, are you with a regular vet or cardiologist? Vets probably have far
            less experience dosing ASA, particularly for cats; it's historically been
            used more often in dogs than cats. Regardless a cardiologist will have more
            experience with cats on their preferred blood thinner, and the dosing.) do
            decide to try ASA, I would definitely recommend starting on a lower dose to
            see how your baby initially tolerates it, and looking into dosing
            recommendations before settling on a final dose.

            The relevant portion of the above link (note that it was written in 2001 -
            standards may have changed, and many - by no means all - cardiologists have
            switched to plavix as the first-line blood thinner since then):
            *Aspirin dosage for cats*

            *Question: *I believe the aspirin dosage you reccommend for cats is
            incorrect on this page: http://www.vetinfo.com/catortho.html

            You suggest 10mg/lb, but every other source I can find suggests 10mg/kg.
            That makes the dosage you suggest more than twice the common
            reccommendation. Here are some other resources:

            http://oacm.uvm.edu/oacm/cat.htm
            http://www.valleypetnews.com/venerable_vet_i.htm

            *Answer: *Mark-

            Thank you for being concerned enough to write to us about the dosage for
            aspirin.

            There are published studies indicating that aspirin is safe when dosed from
            10 to 25mg/kg every 48 to 72 hours and one study indicating no problems when
            it was dosed at 162mg/cat once a week. We use up to 10mg/lb in our
            practice, even though it is at the higher end of the dosage scale. We
            usually do not exceed 81mg per cat and I probably should indicate that in
            our answers online, since this is often closer to 5mg/kg in large cats.

            Mike Richards, DVM 10/15/2001



            Good luck!

            Jean


            [Non-text portions of this message have been removed]
          • taclea
            Thanks everyone for replying. I did some reading and found some google book excerpts of vet medicine textbooks that indicated that asa in doses of 25mg/kg
            Message 5 of 7 , Mar 4, 2009
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              Thanks everyone for replying. I did some reading and found some google book excerpts of vet medicine textbooks that indicated that asa in doses of 25mg/kg twice weekly did not show toxicity. My cat is 16lbs so 81mg is just over 10mg/kg. I mentioned my concern about asa for cats and my vet said the dose of 81mg every 3 days was safe. I will follow with again about this.
            • nala_zq
              ... My cat tolerated plavix for roughly 18 months. It was always given to her after she had eaten. She did not appear to have tummy upset issues. The
              Message 6 of 7 , Mar 5, 2009
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                > I think the most common issue with ASA (and plavix) is that it's hard on the
                > stomach. ASA seems to be better in this regard than plavix, probably in part
                > because it's dosed every three days instead of daily.

                My cat tolerated plavix for roughly 18 months. It was always given to
                her after she had eaten. She did not appear to have tummy upset
                issues.

                The problem with high doses of aspirin in kitties, more so
                than the tummy upset is that kitties lack an enzyme, produced
                by the liver (glucuronyl transferase) that is required to metabolize
                not only aspirin but also other NSAIDs. This means that it takes longer
                for aspirin to clear the kitty's system (3 day dosing) and it makes it
                much easier to overdose a kitty. Especially a compromised
                kitty.

                If there are concerns, then one could further consult with one's vet
                or have a liver panel done to see whether there are problems.

                Additionally some NSAIDs can interfere with the function of ACE inhibitors.
                ACE inhibitors work, in part by dilation of blood vessels in the kidneys and
                some NSAIDs interfere with this dilation. I don't recall whether aspirin is one of
                these specifically.

                A baby aspirin is typically 81 mg of aspirin.

                As far as a specific dose, the FATCAT study that is looking at the effect
                of plavix vs. aspirin for prevention of a second clot in a group of kitties
                that have already experienced a clot is:

                "clopidogrel/plavix (18.75 mg PO q 24 hours) or aspirin (81 mg PO q 72 hours). The dosages chosen for the study drugs are based on the standard accepted dosing regimen for aspirin and preliminary data from clopidogrel pharmacodynamic studies."

                www.ivis.org/proceedings/wsava/2007/pdf/52_20070401192749_abs.pdf

                "Antiplatlet aggregating therapy may be considered when severe left atrial
                enlargement is present, when spontaneous echo contrast is evident in the LA or
                LAV, or when cats have have had preveious thromboembolic episodes. Aspirin may
                be used, dosed at approximately 80mg every three days. Other agents are presently
                under investigation such as clopidogrel (Plavix). Low molecular weight heparin
                drugs are added when cats have thromboembolic complications. Two particular
                agents, enoxaparin (Lovenox) and dalteparin (Fragmin), have received the most
                attention. Both drugs are expensive but appear to have a far greater safety margin
                than unfractionated heparin. Fragmin (100 U/kg q 12-24hrs SQ) or enoxaparine
                (1mg/kg q 12 hrs SQ) have been used relatively safely. This dose of fragmin,
                however, may be too little- or the frequency too low, to be efficacious. Administration
                rates of every 6 to 8 hours are generally impractical, however, for long term
                administration. Hyperkalemia can occur acutely as a result of re-perfusion injury.
                Continuous ECG monitoring is valuable during the first 3 days of hospitalization.
                Periodic evaluation of BUN and electrolytes are useful."

                Hope this helps.

                Nala
              • taclea
                yes, thank you
                Message 7 of 7 , Mar 5, 2009
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                  yes, thank you
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