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In this episode, host Alyssa Watson, DVM, is joined by Linda E. Luther, DVM, MVSc, DACVIM (SAIM), to discuss her recent Clinician’s Brief article, “Manipulation of the Renin-Angiotensin-Aldosterone System.” Dr. Luther delves into proteinuria, hypertension, heart disease, and the often overlooked hyperaldosteronism as conditions that feature chronic RAAS activation. She explains how each of our therapeutic options—ACE inhibitors, angiotensin II receptor blockers (ARB), spironolactone—are best put to use.
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Key Takeaways
The RAAS functions to maintain blood pressure, volume, and electrolytes; chronic RAAS activation is a feature of hypertension, proteinuria, and cardiac disease.
ACE inhibitors, angiotensin II receptor blockers (ARB), and mineralocorticoid receptor antagonists (spironolactone) are the options for interrupting chronic RAAS activation.
The ARB telmisartan is preferred to treat proteinuria in dogs and cats and hypertension in dogs as long as they are not azotemic, whereas amlodipine is preferred to treat hypertension in cats.
Treatment for cardiac disease can still feature ACE inhibitors, though diuretics and pimobendan are generally considered more important.
Be on the lookout for hyperaldosteronism as a cause of hypertension and hypokalemia.
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The Team:
Alyssa Watson, DVM - Host
Alexis Ussery - Producer & Multimedia Specialist