Cardiology insights: Building on the RAPACAT Trial with a new study for cats

On this week's episode of The Vet Blast Podcast presented by dvm360, our host Adam Christman, DVM, MBA, welcomes Derek Matthews, DVM, DACVIM (Cardiology) to the show to educate our listeners more on feline cardiology and Felycin-CA1.

Throughout the episode, Christman and Matthews take a closer look at the medicine, who it should and should not be prescribed to, what to look out for, and previous research, including the results from Delayed-release rapamycin halts progression of left ventricular hypertrophy in subclinical feline hypertrophic cardiomyopathy: results of the RAPACAT trial which was published in the Journal of the American Veterinary Medical Association.

Below is a partial transcript, edited lightly for clarity.

Adam Christman, DVM, MBA: Fascinating. You know, I just love how medicine evolves because you're right, we did not learn those pathways in veterinary school. Definitely did not. Are there any contraindications in any cats?

Derek Matthews, DVM, DACVIM (Cardiology): That's a really good question...it does not work for cats with diabetes, and also cats with preexisting liver disease or are on other drugs that induce cytochrome P450. So that's a lot of drugs, antifungals, beta blockers, calcium channel blockers, cisapride, macrolide antibiotics, metoclopramide, phenobarbital, pimobendan, or any diuretics, and then the label also says that cats with MDR1 gene mutations, it should be used with caution. It hasn't been evaluated at all in cats with like viral diseases or chronic steroid use.

And so you know the other thing, just as a practicing clinician, blood work needs to be monitored closely, like before you start them on it, and after, and 1 to 2 months after starting it, to look for evidence of, you know, are we becoming at risk for diabetes, or do we develop ALT or AST liver enzyme changes, that kind of a thing.

And then, just like cats and heart failure, or cats with severe obstructions inside their heart are also just it's not clear that those cats should be on this medication.

Christman: Got it, interesting. Love it. All right, I know we're talking about the efficacy. Has it been shown to work in any previous studies?