Senior Cat Blood Pressure: Targets, Drugs, 2-Week Rechecks

Treat a senior cat when systolic blood pressure reads 160 mmHg or higher on 2 separate visits, and aim to bring it under 160, ideally 140-150. The first recheck happens 10-14 days after starting medication, not 3 months. Amlodipine is the first-line drug and it is prescription-only: no cat should start it without a vet measuring pressure, a retinal exam, and baseline kidney values.

Blood pressure is the one senior-cat number that damages organs silently for months before anyone notices. A cat at 190 mmHg loses retinal vessels first, kidney function second, and often shows no sign until the pupils stay wide.

The numbers that decide treatment

Veterinary consensus treats under 150 mmHg as normal, 150-159 as borderline, 160-179 as hypertension needing treatment, and 180 or above as severe, with 200+ an emergency for the retina and brain. Measure on 2 visits 1-2 weeks apart, because clinic stress alone can push a cat from 150 to 175. Take 3 to 5 readings and use the lowest consistent value; a Doppler or high-definition oscillometric device is fine, but keep the same device and the same front-leg or tail cuff position at every recheck, since switching methods moves the number by 10-20 mmHg on its own.

Pressure categories and what happens next

Systolic	Category	Action	Recheck
under 150	Normal	Screen every 6-12 months	6-12 months
150-159	Borderline	Repeat, check kidneys and thyroid	1-2 weeks
160-179	Hypertension	Start amlodipine, eye exam	10-14 days
180-199	Severe	Start drug, recheck in 5-7 days	5-7 days
200 or more	Emergency	Same-day treatment, retinal check	24-72 hours

What amlodipine does and does not do

Amlodipine is a calcium channel blocker that relaxes arterioles. The dose is set by the vet by weight and by the reading taken at the 2-week recheck; it is prescription-only, and no number on a page like this one should be copied. It lowers pressure in roughly 7 of 10 cats and it works fast, within 3-7 days. It does not treat the cause: in a cat with chronic kidney disease (CKD) or hyperthyroidism, the underlying disease still needs its own plan, and in about 1 in 5 cats the pressure is driven by kidney disease that will progress regardless. Tablets are small and the pharmacy may hand over a strength that has to be split, so the exact schedule should come from the vet or pharmacist rather than the brand name.

Why the recheck is 2 weeks, not 3 months

Two things can happen in the first 14 days. Pressure can fall too far, and a cat that drops from 190 to 120 mmHg shows lethargy, poor appetite, or hind-limb weakness within 3-5 days. Or it does not fall at all, which means the dose is wrong or the diagnosis was wrong. A 10-14 day recheck catches both while the cat is still easy to adjust. After the pressure is stable under 160 on 2 consecutive visits 4 weeks apart, move to rechecks every 3-4 months, and always check kidney values at the 2-week mark, because dropping pressure can unmask or worsen renal azotemia.

Eyes first, kidneys second

Hypertensive retinopathy is the most urgent consequence: bleeding in the retina, then detachment, then blindness that is usually permanent within 2-6 weeks if pressure stays above 180. Every cat diagnosed with hypertension needs a dilated fundic exam the same week, and a cat that suddenly bumps into furniture needs pressure measured that day. Kidney damage is slower and shows up as a rising SDMA or creatinine over 3-6 months. That is why the eye exam and the blood panel belong in the same visit as the cuff, and why our notes on vision loss in senior cats start with a pressure reading rather than an eye drop.

What else changes at home

Weight is the cheapest monitor you own: a cat losing 5% of body weight in 3 months needs pressure and kidney values checked, since hypertension often tracks with both CKD and hyperthyroidism. Weigh monthly on a baby scale and log it, following the routine in senior cat weight monitoring. Keep the sodium load low, but do not switch to a renal diet in the same week you start amlodipine, or you will not know which change caused the appetite drop. Give the pill at the same hour daily, with or without food, and never stop abruptly: rebound pressure spikes within 24-48 hours.

Home monitoring is optional and easy to get wrong. A $60-90 clinic reading beats a $25 home device used on a lap, where most owner values run 10-15 mmHg high because the cat is restrained. If you do buy one, use a 4-6 cm cuff on a 4-5 kg cat, take 5 readings, throw out the first, and bring the log to every visit; 3 consistent numbers beat 1 clinic number.

Cost and what to expect

A pressure check alone runs $40-70, a full workup with bloodwork, thyroid, and urinalysis $150-300, and a fundic exam $60-120. Amlodipine itself is inexpensive, often $10-25 a month, but the 2-week recheck and the 3-4 monthly monitoring add $200-400 in the first year. Budget the monitoring, not the pill: the drug is the cheap part of this disease, and the rechecks are what keep the cat seeing. Put the numbers into the cost calculator alongside food and litter so the first year does not surprise you.

• Get 3-5 readings on 2 visits before accepting a diagnosis.
• Book the 10-14 day recheck when you pick up the first prescription.
• Do the dilated eye exam the same week treatment starts.
• Ask for kidney values at every pressure recheck, not once a year.
• Weigh monthly; a 5% drop in 3 months triggers a pressure check.

Terms mentioned in this article

CKDSDMA

Frequently asked

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