Confirm the correct dose; Reinforce that the locking ring needs to be in the lock position before administering; Be sure that the pet owner understands that SILEO is administered between the cheek and gum and that it is not swallowed; SILEO gel is presented in a 3 mL multidose oral syringe that can be used for repeated doses on an as-needed basis.
Sileo should not be administered in the presence of preexisting hypotension, hypoxia, or bradycardia. Do not use in dogs sedated from previous dosing. Sileo has not been evaluated in dogs younger than 16 weeks of age or in dogs with dental or gingival disease that could have an effect on the absorption of Sileo.
If cats have pale mucous membranes and unacceptably slow pulses (less than 80 bpm) or hypotension - stimulate them by handling and if this does not resolve the problem administer 10 to 20% of the calculated atipamazole dose IM. If you feel that the cat is in crisis, the full atipamazole dose can be given IV slowly by titration over 2. Each dose will last between two to three hours. SILEO can be re-dosed as needed every two hours, up to five times during each noise event. The pre-filled applicator has between one and 12 doses, depending on the size of the dog. 'SILEO has been demonstrated to be safe and effective in two randomized, double-blinded clinical field studies. Sileo® 0.1 mg/ml oromucosal gel for dogs. Sileo® 0.1 mg/ml oromucosal gel for dogs. Zoetis UK Limited. (in dots) to be administered for the corresponding bodyweight. If the dose for the dog is more than 6 dots (1.5 ml), half of the dose should be administered to the oral mucosa on one side of the dog’s mouth and the other.
Hypertension in Cats
A silent disease
While hypertension can be a common problem in older cats, the condition can be difficult to diagnose.3,4
Hypertension can affect many parts of the body before detection and is strongly associated with target organ damage3,4:
Eyes
Heart and vascular system
Brain
Kidneys
Without treatment, this silent disease can lead to serious illness and, sometimes, death.3,4
Most often develops as secondary hypertension to diseases such as CKD and hyperthyroidism.3
Efficacy
Proven to lower systolic blood pressure1,10
A pilot dose determination laboratory study was conducted to evaluate the effectiveness of multiple oral doses and dose strategies of telmisartan on the reduction of systolic blood pressure (SBP) in clinically normal, healthy laboratory cats within a 14-day time period.11
* Endpoint at day 14 was significant reduction from baseline compared to placebo (P < 0.0005).
† A clinically relevant reduction in group mean SBP was predefined to be ≥ 20 mmHg in the telmisartan group from baseline to Day 28. The number of cats available at Day 28 for comparison is less than at enrollment because of removal of cats for hypertension rescue or adverse reactions.
The only angiotensin receptor blocker (ARB) for first-line treatment of hypertension in cats
Because ARBs feature a unique, targeted mode of action that specifically blocks the harmful vasoconstrictive effects of the renin-angiotensin-aldosterone system (RAAS), SEMINTRA is shown to quickly lower blood pressure within 14 days‡
Shown to be effective in cats with primary and secondary hypertension
Proven to be safe and effective10–13
Safety and Dosing
Flexible dosing to safely lower and maintain blood pressure in cats
SEMINTRA offers a dose-dependent response—an initial 1.5 mg/kg (0.68 mg/lb) dose twice daily for 14 days lowers blood pressure to a healthy level quickly, followed by a 2 mg/kg (0.91 mg/lb) once daily dose to maintain control11
Dose may be reduced by 0.5 mg/kg (0.23 mg/lb) increments to a minimum of 0.5 mg/kg to optimize dosing and prevent hypotensive state
Easily given as oral liquid
Easy-to-use Syringe
— Flexible delivery of dose straight into the mouth or on top of food2
— Selection of accurate dose
Sileo Gel For Cats
Safe for long-term administration
— Safety shown to extend through 6 months in multiple studies10–13
Convenient liquid formulation
As demonstrated in a study:
— 91.2% of cat owners perfer a liquid formulation2
Mode of Action
SEMINTRA is a highly targeted treatment
Telmisartan, the active substance in SEMINTRA, is an ARB, a class of medication that modulates the RAAS by selectively blocking receptors in the effector step of the RAAS. Unlike angiotensin-converting enzyme inhibitors (ACEis), ARBs do not block the conversion of angiotensin I to angiotensin II by angiotensin-converting enzyme in the RAAS cascade, thereby also blocking the activation of some of the receptor types with beneficial effects. And, unlike a calcium channel blocker, a class of pharmaceuticals that block the influx of calcium into cardiac and smooth muscle cells through calcium channels and potentially activate the RAAS, ARBs help to manage the RAAS.
Chronic activation of the RAAS can be harmful to tissues, including the kidney.
Watch this video for more information
Activation of RAAS can be complex, but conditions like chronic kidney disease, cardiac disease, and hyperthyroidism typically increase RAAS activity
Chronic, excessive RAAS activation can result in systemic hypertension because it promotes salt and water retention and increases blood pressure14,15
ACEis reduce the conversion of circulating angiotensin I to angiotensin II, which reduces all of the effects of angiotensin II at all receptors
ARBs have a more targeted mode of action. They bind only to the AT1 receptor, preventing activation of this receptor by angiotensin II
Because ARBs do not bind to AT2 receptors, the potentially beneficial effects of angiotensin II at these receptors are preserved
Sileo Dog Dose
Watch this video for more information
Target-specific mode of action of ARBs
IMPORTANT SAFETY INFORMATION
SEMINTRA is for oral use in cats only.
The most common side effects reported in field studies include vomiting, diarrhea, lethargy, dehydration, poor appetite, and weight loss. If side effects should occur, pet owners should contact their veterinarian. Click here for full prescribing information.
SEMINTRA has not been evaluated in cats with systolic blood pressure > 200 mmHg. The safe use of SEMINTRA has not been evaluated in cats with hepatic disease, cats less than 9 months of age, or cats that are pregnant, lactating, or intended for breeding.
The safe use of SEMINTRA with other anti-hypertensive medications has not been evaluated.
Mild anemia or non-regenerative anemia has been reported.
Pregnant women should avoid contact with SEMINTRA because substances that act on the renin-angiotensin-aldosterone system (RAAS), such as angiotensin receptor blockers (ARBs), can cause fetal and neonatal morbidity and death during pregnancy in humans.
Not for human use. Keep out of reach of children. If SEMINTRA is accidentally ingested, contact a physician.
SEMINTRA is a clear, colorless to yellowish viscous solution containing 10 mg/mL telmisartan.
Sileo Dose In Cats Treatment
References:1. SEMINTRA® (telmisartan oral solution) Prescribing Information. Boehringer Ingelheim Vetmedica, Inc. 2018. 2. Zimmering T. Ease of use of SEMINTRA and its effects on quality of life—update on cat owner feedback (“EASY Programme”) [abstract]. In: Proceedings from the 21st Federation of European Companion Animal Veterinary Associations (FECAVA); October 15–17, 2015; Barcelona, Spain. Poster. 3. Elliott J, Fletcher M, Syme HM. Idiopathic feline hypertension: epidemiologic study [abstract]. J Vet Intern Med. 2003;17:754. 4. Taylor SS, Sparkes AH, Briscoe K, et al. ISFM Consensus Guidelines on the diagnosis and management of hypertension in cats. J Feline Med Surg. 2017;19(3):288–303. 5. Maggio F, DeFrancesco TC, Atkins CE, et al. Ocular lesions associated with systemic hypertension in cats: 69 cases (1985–1998). J Am Vet Med Assoc. 2000;217:695–702. 6. Littman MP. Spontaneous systemic hypertension in 24 cats. J Vet Intern Med. 1994;8:79–86. 7. Stiles J, Polzin D, Bistner SI. The prevalence of retinopathy in cats with systemic hypertensionand chronic renal failure or hyperthyroidism. J Am Anim Hosp Assoc. 1994;30:564–572. 8. Syme HM, Barber PJ, Markwell PJ, et al. Prevalence of systolic hypertension in cats with chronic renal failure at initial evaluation. J Am Vet Med Assoc. 2002;220:1799–1804. 9. Kobayashi DL, Peterson ME, Graves TK, et al. Hypertension in cats with chronic renal failure orhyperthyroidism. J Vet Intern Med. 1990;4:58–62. 10. Coleman AE. Efficacy of oral telmisartan for the treatment of systemic hypertension in cats. In: Proceedings from the American College of Veterinary Internal Medicine; June 14–16, 2018; Seattle, WA. Abstract RRS08-E. 11. Coleman AE, Brown SA, Stark M. Evaluation of orally administered telmisartan for the reduction of indirect systolic arterial blood pressure in awake, clinically normal cats [published online ahead of print March 7, 2018]. 12. Glaus AM, Elliott J, Albrecht B, et al. Efficacy of telmisartan in hypertensive cats: results of a large European clinical trial [abstract]. J Vet Intern Med. 2018;32:577. 13. SEMINTRA® (telmisartan oral solution) [Freedom of Information Summary]. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2018. J Feline Med Surg. doi:10.1177/1098612X18761439. 14. Williams TL, Elliott J, Syme HM. Renin-angiotensin-aldosterone system activity in hyperthyroid cats with and without concurrent hypertension. J Vet Intern Med. 2013;27(3):522–529. 15. Syme H. Hypertension in small animal kidney disease. Vet Clin North Am Small Anim Pract. 2011;41(1):63–89.
Sileo For Cats
Important Safety Information: Do not use SILEO in dogs with severe cardiovascular disease, respiratory, liver or kidney diseases, or in conditions of shock, severe debilitation, or stress due to extreme heat, cold or fatigue or in dogs hypersensitive to dexmedetomidine or to any of the excipients. SILEO should not be administered in the presence of preexisting hypotension, hypoxia, or bradycardia. Do not use in dogs sedated from previous dosing. SILEO has not been evaluated in dogs younger than 16 weeks of age or in dogs with dental or gingival disease that could have an effect on the absorption of SILEO. SILEO has not been evaluated for use in breeding, pregnant, or lactating dogs or for aversion behaviors to thunderstorms. Transient pale mucous membranes at the site of application may occur with SILEO use. Other uncommon adverse reactions included emesis, drowsiness or sedation. Handlers should avoid direct exposure of SILEO to their skin, eyes or mouth. Failure to lock the ring-stop on the syringe before dosing SILEO could potentially lead to an accidental overdose. Always review INSTRUCTIONS FOR USE before dispensing and dosing. See full Prescribing Information.