Behavioral and cardiovascular effects of a single dose of gabapentin or melatonin in cats: a randomized, double-blind, placebo-controlled trial

Abstract

Objectives The aim of this study was to verify whether a single oral dose of gabapentin (100 mg) or melatonin (3 mg) given 60 mins before a cardiac evaluation would reduce anxiety without interfering with heart rate (HR), systemic blood pressure (SBP), electrocardiogram (ECG) and echocardiographic indexes. Methods Seventy-five client-owned healthy cats underwent two sets of cardiac assessments 60 mins apart, randomly divided into gabapentin, melatonin and placebo groups. The interval between treatment and the second ECG and SBP measurement was 60 mins, and 70 mins for echocardiography. A compliance score (CS) classified the behavior, focusing on the ease of handling. Results Most variables did not change between the examinations. The placebo group showed more significant changes (SBP, tricuspid annular plane systolic excursion, HR during echocardiography, aortic flow velocity, S′ wave from lateral mitral annulus), but they were not considered to be hemodynamically relevant. Gabapentin and melatonin significantly increased the cats’ compliance without interfering with cardiac assessment. Eight cats presented with mild sedation, seven after gabapentin and one after melatonin. No major side effects were observed. Conclusions and relevance Gabapentin tranquilized the cats when it was given 60 mins prior to ECG and SBP measurement, and 70 mins prior to echocardiography, without interfering with systolic echocardiographic indexes. Melatonin also decreased the CS, but without sedation in most cases. The waiting period may have relaxed the cats in the placebo group, resulting in lower SBP measurements. However, this tranquility did not last as some echocardiographic changes signaled a sympathetic predominance.

Effect of gabapentin on ambulatory, direct, systemic arterial blood pressure in apparently healthy cats in the at-home and in-clinic environments

“…This is in keeping with the findings of previous studies, in which reported side effects (eg, sedation) have been mild, temporary (ie, persisting fewer than 8 after administration) and well tolerated. 9,11,17 Cats are prone to situational (also referred to as 'whitecoat') hypertension, a physiologic response to stressful situations that is associated with increases in BP, 5,18 and which complicates the diagnosis of pathologic systemic arterial hypertension. 19 An inexpensive, readily available and well-tolerated intervention or drug that successfully prevents situational increases in BP without exerting a direct effect on BP (thereby masking pathological hypertension) would be welcome, as such a treatment would allow for greater confidence in measurements taken inclinic.…”

“…This is in keeping with the findings of previous studies, in which reported side effects (eg, sedation) have been mild, temporary (ie, persisting fewer than 8 h after administration) and well tolerated. 9 , 11 , 17 …”

Gabapentin: Clinical Use and Pharmacokinetics in Dogs, Cats, and Horses

“…The drug turned out to be a good therapeutic option when orally administered before a cardiology examination, with mild sedative effects and minimal decrease in the echocardiographic measurements of systolic function [ 22 ]. Similarly, gabapentin given orally to healthy cats 70 min before echocardiography effectively increased compliance without causing substantial changes in cardiovascular and echocardiographic parameters [ 83 ].…”

Assessment of the effect of gabapentin on blood pressure in cats with and without chronic kidney disease

“…2 Gabapentin has been shown to decrease visit-associated stress in feline patients in a variety of clinical scenarios, including the measurement of BP, and in general is considered to be a relatively safe medication with minimal clinically significant effects on physiologic parameters. [4][5][6][7][8][9][10][11][12][13] However, special consideration should be given when using gabapentin in patients with compromised kidney function. Gabapentin is eliminated almost entirely through renal excretion, and decreased renal function significantly influences the pharmacokinetics of gabapentin in humans.…”