Efficacy of a Single Dose of Pregabalin on Signs of Anxiety in Cats During Transportation—A Pilot Study

Abstract

Objectives: The aim of this clinical pilot study was to evaluate the dosage, efficacy, and clinical safety of a single oral dose of pregabalin in cats that experience fear and anxiety when placed into a carrier and transported by car.Methods: Thirteen client-owned cats were enrolled in a blinded, randomized, crossover study with three treatment days approximately 1 week apart. The cats were assigned to receive pregabalin oral solution at dosages of 5 and 10 mg/kg and placebo in a randomized order, one treatment per week. Treatment was administered ~90 min before placing the cat into a carrier and starting transportation. Efficacy was assessed by the owners using a categorical scale and, based on video recordings, by an external observer, both blinded to the treatment.Results: Owners assessed that cats given pregabalin displayed less vocalization, restlessness, and panting during transportation than did cats given placebo. Correlation between owners' and external observer's assessment of the overall treatment effect was good (0.63, p < 0.01), which confirms the owners' ability to observe reliably their own cat's behavior. Transient mild ataxia was the most common adverse event reported. The human commercial formulation used in this study was found difficult or very difficult to administer by 79% of the owners.Conclusions and Relevance: Based on results of this pilot study, a single oral dose of pregabalin was well tolerated and decreased signs of anxiety and fear associated with car transportation in cats, as evaluated by blinded owners and external observer. The use of pregabalin prior to traveling may improve cat welfare and compliance for transportation. Further studies are needed to investigate the use of oral pregabalin in cats to alleviate signs of anxiety and fear associated with transportation and sequelae, like veterinary visits, and to develop a more user-friendly formulation.

Feline stress management during air travel: a multimodal approach

“…✜ Off-label use and consent It is important to note that, at the time of publication, only one of the below-mentioned short-term medications is available as a veterinary formulation and licensed for cats - pregabalin (Bonqat; Orion Animal Health), which is approved in the EU, UK, Norway and Iceland for the indication of ‘Alleviation of acute anxiety and fear associated with transportation and veterinary visits’. 48 None of the other below-mentioned short-term medications are available in a veterinary formulation or licensed for use in fear, anxiety or stress in cats; these medications are therefore considered ‘off-label’ and the authors thus recommend obtaining informed consent forms and educating clients on the current ‘off-label’ use of these medications in cats. It should also be noted that there are currently no data available for any of these medications at altitude.…”

“…Bonqat (Orion Animal Health) is currently the only pregabalin product licensed for cats and is approved in the EU, UK, Norway and Iceland for the indication ‘Alleviation of acute anxiety and fear associated with transportation and veterinary visits’, which means that the product is, as per label, approved for single use. 48 As gabapentin and pregabalin have no active intermediate metabolites and minimal passage through the cytochrome (CYP) 450 metabolism, the likelihood of side effects is low. 61 If side effects occur, they typically include hypersalivation and vomiting or, if given at a higher dosage, ataxia and sedation.…”

2022 WSAVA guidelines for the recognition, assessment and treatment of pain

“…One study also showed decreased transport‐related stress and anxiety with the administration of pregabalin (Lamminen et al . 2021). In dogs undergoing forelimb amputation, adding preoperative gabapentin to an already robust protocol that included intra‐ and postoperative fentanyl infusion and other analgesics failed to provide significant benefits in the first three postoperative days (Wagner et al .…”

“…A few studies show similar effects in dogs and cats undergoing surgery and in cats during transport and clinic visits (Crociolli et al 2015, van Haaften et al 2017, Steagall et al 2018. One study also showed decreased transport-related stress and anxiety with the administration of pregabalin (Lamminen et al 2021). In dogs undergoing forelimb amputation, adding preoperative gabapentin to an already robust protocol that included intra-and postoperative fentanyl infusion and other analgesics failed to provide significant benefits in the first three postoperative days (Wagner et al 2010).…”

2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques

“…A small study has evaluated pregabalin in cats at 5 mg/kg and 10 mg/kg doses and determined that signs of anxiety and the fear associated with car transportation were reduced. 84 Additionally the pharmacokinetics of pregabalin have been investigated, showing no safety concerns with doses up to 7.5 mg/kg. 85 Trazodone is a sedative that has been recommended for use as a single agent or in combination with gabapentin.…”