Pregabalin Alleviates Anxiety and Fear in Cats during Transportation and Veterinary Visits—A Clinical Field Study

Abstract

Cats frequently suffer from anxiety related to travel and veterinary visits. One sequela is avoidance of veterinary visits and lack of adequate veterinary care. The objective of this study was to test clinical efficacy and safety of a novel formulation of a pregabalin 50 mg/mL oral solution for alleviation of anxiety and fear in cats during transport and veterinary visits. A total of 209 client-owned cats were given either a flavored pregabalin oral solution at the dosage of 5 mg/kg (n = 108) or an identical placebo (n = 101) approximately 90 min before placing them into the carrier and transporting them in a car for at least 20 min to a veterinary clinic. The treatment effect using a 5-point numerical rating scale was evaluated during transportation by the owner and during clinical examination by the veterinarian, both blinded to the treatment. In addition, to verify the owner assessment, an external expert blinded to the treatment and owner assessment evaluated the transportation video recordings using the same rating scale as the owner. Pregabalin 5 mg/kg statistically significantly decreased both travel- (p < 0.01) and veterinary-visit- (p < 0.01) related anxiety compared to the placebo. The external expert’s evaluation was in agreement with the owners’ assessment confirming the treatment effect during transportation (p < 0.01). Treatment was well tolerated with only a few cats showing transient slight incoordination and tiredness. The flavored oral solution formulation with a small dosing volume of 0.1 mL/kg was found by the owners to be user-friendly and was well-accepted by the cats. This study demonstrated that a single oral dosage of the novel pregabalin oral solution alleviates anxiety and fear related to transportation and veterinary visits in cats, thus providing practical aid for both owners and veterinarians to enable cat-friendly handling and improving the welfare of cats in situations they often perceive as very stressful.

2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats

“…112 Gabapentin may decrease arterial blood pressure in cats with and without CKD, which should be considered when using with NSAIDs. 113 < Pregabalin Although studied as an anxiolytic in cats, 114 pregabalin may also have utility as an analgesic in cats, as it does in other species. 115…”

2023 AAFP/IAAHPC feline hospice and palliative care guidelines

“…Gabapentin and pregabalin have been demonstrated to reduce distress during transportation and examination, as well as reduce fear-anxiety during the visit. 54 - 57 The recommended dose for gabapentin is 20 mg/kg 55 , 56 or 100-200 mg/cat 54 given 2-3 h prior to transportation 54 - 56 (use 50% lower dose in cats with reduced renal function 53 ). Pregabalin is labeled in Europe to reduce the fear-anxiety associated with veterinary visits and travel (5 mg/kg PO 90 mins prior to transportation).…”

“…Pregabalin is labeled in Europe to reduce the fear-anxiety associated with veterinary visits and travel (5 mg/kg PO 90 mins prior to transportation). 57 More research should be conducted on the use of gabapentin and pregabalin for maladaptive/ neuropathic pain, as much more is known about the effects of these medications on reducing fear-anxiety. Amantadine is an N -methyl-D-aspartate (NMDA) receptor antagonist and is used to treat central sensitization.…”

Neue Arzneimittel für Kleintiere 2023

“…In einer Feldstudie an 209 Katzen verringerte Pregabalin 5 mg/ kg im Vergleich zu Placebo statistisch signifikant sowohl die reisebedingte Angst (p < 0,01) als auch die tierarztbesuchbedingte Angst (p < 0,01) [5]. Da die Verträglichkeit von Bonqat nur bei Katzen schwerer als 2 kg, im Alter von 5 Monaten bis 15 Jahren, bei gesunden Katzen oder Katzen mit leichten systemischen Erkrankungen, belegt wurde, ist es bei Katzen, die diese Bedingungen nicht erfüllen, nur entsprechend der Nutzen-Risiko-Bewertung durch den behandelnden Tierarzt anzuwenden [3].…”

“…Da die Verträglichkeit von Bonqat nur bei Katzen schwerer als 2 kg, im Alter von 5 Monaten bis 15 Jahren, bei gesunden Katzen oder Katzen mit leichten systemischen Erkrankungen, belegt wurde, ist es bei Katzen, die diese Bedingungen nicht erfüllen, nur entsprechend der Nutzen-Risiko-Bewertung durch den behandelnden Tierarzt anzuwenden [3]. In klinischen Studien wurden nach der Anwendung von Bonqat häufig Lethargie, Propriorezeptionsstörung und Ataxie als Anzeichen einer Sedierung sowie Erbrechen beobachtet [3,5]. Gelegentlich zeigten die Katzen Muskeltremor, Mydriasis, Anorexie, Gewichtsverlust und Leukopenie sowie selten Speicheln [3].…”