Hi Mark,
Thank you for your question. I hope you are enjoying the course. Yes, I’ve been using gabapentin in a similar fashion and agree it can be a game changer for stressed or hospitalized cats when you want to avoid IM sedation. Your examples align closely with mine, I’ve used it in cats with urethral obstruction, pancreatitis, CHF, and even just for routine blood draws in particularly reactive patients. At doses around 50 to 100mg, I’ve found it particularly helpful for reducing the need for chemical restraint, improving compliance for catheter placement or imaging, and making hospitalisation a little easier on everyone.
In terms of evidence, the randomized controlled trial by van Haaften et al. (JAVMA 2017; 251[10]:1175–1181) is a useful reference. It showed that a single 100mg oral dose given 90 minutes before transport significantly reduced stress scores during transport and veterinary examination in pet cats with a history of stress or fractious behaviour. Veterinarian-assessed compliance scores also improved, and while sedation, ataxia, and hypersalivation were reported, all adverse effects resolved within eight hours. This provides solid backing for its use pre-visit and supports what many of us have observed anecdotally in practice.
Regarding renal disease, the 2022 study by Quimby et al. (J Feline Med Surg; 24[12]:1260–1266) found that cats with stage 2 or 3 CKD had significantly higher serum concentrations of gabapentin after a single dose compared to healthy controls, even when the CKD group received half the dose. Serum concentrations were correlated with creatinine and SDMA, and compliance scores improved with increasing serum levels. Based on this, I’d be comfortable using gabapentin for a single dose in CKD cats but would definitely reduce the dose, especially if repeating, and avoid chronic use without close monitoring.
There’s also the 2021 study by Allen et al. (J Am Anim Hosp Assoc; 57[6]:278–284) showing that gabapentin caused mild sedation in healthy cats and modest but statistically significant reductions in echocardiographic parameters of systolic function, though all remained within normal limits. That’s reassuring for its use in mild cardiac patients where gentle sedation is needed — I’ve found it particularly helpful in cats undergoing echocardiography who otherwise can’t be handled.
I agree with your caution about avoiding it in dyspnoeic patients due to the risk of aspiration. For these cats, I’d either delay gabapentin until they’re stable or use an injectable route if anxiolysis is absolutely necessary.
I will look forward to seeing what the others think!
Have a lovely weekend.
Scott 🙂
