Therefore, the purpose of this study was to characterize the PK of gabapentin administered at the 20 mg/kg stress-reduction dose in normal cats and compare this with the serum concentrations of gabapentin in cats with CKD at a 50% reduced dose of 10 mg/kg. Although the PK of gabapentin have previously been determined in normal cats, 9, 10 no information exists on the PK of the 20 mg/kg dose used to reduce stress or its potential alteration in CKD. 7, 8 In cats, anecdotal experience is similar in that higher gabapentin doses (20 mg/kg or 100 mg/cat) can lead to excessive sedation and hypotension in patients with CKD, and a dose decrease of at least 50% is commonly used in clinical practice.Īs a result of these observations, it is necessary to explore the serum concentrations of gabapentin in feline CKD so that these patients could more safely benefit from its use. 7, 8 Toxicity in human patients with CKD can manifest as reduced consciousness, unsteady gait or ataxia, dizziness or weakness, myoclonus, confusion, tremulousness and asterixis, and is more pronounced in patients with decreased renal function who have received higher doses. 7 As a result of these alterations, dose reduction in human patients with CKD is recommended to prevent toxicity. 7 In humans, it has been demonstrated that kidney disease significantly influences the pharmacokinetics (PK) of gabapentin, and a 60% and 85% decrease in gabapentin clearance is seen in moderate and severe renal dysfunction, respectively. Gabapentin is not metabolized or protein bound, and is cleared only by renal excretion in humans it is unknown whether this is also true in cats. The 20 mg/kg stress-reduction dose of gabapentin may be beneficial to facilitate preventive veterinary care in younger, healthy cats, but this dose may be inappropriate for elderly cats, specifically those with chronic kidney disease (CKD). 5, 6 The results of a placebo-controlled study confirmed the beneficial effect of gabapentin in reducing stress and came to the conclusion that 20 mg/kg was an effective dose for healthy adult cats.
4 Gabapentin is a medication that, although traditionally prescribed for chronic pain and seizures, has recently become popular to reduce stress and improve compliance during veterinary visits. 1 Multiple strategies have been explored to reduce stress and increase compliance for veterinary examinations, including behavioral conditioning, 2 low-stress handling 3 and fast-acting anxiolytic medications. Stress associated with transportation, examination and diagnostic procedures is a major barrier to the feline patient’s ability to receive veterinary care.
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