EXPRESS: Effect of Oral Gabapentin Administered In-Hospital on Behavioral Stress, Compliance, and Physiologic Stress Markers: a Randomized, Double-Blind, Placebo-Controlled Trial.

OBJECTIVES:The aim of the study was to determine whether post-admission oral gabapentin improves stress indices and handling tolerance in hospitalized cats. METHODS:In this double-blind, randomized, placebo-controlled, parallel-design trial, healthy client-owned cats were enrolled. After initial exam, cats received a 100-mg gabapentin or placebo capsule. At ninety minutes, a second examination, venipuncture, and brief dorsal positioning were performed. Five stress behaviors (struggling, vocalization, repelling, hypersalivation, mouth breathing), compliance, and enclosure activity score (1, sedate; 5, very active) were recorded; blood glucose, lactate, serum cortisol, and lymphocyte count were measured. Serum gabapentin concentrations were obtained 90-minutes post-capsule. RESULTS:Thirty cats (15 cats/group) were included in analysis. In the 15 cats that received gabapentin, median gabapentin dose was 21.7 mg/kg (range, 14.3-28.1 mg/kg), yielding a median serum concentration 16.4 mcg/mL (range, 1.3-24.5 mcg/mL). Most cats gabapentin-treated cats exhibited less stress behaviors (86%; 13/15) and better compliance for handling during examination (73%; 11/15) at 90-minutes post-capsule compared with 20% (3/15) and 26% (4/15), respectively, in placebo cats. Between group differences were not detected for behavioral or compliance scores during venipuncture or dorsal positioning. Enclosure activity scores in the gabapentin group decreased from median 3 at baseline to 2 from 90-360 minutes post dose (120, 240, and 300 minutes; P <0.05, respectively), consistent with mild sedation. Blood lactate and cortisol concentrations were lower in gabapentin group than placebo group (P = 0.002 and P = 0.04, respectively). CONCLUSIONS AND RELEVANCE:A 100-mg oral dose of gabapentin provides modest improvement in stress behaviors during examination and favorably alters select physiologic stress markers within 90 minutes of administration, with sustained reductions in kennel activity. Findings support incorporating gabapentin within a multimodal, low stress approach for cats presenting without pre appointment medication, while maintaining contingency plans for additional sedation as needed.