Procedural sedation and stress reduction of cats in the hospital environment

Authors: Chagas JAB
Publication: Australian Veterinary Practitioner, Volume 55, Issue 1, pp 29-37, Mar 2025
Publisher: Australian Veterinary Association

Animal type: Cat
Article class: Clinical Article

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Abstract:

Cats often arrive at the veterinary clinic feeling fearful and anxious, which is frequently expressed through aggressive behaviour, mistakenly contributing to their reputation as difficult patients. Stress and anxiety also increase sympathetic tone and catecholamine release, altering physiological parameters - resulting in tachycardia, hypertension, and tachypnoea - elevating the risk of complications related to sedation and anaesthesia. Several cat-friendly techniques have been proposed to alleviate stress and improve transportation, handling, and physical examinations, and are recommended to be implemented whenever possible.

The administration of medications that produce anxiolytic or calming effects, such as gabapentin and trazodone, before the veterinary visit (also called pre-visit pharmaceuticals) has become a widespread practice for cats and is associated with decreased stress, facilitation of examination, and performance of non-invasive diagnostic procedures. In some circumstances, pre-visit administration of anxiolytics is not possible. In other situations, more profound sedation is required to make the patient cooperative, ensure staff and patient safety, and improve the patient’s experience in the hospital environment.

To make appropriate decisions regarding the technique or medications to be used, the clinician must be familiar with the cat's behaviour and temperament, their clinical condition, the type of procedure to be performed and its duration, the expected level of pain, and the effects of the medications on various body systems. There is no "one-size-fits-all" protocol, and individual patient needs must be considered when planning a procedure.

This article provides a brief overview of medications utilized to alleviate stress and promote sedation during short medical procedures for patients in a hospital setting. It also presents a summary of selected and frequently used drug combinations and their associated clinical effects.

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