Veterinary visits by cats in the United States decreased 14% from 2001 to 2011, as reported by the AVMA.1 In the Bayer Veterinary Care Usage Study,2 owners reported cat resistance to carriers and transport-related anxiety as well as stressful events at the veterinary clinic as major deterrents to veterinary visits. The reduced number of veterinary visits negatively impacts the health and welfare of cats as well as the financial bottom line of veterinary practices.
Wellness visits when cats are apparently healthy provide opportunities for delivering best care in terms of diet, vaccines, and behavior. Health problems can be identified early in their course to optimize treatment success. If cats are not brought for veterinary visits on an annual or more frequent basis, then by the time a need for veterinary care is identified by owners, existing disease processes can be more advanced and treatment more complicated and costly.
Further complicating the situation, when cats with signs of anxiety are brought for veterinary visits, they may physically resist a comprehensive examination and risk injury to veterinary personnel, clients, and themselves. Vital signs and laboratory test results may reflect the effects of distress and be difficult to interpret.3,4 In addition, each veterinary visit associated with anxiety and distress may condition cats to expect that future visits will be similar.4
Many veterinarians are actively working to make veterinary visits less stressful for cats. Feline-friendly waiting and examination rooms provide a more pleasing environment for cats than traditional rooms do. Behavioral interventions, such as conditioning cats to carriers,5 can reduce signs of transport-related anxiety, and low-stress handling can reduce signs of veterinary examination–related anxiety. In addition to these techniques, a safe, effective, and easy-to-administer single-dose medication for cats for reduction of stress associated with veterinary visits would be an important advantage.
Pharmacological agents that may be used to overcome the distress of carrier confinement, transport, and veterinary examinations are limited for cats. Several types of tranquilizers or sedatives are available by prescription, but all have disadvantages. Orally administered acepromazine maleate6 or diazepam6 and oromucosally applied dexmedetomidine gel (with or without buprenorphine hydrochloride)7 have been proposed. However, the potential adverse effects of these agents limit their usefulness prior to transport for veterinary visits. For example, acepromazine is associated with paradoxical excitation in cats and dexmedetomidine is associated with vomiting following administration,8 whereas more serious hepatic necrosis may follow oral administration of diazepam.9
Various over-the-counter treatments are available, such as L-theanine or synthetic feline pheromone sprays or diffusers,10 although anxiolytic effects in cats during veterinary examination have not been demonstrated. The purpose of the study reported here was to evaluate the efficacy of oral administration of a single dose (50 mg) of the drug trazodone hydrochloride to cats to reduce signs of anxiety during transport to the veterinary clinic and during veterinary examination. Classified as a serotonin antagonist and reuptake inhibitor, trazodone has been used successfully in dogs for its anxiolytic and mild sedative properties.11,12 In a small sample of laboratory cats, a single dose of trazodone at 50, 75, or 100 mg PO appeared to be well tolerated and resulted in a considerable sedative effect.13 We hypothesized that when given to client-owned cats prior to veterinary visits, trazodone would reduce signs of transport-associated anxiety and facilitate veterinary examination. We also predicted that there would be no difference in values of certain physiologic variables between trazodone and a placebo.
Supported in part by the Animal Behavior Fund of the North Carolina Veterinary Medical Foundation. Eva Frantz was sponsored by the Morris Animal Foundation Veterinary Student Scholars Program and the North Carolina State Merial Summer Scholars Program. Dr. Gruen received support from the NIH Ruth L. Kirschstein National Research Service Award T32OD011130.
The authors declare that there were no financial conflicts of interest.
Oral abstract presented at the Veterinary Behavior Symposium, Boston, July 2015.
The authors thank Janet Bogan of the North Carolina State Clinical Studies Core and Gigi Davidson of the North Carolina State Veterinary Pharmacy for technical assistance.
Teva, North Wales, Pa.
Pill Pockets, Nutro Co, Franklin, Tenn.
Medrio Electronic Data Capture, San Francisco, Calif.
2. Volk JO, Thomas JG, Colleran EJ, et al. Executive summary of phase 3 of the Bayer veterinary care usage study. J Am Vet Med Assoc 2014; 244: 799–802.
3. Rand JS, Kinnaird E, Baglioni A, et al. Acute stress hyperglycemia in cats is associated with struggling and increased concentrations of lactate and norepinephrine. J Vet Intern Med 2002; 16: 123–132.
4. Rodan I. Understanding feline behavior and application for appropriate handling and management. Top Companion Anim Med 2010; 25: 178–188.
5. Gruen ME, Thomson AE, Clary GP, et al. Conditioning laboratory cats to handling and transport. Lab Anim (NY) 2013; 42: 385–389.
6. Tranquilli WJ, Thurmon JC, Grim KA. Anticholinergics and sedatives. In: Lumb and Jones’ veterinary anesthesia and analgesia. 4th ed. Ames, Iowa: Blackwell Publishing, 2007; 208, 228–229.
7. Porters N, Bosmans T, Debille M, et al. Sedative and antinociceptive effects of dexmedetomidine and buprenorphine after oral transmucosal or intramuscular administration in cats. Vet Anaesth Analg 2014; 41: 90–96.
8. Thawley VJ, Drobatz KJ. Assessment of dexmedetomidine and other agents for emesis induction in cats: 43 cases (2009–2014). J Am Vet Med Assoc 2015; 247: 1415–1418.
9. Center SA, Elston TH, Rowland PH, et al. Fulminant hepatic failure associated with oral administration of diazepam in 11 cats. J Am Vet Med Assoc 1996; 209: 618–625.
10. Gaultier E, Pageat P, Tessier Y. Effect of a feline appeasing pheromone analogue (Feliway) on manifestations of stress in cats during transport, in Proceedings. 32nd Congr Int Soc Appl Ethol 1998;198.
11. Gruen ME, Sherman BL. Use of trazodone as an adjunctive agent in the treatment of canine anxiety disorders: 56 cases (1995–2007). J Am Vet Med Assoc 2008; 233: 1902–1907.
12. Gruen ME, Roe SC, Griffith E, et al. Use of trazodone to facilitate postsurgical confinement in dogs. J Am Vet Med Assoc 2014; 245: 296–301.
13. Orlando JM, Case BC, Thomson AE, et al. Use of oral trazodone for sedation in cats: a pilot study. J Feline Med Surg 2016; 18: 471–475.
14. Kessler MR, Turner DC. Stress and adaptations of cats (Felis silvestris catus) housed singly, in pairs and in groups in boarding catteries. Anim Welf 1997; 6: 243–254.
15. Jaeger GH, Marcellin-Little DJ, DePuy V, et al. Validity of goniometric joint measurements in cats. Am J Vet Res 2007; 68: 822–826.