In the Literature
Quimby JM, Jones SE, Saffire A, et al. Assessment of the effect of gabapentin on blood pressure in cats with and without chronic kidney disease. J Feline Med Surg. 2024;26(5):1098612X241240326. doi:10.1177/1098612X241240326
The Research …
Chronic kidney disease (CKD) is the most prevalent feline metabolic disease, and ≈1 in 4 cats with CKD exhibit systemic hypertension.1,2 Reliable measurement of systemic arterial blood pressure (BP) is therefore important to identify and treat adverse effects of high BP on the kidneys, eyes, brain, and cardiovascular system.2
Perception of anxiety and stress in cats often results in pet owner reluctance to seek veterinary care, and anxiety-induced changes in BP (ie, white-coat hypertension, situational hypertension) can make measurements unreliable.2-5 Gabapentin is commonly used to help reduce stress associated with transportation, clinic visits, and veterinary procedures in cats.3 Understanding the impact of gabapentin on BP is thus important, but data are conflicting.3,6,7
In this randomized, blinded, placebo-controlled crossover study, effects of gabapentin on BP were assessed in healthy cats (n = 16) and cats with stable CKD (International Renal Interest Society stage 2-48; n = 13). BP was measured 3 hours after a single administration of gabapentin (10 mg/kg PO) and 3 hours after a single administration of an oral placebo. Measurements were separated by ≈1 week, and the order in which gabapentin and the placebo were given was randomized.
Median change in BP attributed to gabapentin was −12 mm Hg (range, −95 to 10 mm Hg) in healthy cats and −12 mm Hg (range, −43 to 21 mm Hg) in cats with CKD. Mean age differed in healthy cats (6.7 years) and cats with CKD (12 years), but minimal data are available to suggest this difference contributed substantially to the study results. The authors concluded that gabapentin affects BP in cats with and without CKD, which should be considered when gabapentin is administered to cats that require BP measurement.
… The Takeaways
Key pearls to put into practice:
BP measured in a cat following administration of gabapentin is likely lower than the patient’s nonsedated BP.
In this study, the range of effects of gabapentin on BP in individual cats was large in both treatment groups. Despite appropriate standardization of doses and timing, serum gabapentin concentrations following administration of an identical oral dose varied widely (3,709-22,050 ng/mL) in cats with CKD, and cats in this group with higher serum gabapentin concentrations exhibited a larger decrease in BP.
Gabapentin may be the best available treatment for facilitating BP measurement in uncooperative or anxious cats or in cases in which an owner requests patient sedation; however, BP measurement in calm, cooperative, nonsedated cats is the best approach for obtaining reliable measurements.2
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