Temporal Changes in Pain, Demeanour, Sedation and Salivary Cortisol During Repeated Pregabalin Administration in Hospitalised Feral Cats: An Exploratory Prospective Single-Arm Study

Hospitalised feral cats may experience stress, pain, and defensive behaviour that complicate care. This prospective, exploratory, uncontrolled study described temporal changes during repeated pregabalin administration. Twenty-five cats were enrolled and 20 completed the study. Pregabalin (10 mg/kg) was given every 12 h for four doses. Heart rate (HR), respiratory rate (RR), Feline Grimace Scale (FGS), Demeanor Scoring System (DSS), and Global Sedation Score (GSS) were assessed from T-Pre to T60; salivary cortisol was measured. Repeated-measures general linear models included 18 complete cases for scores, eight for HR, and 15 for RR; cortisol subgroup analyses were post hoc. Time affected FGS, DSS, and GSS (all p < 0.001). At T36, mean individual changes were −48.3% (95% CI, −65.8% to −30.8%) for FGS and −54.1% (95% CI, −63.7% to −44.5%) for DSS. GSS peaked at T6, indicating mild sedation. No significant temporal effects were detected for HR (p = 0.112), RR (p = 0.259), or overall cortisol (n = 16). At washout (Tw), cats with severe persistent illness had higher cortisol than those without (p < 0.001); procedures were associated with transient increases. No adverse events were recorded. Clinical recovery, acclimatisation, concomitant treatments, rescue analgesia, and repeated handling may have contributed, so these associations do not establish pregabalin efficacy. Controlled studies are required.