Pregabalin and gabapentin in fractious cats: an exploratory comparison of handling-related outcomes and adverse effect profiles

Objective: To compare pregabalin and gabapentin on manageability, ease of placing into a carrier, ease of transport, and adverse effects in cats exhibiting fractious behavior. Methods: An exploratory double-blind, randomized crossover study enrolled 32 cats with a history of fractious behavior. Each cat received pregabalin (5 mg/kg; Bonqat) or gabapentin (compounded, 20 mg/kg), administered 2 hours before examination, with treatments allocated in random order 15 days apart. Outcomes included manageability (veterinarian-recorded), ease of placing the cat into the carrier (owner-reported), transport (owner-reported), and adverse effects (owner-reported and veterinarian-recorded). Results: Median scores (with IQRs) overlapped between pregabalin and gabapentin for manageability, ease of placing the cat into the carrier, and ease of transport. Owner-reported adverse effects did not differ between treatments, and drowsiness and muscle relaxation were the most frequently owner-reported effects, while veterinarian-recorded adverse effects were more frequent with gabapentin. Marked interindividual variability was observed: some cats responded substantially better to one drug than to the other. Conclusions: In this exploratory study, pregabalin and gabapentin provided overlapping outcomes for handling-related outcomes in fractious cats but differed in their adverse effect profiles, with gabapentin associated with a greater frequency of clinician-observed effects. The cat-dependent variation in response warrants further investigation. Clinical Relevance: Both gabapentinoids produced comparable handling-related outcomes in fractious cats. When adverse effect burden is a concern, pregabalin may offer a marginally favorable safety profile. Individual variation in drug response suggests that if one agent proves ineffective, the other may be trialed.