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Hi Dr. Pam,
I need your insight when you have time. What is the highest dose of Gabapentin you have prescribed for cats with heart disease to make a trip to the cardiologist safely? Ie, not killing them, taking them!!!
We have recently been shell-shocked with our 12 years young cat Saxton. Our vet detected a gallop on his six-month wellness exam. She did a home visit next to rule out stress and still heard the gallop, we did a follow-up a week later with bp, heart rate, and lungs. She was happy with all.
We did labs, and Saxton's probnp is 8 times higher than it should be
Cardiopet proBNP (Feline) 839 range ( 0 - 100 pmol/L)
His ALT is also high ALT 170 (range 27 - 158 U/L)
The thyroid is good Total T4 a 2.5 range ( 0.8 - 4.7 μg/dL.)
We have a cardiologist appt on the 26 of this month and our primary concern is getting him there without killing him! He is a highly stressed kitty for vet visits, thunderstorms, fireworks, etc. Otherwise, he is not!
We have tried so many combinations nothing has helped him. So our vet is now suggesting a 200 mg of Gabapentin trial at home with 8 mg Cerenia. To see how he does. I am comfortable trying 100 mg and seeing and going from there. We have trialed 50 mg, and he was wired on it.
Any insight into that 200 mg high dosage? It scares me to death. Saxton is 14.08 lb 14.1.3 lb oz 6.390 kg (ideal weight) for him.
THANK YOU!
Holly, Purrkins & Sexy Saxton
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Gabapentin is very safe but that dosage is high. I typically have people give 100 mg the night before the appointment then repeat 100 mg the next day at least 2 hours prior to the visit if possible. 200 mg is probably okay I have just not gone that high even in a Maine Coon cat. I have also used low dose trazodone if needed which our cardiologist here says is safe and does not affect the echo results.
Pam
Thank you Dr, Pam yes, it is HIGH, and that was my concern!
After voicing my concerns, I have since heard back from our vet (feline- only).
I had also suggested the loading dose as you do. I read that on the fear-free site here. https://fearfre.....7-18-1.pdf
I will post her response below in case it could help another soul one day
We can try 100mg gabapentin first and cerenia.
Gabapentin is one of the safest drugs out there. For really anxious and aggressive cats I have tried up to 300mg.
Yes, he will be sedated, wobbly but it's temporary and will prevent Saxton from getting stress out. We can try 100mg as a starting point but know we have room to help him. Gabapentin will not alter his cardiac function or blood pressure.
Keep me posted when you try it, and we will find a good and safe cocktail for Saxton.
We will try the 100mg with cerenia to see how he responds and see if an increase is warranted. It may be Saxton has blown through all we have tried to date. Our vet will be available for us if, for some reason, we need her; that takes the weight off of me.
Thank you for your time and insight, Dr.Pam it's much appreciated!
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I wanted to update this thread to say we trialed the Gaba 100 mg evening dose and 100 mg morning. Unfortunately, it was not enough medicine for Saxton. Our vet came to the home to assess Saxton. We did a trial drive, and his resting respiratory rate went up.
So we ended up doing 100 mg the night before our appt and 200 mg the morning of, plus 8 mg cerenia.
Saxton did well and got to and from the cardiologist appt without incidence, thanks to the high dosage of Gaba. So if anyone researches and finds this, the mix worked for our Saxton, a critical cardiac patient.
Thank you, Dr. Pam!
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Holly thank you so much for letting us know what worked. It's super valuable information for cat parents especially. Your vet was so generous to work with you in the way that she did to dial in the dose. YAY FOR EXTRA PAWESOME VETS!
And YAY for Saxton feeling calm at the cardio appointment! WHEW!
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