2015 AAHA Canine and Feline Behavior Management Guidelines
Medications for fearful dogs and cats
Anxiolytic medications or sedatives can make veterinary visits less stressful for canine and feline patients. Some medications can also provide chemical restraint when needed. The following medications are suitable for administration by the owner the day before and the day of the exam: BZDs (e.g., alprazolam, midazolam, lorazepam), gabapentin, SARIs (e.g., trazodone), and clonidine. All of those medications can be used with dexmedetomidinec (a 2A-agonist class sedative) and atipamezoled (a 2A-antagonist reversal agent). All of those medications can be given q 12–24 hr or as needed for veterinary visits.
BZD dosing is highly individualized, and trial and error is needed to find the best dose for each patient. BZDs are given 1–2 hr before the exam and repeated 30 min before the exam. Whole or half-dose increments can be given to achieve optimal dosages. Most BZDs are scored and easily cut. For patients that do not take tablets well, BZDs can be made into a paste with a small amount of liquid and immediately smeared on the gums or tongue. As soon as the patient licks or swallows, the medication enters the system.
Maropitant citratee is approved for use in dogs and may quell nausea associated with travel to a veterinary exam. Maropitant citrate in a weight-adjusted dose can be given in tablet form 1–2 hr before an appointment. For mild sedation of cats, oral chlorpheniramine given q12–24 hr or phenobarbital given 1 hr prior to travel (and repeated during travel if needed) are appropriate medications. Recommended canine and feline dosages for medications are described in detail elsewhere. 14
The time to prevent difficulties in administering medication is when the patient is a puppy or kitten. All patients should be taught at an early age to take pills or liquid medications in real or placebo form.