Table 1.
Medication chart (continued on page 12)
| Dose range | Onset of action | Duration of action | Side effects | Contraindications | Author comments |
|---|---|---|---|---|---|
| GABAPENTIN
The authors have had success with the following pre-flight gabapentin protocol: giving the established dose q12h for 2-4 days before the flight and then the final pre-flight dose 90-120 mins prior to placing the cat in the travel carrier | |||||
| 5-25 mg/cat PO q8-12h for more frequent or regular use, with an ‘as needed’ dose range of 50-100 mg/cat PO q8-12h | 90-120 mins;
individual differences should be established during trial doses |
6-12 h; individual differences should be established during trial doses | Hypersalivation and vomiting, and, at higher doses, ataxia and sedation 49 | Patients with renal disease 50 | Anecdotally, veterinary practitioners likely use doses higher than those listed here for veterinary visits, but these are not necessarily suitable for air travel as more profound sedation and ataxia are not desired |
| PREGABALIN
The authors have not yet had the opportunity to use Bonqat (Orion Animal Health) as it is not yet available in their countries of practice, but this may be a good option for the future | |||||
| 5-10 mg/cat PO
q12h |
90-120 mins;
individual differences should be established during trial doses |
6-12 h; individual differences should be established during trial doses | Hypersalivation and vomiting, and, at higher doses, ataxia and sedation 49 | Patients with renal disease 50 | |
| TRAZODONE
The authors currently do not use trazodone very often due to its increased sedative effects | |||||
| 15-25
mg/cat PO q12-24h, or up to 50 mg/cat for ‘as needed’ usage 51 |
90-120 mins;
individual differences should be established during trial doses |
6-12 h; individual differences should be established during trial doses | Lethargy, sedation, vomiting, increased vocalisation, restlessness, agitation 52 | Cautious use in patients with cardiac disease; may lead to hypotension 53 | The pre-flight dose should be given 90-120 mins prior to placing the cat in the travel carrier |
| BENZODIAZEPINES
Benzodiazepines are not frequently utilised for air travel by the authors due to the risk of side effects, including ataxia and increased appetite during a period when food is being withheld, and as there are alternative medication choices available that pose less risk of side effects | |||||
| Alprazolam | |||||
| 0.125-0.25 mg/cat PO
q8-12h |
30-45 mins;
individual differences should be established during trial doses |
Short/medium: 2-6 h; individual differences should be established during trial doses | Sedation, ataxia, muscle relaxation, increased appetite (this may not be beneficial when food is being withheld for long periods due to travel), paradoxical excitation, disinhibition of behaviour, which may lead to aggression | Patients with hepatic or renal disease; doses should be decreased in older or obese patients with known sensitivity to benzodiazepines; pregnant or lactating females; cats with glaucoma; should not be used in conjunction with itraconazole or ketoconazole | |
| Clonazepam | |||||
| 0.25-1
mg/cat PO q12-24h |
45-60 mins;
individual differences should be established during trial doses |
Long: 8-12 h; individual differences should be established during trial doses | Sedation, ataxia, muscle relaxation, increased appetite (this may not be beneficial when food is being withheld for long periods due to travel), paradoxical excitation, disinhibition of behaviour, which may lead to aggression | Patients with hepatic disease due to extensive metabolism in the liver; patients with renal disease; patients with a known sensitivity to benzodiazepines; pregnant or lactating females; cats with glaucoma | |
| Diazepam | |||||
| 1-2.5
mg/cat PO (but avoid where possible in cats) |
45-60 mins;
individual differences should be established during trial doses |
Medium/long: up to 6 h; individual differences should be established during trial doses | Sedation, ataxia, muscle relaxation, increased appetite (this may not be beneficial when food is being withheld for long periods due to travel), paradoxical excitation, disinhibition of behaviour, which may lead to aggression | Oral diazepam has been associated with idiopathic hepatic necrosis in one case series 54 (single case series that has not been replicated) and is therefore not frequently used | |
| Lorzepam | |||||
| 0.125-0.25 mg/cat PO
q12-24h |
30-45 mins;
individual differences should be established during trial doses |
Short: 2-4 h;
individual differences should be established during trial doses |
Sedation, ataxia, muscle relaxation, increased appetite (this may not be beneficial when food is being withheld for long periods due to travel), paradoxical excitation, disinhibition of behaviour, which may lead to aggression | Cats with a known sensitivity to benzodiazepines; pregnant or lactating females; cats with glaucoma | |
| Oxazepam | |||||
| 1-2.5
mg/cat PO q12-24h |
45-60 mins; individual differences should be established during trial doses | Medium: 4-6 h; individual differences should be established during trial doses | Sedation, ataxia, muscle relaxation, increased appetite (this may not be beneficial when food is being withheld for long periods due to travel), paradoxical excitation, disinhibition of behaviour, which may lead to aggression | Cats with a known sensitivity to benzodiazepines; pregnant or lactating females | In animals with hepatic or renal disease, a benzodiazepine without active metabolites, such as oxazepam, is recommended |
| MAROPITANT (not an anxiolytic) | |||||
| 1 mg/kg SC or PO | 45-60 mins | 24 h | Diarrhoea, anorexia lethargy, sedation, pain at injection site 55 | Gastrointestinal obstruction, ingestion of toxins | Oral tablets may be cost-prohibitive in some countries |