Managing Anxiety in Cats

Approximately 50% of owned cats receive annual veterinary care. A significant contributor to this low level of care is the stress caused by transportation and examination, especially for fractious patients. Following a stressful experience, owners may avoid further visits.

There are few good options for oral anxiolytics in cats. Trazodone is a serotonin antagonist and reuptake inhibitor used as an antidepressant, anxiolytic, and hypnotic agent in humans. In dogs, studies have demonstrated acceptable safety and anxiolytic efficacy. This pilot study examined the safety and efficacy of single-dose oral trazodone for sedation in cats. Six laboratory cats, 5 already conditioned to willingly enter carriers, were treated with 50-mg, 75-mg, and 100-mg doses of trazodone and a placebo in this crossover study. Each cat served as its own control. Doses were chosen based on commercially available tablet sizes.

Prestudy and poststudy physical examinations and laboratory evaluations showed no adverse effects attributable to trazodone. Medication was given in food 90 minutes before planned examination. Sedation was assessed based on activity measured by activity observations and by accelerometers. The mean latency-to-peak-sedation value for trazodone (100-mg) occurred at 2 hours. There was a significant decrease in observed activity with the 100-mg trazodone dose compared to placebo. However, scores for behavioral response (eg, vocalization, struggling, aggression, hypersalivation, immobility response, open-mouth breathing) to examination did not differ between treatments and placebo, perhaps because of premature timing of examinations. Further study is needed before oral trazodone use in cats can be recommended.

The importance of reducing stress during transportation in cats cannot be underestimated. In a recent 2-year period (2011-2012), 64 pets died during airline transportation.¹ In humans, there is a link between stress or anxiety and cardiac arrhythmias² and it seems plausible that an animal’s response to a highly stressful experience could result in similar consequences and/or play a role in transportation stress. This proof-of-concept study showed, most importantly, that the sedation observed in cats after oral trazodone is worthy of follow-up studies. It is unclear how useful this drug will be with the slow (≈2 h) onset and unspecified duration. More detailed safety and efficacy studies as well as pharmacokinetic data in the cat are necessary before it should be recommended to pet owners for alleviation of transport stress.—Paula F. Moon-Massat, DVM, DACVAA