Pregabalin for cats: Uses, dosage, and side effects

In this article:

• What is pregabalin used for in cats?
• Safety
• Dosages
• Alternatives

In this article

• What is pregabalin used for in cats?
• Safety
• Dosages
• Alternatives

Pregabalin is a generic prescription that veterinarians primarily use to alleviate anxiety and fear when cats are transported or facing a veterinary visit. Less commonly, veterinarians use pregabalin to treat chronic pain or seizure disorders in cats. Pregabalin is a drug very similar to gabapentin, another antiseizure drug often used for chronic pain. 

RELATED: Save up to 80% on pregabalin

What is pregabalin used for in cats?

Pregabalin is an anticonvulsant that veterinarians primarily use as an anxiolytic (anxiety medication) in cats and sometimes as an analgesic (pain reliever). As an anxiety medication, pregabalin is FDA approved in cats for the alleviation of situational anxiety, particularly travel anxiety or veterinary visits. Veterinarians may also use pregabalin off-label to relieve chronic pain or prevent seizures, but they prefer to use other medications for these problems. For these problems, pregabalin is a viable choice as a standalone or add-on treatment when other medications don’t work.

Anxiety

The FDA has approved Bonqat, a liquid version of pregabalin, to treat cat anxiety provoked by travel or veterinary visits. Veterinarians may prescribe regular pregabalin capsules off-label for the same purpose.

Pregabalin relieves feline anxiety by slowing down and weakening nerve signals. It accomplishes this by reducing neurotransmitter concentrations at the junctures between nerves. This mechanism of action also relieves nerve pain (neuropathies) or prevents seizures.

Caregivers will administer one oral dose about one and a half hours before travel or a visit to a veterinary clinic. Most cats will require just one dose, but a second dose can be given the next day if the cat is still traveling.

Chronic pain

Pregabalin is not a veterinarian’s first choice as a chronic pain reliever. Opioids and nonsteroidal anti-inflammatory drugs are typically the first pain relievers veterinarians use in cats. 

Both gabapentin and pregabalin are used in people to treat chronic neuropathic pain like back pain. In veterinary medicine, pregabalin is primarily used to treat chronic osteoarthritis pain in dogs. Unfortunately, there is no evidence that either gabapentin or pregabalin is effective at treating chronic pain in cats, so veterinarians are less likely to rely on the drug.

Seizure disorders

A seizure is a short-lived neurologic problem in which multiple nerve pathways fire at the same time. Some seizures are mild, like temporarily “blanking out,” and some may be severe, involving loss of consciousness and convulsions. 

When seizures happen frequently, veterinarians diagnose the cat with a seizure disorder. About 16 in 10,000 cats are diagnosed with a seizure disorder, but many cats go undiagnosed.

There are many types of seizure disorders based on where in the brain the seizure occurs and what happens during a seizure. Veterinarians use medications called anticonvulsants to reduce the frequency of recurrent seizures. Some drugs can treat most seizure disorders, while others work best at preventing some types. 

When it comes time to start a drug, veterinarians use just one drug (monotherapy) in order to minimize side effects. If that one drug doesn’t work at controlling seizures, veterinarians add another anticonvulsant to the mix.

Pregabalin is one such add-on or “adjuvant” treatment for refractory seizures in cats. However, it’s not at the top of the list because it hasn’t been proven effective in cats. Cats will typically use other drugs—including gabapentin—as add-on treatments first. 

Is pregabalin safe for cats?

Veterinarians consider pregabalin safe for healthy cats. Side effects are minimal. The most common problems cats experience are tiredness and coordination problems. 

Pregabalin is not safe for any cat that has had an allergic reaction to pregabalin.

Veterinarians are cautious about using pregabalin in cats with kidney problems.

Side effects of pregabalin in cats

In clinical trials, the most commonly reported side effects of pregabalin in cats were:

• Incoordination (ataxia)
• Lethargy
• Vomiting

Possible severe side effects include:

• Low body temperature
• Depression
• Extreme sleepiness
• Severe incoordination

If the cat has any of these symptoms, keep the cat warm and allow the drug to wear off. These symptoms should resolve in four to six hours.

Although not listed as possible side effects in cats, the most serious adverse reactions of pregabalin in people are:

• Kidney dysfunction
• Slowed breathing
• Swelling
• Eye problems
• Slight changes to heart rhythms

Interactions of pregabalin with other pet meds

To avoid possible drug interactions, tell the veterinarian about all the drugs, supplements, and herbal remedies the cat is being given, particularly: 

• Other CNS depressants such as opioids, benzodiazepines, sedating antihistamines, or CBD (cannabidiol)
• ACE inhibitors such as benazepril or enalapril
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Pregabalin dosage for cats

Veterinarians use pregabalin for anxiety, chronic pain, or seizures. The published dosages are:

• For situational anxiety (travel or vet visits): 5 mg/kg given once 1.5 hours before travel—a second dose can be administered the next day
• For chronic pain: 1–2 mg/kg given twice daily 
• For seizure disorders: 1–2 mg/kg given twice daily 

The FDA has approved a pregabalin oral solution (Bonqat) for use in cats for acute anxiety brought on by travel or veterinary visits. Human formulations of pregabalin oral solution are also available.  

Pet owners can also purchase pregabalin capsules made for people, including a brand-name version called Lyrica. The dosage strengths may be too high to accurately dose a cat. The lowest dosage strength is 25 mg per capsule. A 10-pound cat would require a 25 mg dose for situational anxiety, but a 5 or 10 mg dose for pain or seizure disorders. 

A compounding pharmacy can provide lower-dose capsules. 

Can cats overdose on pregabalin?

The maximum pregabalin dosage for cats is 5 milligrams per kilogram of body weight (about 2.5 mg per pound) given as a single dose. 

Contact an animal poison control center or talk to a veterinarian if a cat is given too much pregabalin. Although overdoses have not been studied in cats, a pregabalin overdose can cause seizures, heart block, or death in a person. 

Possible signs of an overdose are severe tiredness, lack of coordination, and hypothermia.  

Can I give my cat pregabalin every day?

Pregabalin is only FDA-approved as a single-dose treatment for situational anxiety in cats. Doses are high and may sedate the cat, so they are not appropriate for daily use. 

Pregabalin is not commonly used for seizures or chronic pain. If it is, veterinarians will use it as a long-term treatment. Cats with seizure disorders usually take anticonvulsants like pregabalin for life.

How to give your cat pregabalin

Veterinarians usually prescribe pregabalin to cats on an as-needed basis to alleviate acute anxiety or fear due to a stressful event. Most pet owners will do no more than give a single dose of pregabalin every once in a while.

• Give this medication as prescribed.
• Do not increase the dose or give doses more frequently than prescribed.
• Give doses with or without food.
• How to administer Bonqat CV oral solution:
  • Please read the Client Information sheet that comes with this medicine.
  • Always use the dosing syringe provided with the medicine to measure doses.
  • Cats weighing more than 22 pounds may require that two doses be measured and administered. The dosing syringe can only hold 1 milliliter of the oral solution.
  • If you don’t know how to administer liquid medicine to a cat, ask a veterinary assistant to demonstrate the proper procedure.
  • Store Bonqat oral solution in the refrigerator.
  • Bonquat oral solution can also be stored at room temperature below 77˚for up to 30 days.
  • Throw away any unused medicine six months after opening the bottle. 
• How to administer pregabalin capsules:

• • If you don’t know how to give a cat capsules, ask a veterinary assistant for a demonstration.
  • Store pregabalin capsules at room temperature. 
• Pregabalin is a controlled substance in some states because of the risk of abuse, dependence, or harm to other people. Keep pregabalin in a child-proof container out of the reach of children and other people.

Pregabalin alternatives for cats

For situational anxiety, veterinarians have a variety of medications to choose from, including:

• Benzodiazepines such as alprazolam
• Trazodone
• Gabapentin

Alternative natural treatments include pheromones or cat-calming treats. 

For epileptic cats, the first drugs a veterinarian will try are phenobarbital, zonisamide or levetiracetam. 

Pregabalin is never used as a first-line treatment but added to a first-line drug if the cat continues to have seizures. Alternatives to pregabalin in treating epileptic cats include:

• Levetiracetam
• Gabapentin
• Clonazepam
• Topiramate

For chronic pain management, veterinarians typically start with nonsteroidal anti-inflammatory drugs (such as meloxicam or robenacoxib) and opioids (such as buprenorphine). Pregabalin is typically used as an add-on treatment if these first-line treatments don’t adequately control pain. 

Besides pregabalin, second-line treatments include:

• Amantadine
• Amitriptyline
• Gabapentin
• Prednisolone

Alternative chronic pain therapies include dietary changes, supplements, and exercise.

Summary

Veterinarians most commonly use pregabalin in cats as a mild sedative before the stress of travel or a veterinary visit. They may also use it for seizure control or chronic pain. It is a safe drug for cats, but it’s only been proven effective for situational anxiety. Pregabalin can make cats sleepy, clumsy, or cold, so cat owners should monitor their cats for side effects.