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The root cause of aggressive behavior in cats at the vet office is fear, and fearful cats are fractious cats.Fractious cats are a danger to themselves, as well as to our techs and doctors who have to examine and restrain them.Obviously I would prefer for the dyspneic patient to receive oxygen before, during, and after all interventions, but you've probably noted that some patients will struggle even if you are trying to blow some oxygen in their face; they may need sedation before you can even examine them.My concoction of choice for sedating cardiac patients, both dogs and cats, is diazepam (Valium) and butorphanol, 0.2 mg/kg of each, mixed for an IV injection (stings if given out of the vein).I don't know if the decreased respiratory drive may actually be an advantage, decreasing the stress associated with the patient's perceived need for oxygen.In any case, it's my strong belief that you will come out on the positive side of the risk/benefit ledger using this combination.Gabapentin comes in a pre-loaded syringe in liquid form. We recently examined and treated a feral cat who had been pre-medicated with this drug and she was an absolute breeze to handle.Gabapentin does not cause full sedation, but causes a cat to be a little slow. Danna said the best way to describe the effects is that it makes the patient indifferent. For safety, owners should know that a cat treated with gabapentin may be woozy or uncoordinated until the medication wears off.

This can be enough of a problem that I would think twice about using the above if the patient is already bradycardiac.

Call the office to reserve a syringe for your fractious cat!

Many veterinarians are apprehensive about sedating an animal with a potential heart problem, particularly one that is dyspneic.

It takes away enough stress so that you can accomplish critical procedures, such as those listed above, but the patient will still be able to stand, walk, or go home with the client (if appropriate) right after you're done.

This is also my choice for pre-anesthesia in cardiac patients; more on this in another article.

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