Brand names: Bonqat,® Lyrica®

Availability: This medication comes in capsules, tablets, and an oral solution.

Make sure liquid formulations do not contain xylitol, which is unsafe for pets. 

Background

Pregabalin has been used in human medication mostly for nerve pain and can be similarly used for pets. It came into veterinary use in 2024 when it was approved for cats needing help with transport anxiety. Many cats do not receive proper routine medical care because of fear of pet carriers and stress associated with transport and the veterinary profession has been seeking techniques to improve feline well-being and alleviate veterinarian visit anxiety for some time.

Gabapentin, a related compound, has been in use for some time and has helped tremendously, but its sedation side effect has been undesirable. Pregabalin works similarly but has much less potential for sedation. Bonqat® was designed for feline use with feline-friendly flavoring and packaging for short-term use.

How This Medication Works and How It Is Used

Pregabalin became available as a successor to gabapentin and is also used to control several other neurologic conditions, including neuropathic pain, a type of pain caused by nerves. More recently, pregabalin has been useful to control anxiety in animals, especially when being transported. Pregabalin is structurally similar to gamma amino butyric acid (GABA), a chemical messenger in the brain that reduces brain activity.

Originally, it was thought that pregabalin acted like GABA. However, pregabalin appears to accomplish most of its actions by altering how calcium enters nerve cells, which is different than other drugs used to control seizures, pain, or anxiety. This makes pregabalin especially useful when it is combined with other drugs.

For seizures (usually in dogs), twice daily use is typical.

For transport anxiety in cats, a single dose is used one and a half hours before transport, and the effects last approximately 14 hours.

Pregabalin may be given to a cat on two consecutive days.
If a dose is skipped accidentally, pick up with the next scheduled dose and do not double up. Do not re-dose if the cat vomits or spits out the medication.

Pregabalin works best on an empty stomach and must be refrigerated.

Side Effects

• While pregabalin has less potential for sedation than gabapentin, it still has some potential for sedation. 
• As with most oral medications, GI side effects such as nausea, reduced appetite loss, or diarrhea may occur.
• Liver enzymes may increase incidentally on blood testing. It may be useful to check baseline levels for comparison.
• Serious side effects have not been reported, but there are cautions about using pregabalin with concurrent medical problems (see below).

Interactions With Other Drugs

Concurrent use with opiates (or other medications with tranquilizing side effects) will increase the potential for sedation.

Concerns and Cautions

• Pregabalin was not tested in cats under seven months of age or in cats with high blood pressure, heart disease, or kidney disease.
• Pregabalin has not been tested in pregnant or nursing animals.
  Pregabalin works best on an empty stomach. Food can delay the onset of action.
  If used long-term, pregabalin should not be abruptly discontinued. It should be tapered off.
  The Bonqat® product is good for six months after opening if refrigerated but only one month after opening if kept at room temperature.