Quick sedation gets a fresh look in dogs and cats

CURRENT FULL VERSION: A March 17 episode of Dr. Andy Roark’s How Do You Treat That? podcast zeroes in on one of small animal practice’s most practical questions: how to safely sedate dogs and cats for short procedures without turning every radiograph, wound repair, or diagnostic workup into a full day of anesthesia. Guest Tasha McNerney, CVT, VTS (Anesthesia & Analgesia), frames the conversation around reversible sedation, multimodal pain control, airway protection, feline-specific planning, and using local anesthesia to carry more of the burden during painful procedures. Roark sets it up as a real-world general practice problem shaped not only by medicine, but also by time and client finances, including cases where otherwise healthy patients need anything from low-pain handling to more involved wound cleaning and suturing without the resources for full anesthesia. (drandyroark.com)

That focus fits with a broader shift already underway in companion animal medicine. Over the past several years, veterinary guidance from groups including AAHA and AAFP/ISFM has pushed clinics toward lower-stress handling, pre-visit pharmaceuticals, and sedation plans tailored to fear, anxiety, stress, procedure type, and patient health, rather than relying on physical restraint alone. AAHA’s sedation and premedication materials, for example, outline options ranging from oral gabapentin, trazodone, and oral transmucosal dexmedetomidine for lower-FAS cases to injectable dexmedetomidine, opioids, benzodiazepines, alfaxalone, or ketamine-based combinations when deeper sedation is needed. (aaha.org)

What’s notable about the Roark-McNerney discussion is that it translates that framework into a workflow question many general practices wrestle with every day: what’s enough sedation for a “quick” case, and how do you get there efficiently and safely? The episode specifically distinguishes between healthy pets needing sedation for low- or no-pain procedures and those needing a deeper, analgesia-forward plan for more invasive short interventions. The episode description highlights reversible protocols, opioid-dexmedetomidine combinations, local blocks, and selective ketamine use, suggesting an approach that prioritizes analgesia and controllability, not just immobilization. That distinction matters because a painful or fearful patient may need more than a tranquilizer; they may need a plan that addresses both distress and nociception. (drandyroark.com)

The wider literature supports that direction. In cats, oral trazodone and gabapentin both have evidence for reducing transportation and examination stress, and newer work suggests trazodone alone or combined with gabapentin can produce measurable sedation in healthy feline patients. Pregabalin oral solution, marketed in the U.S. as Bonqat, is the first on-label feline option for acute fear and anxiety associated with transportation and veterinary visits, with labeled administration about 90 minutes before the stressful event. Meanwhile, recent canine research has also explored oral transmucosal acepromazine and combinations that include gabapentin, melatonin, or acepromazine for anxious or aggressive dogs. (todaysveterinarypractice.com)

Industry and clinical commentary has been moving in the same direction. Today’s Veterinary Practice has described sedation as a welfare tool that can improve care quality rather than a sign that a patient is “difficult,” and has highlighted practical protocols such as trazodone-gabapentin combinations and transmucosal dexmedetomidine in selected cases. That aligns with behavior-focused guidance that encourages clinics to think about sedation upstream, including pre-visit medication plans, quieter intake, and minimizing escalation before the patient reaches the treatment area. Roark’s related discussions on managing lunging, high-FAS dogs and on technician moral distress point to the same operational reality: when teams rely on force-forward handling in fearful or painful patients, the consequences are not just medical but behavioral, ethical, and staffing-related. (todaysveterinarypractice.com)

Why it matters: For veterinary professionals, this is a reminder that quick sedation is no longer just an anesthesia topic, it’s a workflow, safety, and client-communication issue. Short procedures can become prolonged, risky, and emotionally costly when teams try to “push through” fear or pain with manual restraint. A more intentional sedation strategy can reduce staff injury risk, improve diagnostic quality, support spectrum-of-care decision-making, and make it easier for pet parents to say yes to needed care when the plan feels controlled and humane. It may also help address a less discussed pressure point in practice: the cumulative strain on technicians and assistants asked to physically manage high-FAS or painful patients when better chemical restraint options may exist. The caveat is that these protocols still require patient-specific judgment, especially in brachycephalic animals, medically compromised patients, and cats or dogs with renal, hepatic, or cardiovascular concerns. (drandyroark.com)

What to watch: The next step isn’t likely to be a single breakthrough product so much as wider adoption of layered protocols, better pre-visit medication planning, and more clinic-level training on when to use oral, transmucosal, injectable, reversible, or fully anesthetic approaches for short procedures. Expect that conversation to stay tied not only to patient welfare and efficiency, but also to safer handling of high-FAS dogs and a broader push to reduce avoidable moral distress on veterinary teams. (drandyroark.com)