Veterinary Professionals

Oral Anti-Anxiety Medicines

Veterinary Professionals

Guidance for Referring Veterinary Surgeons

Pre-Referral Use of Oral Anxiolytic and Sedative Medication

At NDSR, we are committed to delivering care that prioritises patient welfare, low-stress handling, and safety throughout the referral process.

We recognise that for some patients, particularly those that are anxious, fearful, or difficult to handle, pre-referral anxiolytic or sedative medication can significantly improve both:

  • The journey to the hospital, and
  • The consultation and handling experience on arrival

We fully support the use of your clinical judgement in selecting appropriate medication based on the individual patient.

Please update us of any anti-anxiety medications planned for your patient, and ask the owners to bring the medication boxes with them, and record the time of medication administration.

A nurse with a relaxed patient

General Principles

  • Aim for anxiolysis first, sedation second
  • Time administration to allow peak effect on arrival
  • Consider combination protocols where appropriate
  • Ensure owners are clearly instructed on timing and administration

Commonly Used Oral Agents

Trazodone (Dogs and Cats)

  • Dose (dogs): 2–8 mg/kg PO every 8–12 hours
  • Dose (cats): 25mg per cat PO (can be titrated to effect up to 100mg per cat)
  • Onset: Peak effect 1–2 hours

Key considerations:

  • Avoid in significant hepatic dysfunction
  • Use caution with serotonergic drugs (risk of serotonin toxicosis)

Gabapentin (Dogs and Cats)

  • Dose (dogs): 10–30 mg/kg PO
  • Dose (cats): 10–20 mg/kg PO (commonly ~100 mg/cat)
  • Timing: 1–3 hours before event

Key considerations:

  • Short half-life (< 4 hours)
  • Dose reduction in renal disease (cats)

Pregabalin (Cats only – UK licensed)

  • Dose: 5 mg/kg PO single dose
  • Timing: ~1.5 hours before event
  • Duration: Up to 7 hours

Key considerations:

  • Use cautiously in renal disease

Tasipimidine (Tessie®) (Dogs only)

  • Dose: 30 mcg/kg (special dosing syringe)
  • Onset: ~1 hour
  • Duration: ~3 hours

Key considerations:

  • May cause vomiting, lethargy, bradycardia
  • Monitor cardiovascular effects

Dexmedetomidine Oromucosal Gel (Sileo®) (Dogs only)

  • Administration: Transmucosal (buccal).  Dose expressed in “dots” on dosing syringe (0.25 mL per dot), syringe-dosing instructions provided by manufacturer on a patient weight basis.  Must not be swallowed by the patient (reduced efficacy).  Use gloves when handling
  • Onset: 30–60 minutes
  • Redosing: ≥2-hour intervals

Key considerations:

  • Avoid in cardiac, respiratory, hepatic, or renal disease

Patients Requiring Additional Consideration

Additional care should be taken in patients with:

  • Hepatic, renal, or cardiac disease
  • Neurological conditions
  • Severe systemic illness
  • Polypharmacy and drug interaction risk
  • Geriatric or paediatric status
A nurse with a very sedated patient

Anaesthesia Team Support

If there is any uncertainty regarding:

  • Drug selection
  • Dosing strategies
  • Contraindications or safety

We strongly encourage discussion with our Anaesthesia Team.

📧 [email protected]

We are very happy to provide case-specific guidance to ensure safe and effective pre-referral management.

Our Approach

Our goal is to ensure that every patient arrives:

  • Calm and settled
  • Safe to handle
  • Experiencing minimal stress

Effective pre-visit anxiolysis can a key part of achieving a low-stress, patient-centred referral pathway.