Pre-Visit Pharmaceuticals (PVPs): reducing fear, anxiety, and stress
Your veterinary team may have recommended a "PVP", or pre-visit pharmaceutical, for your pet to reduce feelings of fear, anxiety, and stress (FAS) associated with a veterinary visit. Some pets are more nervous than others about their visits to the vet - this is understandable as we are expecting your pet to quickly adapt to a new environment with unfamiliar sights, sounds, and smells. Even the car ride to the hospital can be upsetting for some of our pets - especially cats! Adding in physical touch from an unfamiliar person (a vet team member) or an uncomfortable procedure like a vaccine, and any animal can become quickly overwhelmed by feelings of fear, anxiety, and stress. If these feelings are not addressed early on, subsequent visits can lead to heightened levels of FAS and reactivity.
If you have a pet that is scared and stressed, there are safe medications that you can give in advance of the appointment to make their visit to the vet more enjoyable, less stressful, and ultimately more successful. The medications are intended to address specific neurotransmitters associated with fear, anxiety, or stress so that your veterinary team can work to change the way your pet feels about specific procedures such as being handled or receiving a vaccination. The PVP medications that we recommend have been documented, studied, and practiced in veterinary behavior literature and in veterinary practices for years and are considered safe for use.
Pets who have received PVP medications will feel more relaxed and comfortable during the journey to the hospital, throughout the visit, and during the return trip home. Although they might appear quite sleepy at home, the car ride and time in a vet hospital are often stimulating enough that your pet remains alert but more accepting of a complete examination, diagnostic testing and/or treatments without a struggle. It is important to us that we are able to help take care of your pet's physical and mental wellbeing!
Common short-acting PVPs that we prescribe include Gabapentin and Trazodone.
Gabapentin is a medicine that has been traditionally used to reduce seizures and neurological pain. Because it inhibits the release of excitatory neurotransmitters, we often also use it to reduce anxiety. We expect your pet to feel more calm and a little sleepy. Other than drowsiness and sometimes a wobbly gait, gabapentin has a low risk of side effects. It is quick-acting, taking effect 1-2 hours after oral dosing, and leaving the system within 12-24 hours.
Trazodone is an antidepressant medicine that regulates serotonin levels in the brain, resulting in mild sedation and lowered stress levels. We expect your pet to feel calm and a little sleepy. Side effects, although rare, include being more sedate than expected, or more anxious/excited than expected - this is why it is always best to do a trial at home so that you can monitor your pet's response to your vet's recommended dose. It is quick-acting, taking effect 1-2 hours after oral dosing, and leaving the system within 8 hours.
When a PVP medication has taken full effect, your pet is going to be quieter, less reactive, groggy, and possibly unsteady on their feet. Some pets might even feel so relaxed that they could experience some involuntary incontinence (particularly when sleeping overnight). It is a good idea to keep a close eye on your pet while they are medicated, especially if it is their first experience with a particular PVP or new dose of PVP. Please note any unusual effects and let us know if you have any questions or concerns. While some mild side effects are expected and not harmful, your vet may choose to adjust the dose or type of PVP if there are concerns.
You may also notice that your pet becomes more profoundly sedate while they are at home before your visit. This is because they are already quite comfortable and relaxed at home. During travel to and arrival at the hospital, however, they will become stimulated by the new sights, sounds, and smells around them. This stimulation might make them feel more scared and reactive, but with the help of their PVP buffer already in place they will hopefully feel more calm and relaxed.
The Peninsula Veterinary Hospital Team thanks you for working with us to support your pet's mental wellbeing. We are happy to answer any questions you have about PVPs!