NU03 - Effect of Sedation on Kidney Function Markers in Cats with Chronic Kidney Disease

Abstract:

Background: Previous studies had shown that sedation does not adversely affect kidney function in healthy cats, but the effect of study protocol on cats with chronic kidney disease (CKD) is unknown.

Objectives: To determine the short-term effects of sedation on markers of glomerular filtration rate (GFR) in cats with CKD. Animals: Client-owned cats with CKD undergoing routine abdominal sonography.

Methods: Prospective observational study. Each cat received a standard sedation protocol of oral gabapentin, butorphanol and midazolam intramuscularly, followed by alfaxalone intravenously to effect. Pre- sedation blood tests included haematology and biochemistry. A second blood test for GFR markers (symmetric dimethylarginine [SDMA] and creatinine) only was collected at the point of maximum sedation (20 cats) or two hours post-sedation (12 cats).

Results: Thirty-two cats (age 15 years median, range 7–20) had pre-sedation SDMA and creatinine concentrations of 19 µg/dL median (Q1–Q3 14.5–23) and 200 µmol/L median (Q1–Q3 147.5–260) respectively. There was no significant difference between pre-sedation and samples obtained at the point of maximal sedation (SDMA 19 µg/dL median, Q1-Q3 15–24.5, p=0.31; creatinine 200 µmol/L median, Q1–Q3 147.5–255, p=0.71) or two hours post-sedation (SDMA 25 µg/dL median, Q1–Q3 20–26, p=0.51; creatinine 200 µmol/L median, Q1-Q3 175–280 ,p=0.06). The main adverse effect was prolonged sedation after discharge in some cats.

Conclusion: Sedation with a combination of gabapentin, butorphanol, midazolam, and allfaxalone appeared adequate for cats with underlying CKD to complete routine, non-invasive diagnostic procedures and is not associated with short term changes in markers of GFR.