Short-term effect of sedation on kidney function markers in cats with chronic kidney disease.

Gabapentin, butorphanol, midazolam, and alfaxalone sedation does not acutely alter GFR markers in CKD cats.

This prospective observational study evaluated the short-term effects of a multimodal sedation protocol on glomerular filtration rate (GFR) markers—symmetric dimethylarginine (SDMA) and creatinine—in client-owned cats with chronic kidney disease (CKD) undergoing abdominal ultrasonography. Thirty-two cats with confirmed CKD received oral gabapentin (50 mg), intramuscular butorphanol (0.3 mg/kg) and midazolam (0.3 mg/kg), followed by intravenous alfaxalone (1 mg/kg) to effect. Blood samples for SDMA and creatinine were collected at baseline and either at the point of maximum sedation (n=20) or two hours post-sedation (n=12). In both groups, neither SDMA nor creatinine concentrations showed statistically significant changes compared to presedation values (all P > 0.05). The only notable adverse effect was prolonged sedation duration in a subset of cats. These findings suggest that this sedation protocol does not acutely compromise renal function as measured by established GFR biomarkers, making it a viable option for CKD-affected cats requiring noninvasive diagnostic procedures. Limitations include the relatively small sample size, lack of a control group, short observation window, and the inability to assess longer-term renal outcomes. Nonetheless, the study provides clinically relevant reassurance for practitioners who may otherwise hesitate to sedate renally compromised feline patients, offering a practical and apparently safe protocol for routine diagnostic workups in this vulnerable population.

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