Veterinary 2025 Guide: Lorazepam (Ativan®) Use in Dogs & Cats 🐾🩺

Hello, I’m Dr Duncan Houston BVSc. In this 2025 guide, we explore the off-label use of lorazepam (Ativan®) in dogs and cats—covering its applications for anxiety, fear-triggered events, seizure emergencies, dosing strategies, side effects, monitoring, withdrawal, and client guidance, all supported by Ask A Vet 😊.

🔍 1. What Is Lorazepam?

Lorazepam is a human-approved benzodiazepine (Ativan®, Intensol®), used extra-label in veterinary medicine for situational anxiety, noise phobias (e.g., storms, fireworks), and emergency seizure control via IV or intranasal routes :contentReference[oaicite:3]{index=3}.

⚙️ 2. Mechanism of Action

It enhances GABAergic activity in the CNS, producing sedation, muscle relaxation, anxiolysis, anticonvulsant, and amnesic effects :contentReference[oaicite:4]{index=4}.

🎯 3. Clinical Applications

• Anxiety/emergent fear episodes: Administer 0.01–0.045 mg/lb (0.02 mg/kg) PO ~1 hour before the event :contentReference[oaicite:5]{index=5}.
• Status epilepticus/cluster seizures: Single injection 0.09 mg/lb (≈0.2 mg/kg) IV/IM/IN under veterinary supervision :contentReference[oaicite:6]{index=6}.
• Appetite stimulation in cats: Off-label use with careful monitoring :contentReference[oaicite:7]{index=7}.

💊 4. Dosing & Administration Tips

• PO tablets or liquid—give with or without food (food reduces GI upset) :contentReference[oaicite:8]{index=8}.
• Oral dosage once or twice daily for short duration (typically 2–4 weeks) :contentReference[oaicite:9]{index=9}.
• Injectable forms are for veterinary use only and not intended for home administration by owners :contentReference[oaicite:10]{index=10}.
• If using long-term, taper dose gradually (reduce by ~25% weekly) to avoid withdrawal seizure or rebound anxiety :contentReference[oaicite:11]{index=11}.

⚠️ 5. Common Side Effects & Risks

• Sleepiness, incoordination, muscle weakness, drooling—especially during acute dosing :contentReference[oaicite:12]{index=12}.
• Paradoxical effects: hyperactivity, aggression, increased anxiety—monitor behavioral response :contentReference[oaicite:13]{index=13}.
• Appetite stimulation, particularly in cats :contentReference[oaicite:14]{index=14}.
• Rare but serious respiratory depression in compromised pets; avoid in brachycephalic or respiratory-diseased dogs without monitoring :contentReference[oaicite:15]{index=15}.
• Dependence and withdrawal risk if used long-term—taper gradually to avoid tremors, rebound anxiety, or seizures :contentReference[oaicite:16]{index=16}.

🚨 6. Contraindications & Precautions

• Avoid in pets with narrow-angle glaucoma, severe respiratory disease, hepatic or renal insufficiency, or benzodiazepine hypersensitivity :contentReference[oaicite:17]{index=17}.
• Use caution in working or aggressive dogs due to potential disinhibition :contentReference[oaicite:18]{index=18}.
• Pregnant or nursing animals should only receive lorazepam under veterinary guidance due to CNS depression in neonates :contentReference[oaicite:19]{index=19}.

🔄 7. Drug Interactions

Interactions with other CNS depressants (opioids, antihistamines), fluoxetine, itraconazole, antihypertensives, diuretics, and theophylline—monitor for additive sedation or altered drug levels :contentReference[oaicite:20]{index=20}.

📊 8. Monitoring & Home Care

• Track behavior, sedation level, ataxia, and appetite daily.
• If used long-term, schedule veterinary checks every 2–4 weeks, including neurologic and physical exam.
• Taper gradually upon discontinuation over 2–4 weeks depending on duration of use :contentReference[oaicite:21]{index=21}.
• Ensure safe storage: locked cabinet, cool/dry environment, refrigerated liquid, preventing human misuse :contentReference[oaicite:22]{index=22}.

🛠 9. Client Education Tips

• Explain extra-label status, controlled substance laws, storage, and disposal regulations.
• Demonstrate proper administration—tablet, liquid, or full measure for injectable if used in clinic.
• Stress that it should only be used for situational anxiety or seizures, not as a daily “calming” routine.
• Use the Ask A Vet app for timing reminders, logging effects, taper scheduling, and direct vet messaging 😊.

📌 10. 2025 Vet Takeaways

• Lorazepam is a fast-acting benzodiazepine ideal for acute anxiety or seizure intervention.
• Low dose, short-term PO use (0.02 mg/kg) with proper taper minimizes risk.
• Monitor for sedation, paradoxical behaviors, and respiratory compromise.
• CNS depressant interactions and dependence risk demand careful oversight.
• Enhance owner compliance and safety using Ask A Vet tools ❤️.

At Ask A Vet, we provide dosing trackers, anxiety/log journals, taper schedules, and 24/7 vet access to support responsible lorazepam use. Download the app today to empower your clients and protect their pets 😊