Ultimate Guide to Understanding Gabapentin for Dogs
Gabapentin is a known drug to help your dog experiencing pain or stress management. It is a known anti-epileptic drug but as most over-the-counter medicine, this is not just something you can give to your dog without the right prescription as this is a drug that should be used with precaution.
The best thing you can do as a pet owner is to know and familiarize yourself with as to what the medicine is, its use, side effects and other facts so that if anything happens you would know what is the best way to handle it.
This article will guide you through what you should need to know all about Gabapentin.
- What is Gabapentin?
- How do you know if your dog is in pain?
- Treatment uses of Gabapentin in dogs
- Administration protocols
- Adverse effects of Gabapentin
- Important precaution
What is Gabapentin?
Gabapentin is considered an important drug in the management of severe and chronic neuropathic pain among dogs. Neuropathic pain is described as a kind of pain directly caused by a lesion on a nerve that affects the somato-sensory system of dogs, either at the peripheral or central nervous system.
Gabapentin is also used as a treatment to control dog seizures, either by itself or in combination with other anti-epileptic drugs. Available only as an oral medication, gabapentin is absorbed in the dog’s small intestine by a combination of diffusion and facilitated transport. Following oral administration, its transport from the gut is facilitated by a receptor linked to a saturable L-amino acid transport mechanism.
Gabapentin started out as a medicine used to treat seizures in humans, and was later on discovered to treat nerve pain. For the same reasons, it slowly found its way into veterinary treatment especially in treating dogs.
It is very important that dog owners know what course of action they should take when their dogs are attacked by seizure and or suffering from chronic pain. Moreover, dog owners will only be able to effectively tend to their pet’s painful condition if they know so well what treatment to give to their suffering pet. Thus, this article intends to serve as an ultimate guide to understanding how gabapentin works for dogs, including its potential risks and adverse effects, precautions to be made, and ways of administering it.
How Do You Know if Your Dog is in Pain?
Dogs display outward signs of pain differently. Some dogs will obviously communicate to their owners when they are hurt while other dogs are very enduring who won’t manifest any signs of pain. When signs of pain are subtle, it needs an expert gaze from a veterinarian to determine exactly the kind of pain that causes suffering to dogs.
Dogs suffering from mild pain are sometimes difficult to pinpoint, but a clue could be seen in the changes of the dog’s appetite and routine. But with more moderate pain, these following signs could become noticeable:
- Inability to jump like they used to
- Loss of stamina
- Laying down
- Lack of energy
In most cases, moderate pain can be well-controlled by gabapentin combined with other NSAIDs. Old arthritic dogs who can no longer climb stairs began to go up gradually with little struggle, and began to play again by just using these two drugs.
With severe pain, signs could change into:
- Loss of appetite
- Intense pain (where dogs may even cry out)
- Difficulty in sleeping
- Loss of interest in doing fun things like petting or playing
- Panting or shaking to show they are hurting
Dogs do not commonly cry out, but when they do, they are experiencing severe pain and immediate intervention is required.
Treatment Uses of Gabapentin for Dogs
Originally designed as an anti-epileptic drug, gabapentin has shown promising treatment properties of neuropathic and chronic pain conditions in dogs with diseases such as herpetic neuralgia, chronic arthritis, amyotrophic lateral sclerosis (ALS), and diabetic neuropathy.
Other treatment uses of gabapentin in dogs are the following:
Canine Degenerative Lumbosacral Stenosis (CDLS)
Canine degenerative lumbosacral stenosis is a relatively common multifactorial disease that most commonly occurs in medium-breed to large-breed dogs of middle to older age. It is a syndrome in dogs associated with degeneration of the lumbosacral junction structures that lead to signs of low back pain associated with compression of the cauda equina.
A combination of clinical signs and advanced imaging techniques are essential to arrive at a final diagnosis of CDLS. Early intervention and an evaluation of the dog’s response to that intervention is needed to manage the pain.
In a study made by Giudice et.al (2019) published in the Journal of Veterinary Behavior, it evaluated the analgesic activity of gabapentin in dogs by degenerative lumbosacral stenosis. In the said study, gabapentin is considered as an alternative treatment in cases when dogs become unresponsive. Clinical findings of that study show that dogs who were given gabapentin orally showed low pain scores and their condition improved at the end of the treatment session. Supported by evidence, it was suggested that gabapentin is a valid alternative treatment in an outpatient setting.
Also known as drug-resistant epilepsy, refractory epilepsy is a condition where dog seizures are not effectively controlled by anti-epileptic drugs. This epileptic condition is a particularly challenging one in veterinary medicine since despite proper medication given, seizures continue to occur.
However, in a study conducted about how to improve seizure control in dogs with refractory epilepsy, evidences show that gabapentin can be used as an adjunctive agent to phenobarbitone and or potassium bromide – a different kind of anti-epileptic drug (Revington, 2005).
Moreover, in a study made by Peck (2017), it stated that the evidence regarding gabapentin as an anti-epileptic drug in dogs is insufficient. Thus, it is mainly recommended as an alternative adjunctive therapy alongside phenobarbital and potassium bromide in cases of treatment failure.
These are the result of using gabapentin as an adjunctive drug for dogs with refractory epilepsy:
- It proves to be useful in the prevention of withdrawal seizures in dogs.
- As gabapentin is not mainly metabolized by the liver, it may be useful in dogs with hepatic dysfunction, such as those hepatopathy or congenital porto-systemic shunts.
- It appeared to further decrease the frequency and severity of seizures in some dogs.
- It prevents ongoing clusters of seizures
The addition of gabapentin to phenobarbitone and or potassium bromide increased the interictal period and shortened the post-seizure recovery in some dog epileptics. In some dogs, seizures were completely prevented, while there was an increase in interictal period in other dogs.
Although gabapentin has improved seizure control in epileptic dogs, its high cost may hinder therapy in large dogs. But in smaller dogs, gabapentin does not represent a large financial burden (Revington, 2005).
To know more about dog seizures you can read more about it in our other post: Definitive Guide to Understanding and Treating Seizures in Dogs
Acute Postoperative Pain Management
Gabapentin has been shown to be beneficial in treating dogs with neuropathic pain as well as postoperative pain following hysterectomy and spinal surgery. Several studies show that perioperative use of gabapentin reduces postoperative pain in dogs (Chang et.al, 2014).
Gabapentin works by reducing lesion-induced hyperexcitability of posterior horn neurons responsible for central sensitization. It can be applied in managing acute pain of these following postoperative operations in dogs:
- Coronary Artery Bypass Graft
- Thoracic Surgery
- Thyroid Surgery
- Neurological Surgery
- Lumbar Spinal Surgery
- Major Bowel Surgery
- Orthopedic Surgery
One of the most common behavioral disorders of dogs is separation anxiety. Separation anxiety is best understood as a panic attack that happens when the attachment figure is not around. Dogs from rescue or shelters are at an increased risk and could be more resistant to improvement with behavioral therapy.
Signs in dogs that experience separation anxiety include:
- Destructive behavior
- Excessive vocalization
- Inappropriate elimination
- Hyperactivity or depresses activity
- Excessive panting
- Self-injurious behavior
- Escape behavior
- Rare aggression
Gabapentin as an anticonvulsant can be used to treat dogs with anxiety for it has good anti-anxiety effects and pain-relieving properties. Effects may include increase in appetite and negative side effects are rarely seen.
The suggested starting dose is 5-10 mg/kg twice a day (divide your dog’s weight in pounds by 2.2 to get kilograms. For instance, a 50-pound dog is 22 Kg). Always start with an evening dose as it causes sedation and dogs will sleep at night through this sedation. A week after, morning dose can then be added. But if too much sedation happens, then lower the dose.
As needed, the dose can be safely increased (usually by 25-50% every 7-14 days) until an effective level is attained. You can also increase the dose by adding a mid-day dose of the medication.
Gabapentin has been noted to be quickly absorbed and active after oral consumption. In most cases, gabapentin is given in a 50mg/kg dose administered twice daily.
The oral dose needed in dogs to generate the therapeutic plasma concentration similar to humans is 10-20mg/kg every eight hours.
Terminal half-life in dogs after oral administration has been proven to be 3-4 hours. Because of this property, gabapentin needs to be administered 3 times daily to maintain target concentration. Due to lack of studies on gabapentin’s pharmacodynamics in veterinary medicine, a target concentration of 2mL was followed – a concentration which has been derived from human medicine.
Adverse Effects of Using Gabapentin for dogs
In dogs with epilepsy treated with gabapentin, the adverse effects reported are the following:
- Mild sedation, depresses the dog’s consciousness but still leaves him capable of responding to external stimuli (tactile or verbal).
- Sedation, an induced, reversible, and controlled loss of consciousness whereby a dog’s response to external stimuli becomes limited.
- Ataxia, a lack of voluntary muscle coordination or the loss of muscle coordination.
- Somnolence, a state of hypersomnia or drowsiness which occurs due to the muscle-relaxing effect of gabapentin.
- Dizziness, the feeling of being lightheaded, unbalanced, and physically unsteady.
- Fatigue, a state of extreme physical tiredness and lack of energy.
- Convulsion (the most serious), it occurs when the dogs’ muscles contract uncontrollably which can last for a few seconds or minutes.
Withdrawal symptoms is a major complication that develops after a sudden discontinuation of high-dose gabapentin, used for the prevention of chronic postoperative pain. Signs and symptoms include:
There is a potential risk for hepatotoxicity if gabapentin is administered in dogs with other liver-straining substances such as phenobarbital. Some formulas of gabapentin contain small amounts of xylitol – a chemical compound toxic to dogs. Combining formulas of gabapentin with other xylitol containing agents is not recommended for use.
The use of gabapentin should not be abruptly stopped because an increased risk for seizures and other withdrawal symptoms could happen when gabapentin treatment is abruptly discontinued. Instead, a gradual decrease of dosage should be done over the course of two to three weeks.
Gabapentin is associated with teratogenic effects in pregnant dogs. It should only be used during lactation or pregnancy when the benefits to be gained outweighed the potential risks.
1Hepatic or Renal Dysfunction
Gabapentin is highly bioavailable in dogs and is metabolized in the liver and excreted through the kidney. Therefore, in dogs with hepatic diseases, dosing administration should be altered or decreased.
Prolonged use of gabapentin could lead to gabapentin insensitivity.
Before administering gabapentin to dogs, consult first a veterinarian in order to evaluate your dog’s profile and medical history. Also, mention to the vet other treatments administered on your dog and his health issues (like kidney failure). If administered to dogs who have allergic reactions, it may lead to hives, swelling, rashes, or breathing difficulties. Thus, veterinary consultation ensures the safety and good health of your dog.
Missed Dose and Overdose
In cases where you missed to give a dose of gabapentin to your dog, give the missed dose during that same day as soon as you remember it. However, if you only remembered the following day, skip the dose you missed and give only the regularly scheduled dose. A double dose of gabapentin is strictly not to be given to dogs.
If your dog happens to be overdosed by gabapentin, immediately seek veterinary medical treatment. The following symptoms will help you know if your dog has been overdosed:
- Reduced activity
- Excessive sleepiness
- Loss of balance
Providing adequate analgesia to dogs in pain is a vital aspect in ensuring their welfare. The development of alternative treatment for chronic pain is therefore essential in strengthening the quality of life for dogs suffering from neuropathic and chronic pain.
The increasing studies on the efficacy of gabapentin makes it potentially useful in the treatment of dogs’ pain syndromes and seizures.
Although some medical evidence was shown to prove the effectiveness of gabapentin in the treatment of dogs’ chronic pain and seizures, sufficient data are still unavailable on its complete pharmacokinetics, safety, and efficacy. So, it is very important to further investigate if gabapentin provides the same analgesic effects for dogs as seen in human studies.
- Chang, C., et.al. (2014). Gabapentin in Acute Postoperative Pain Management.
- Giudice, E., et.al. (2019). Clinical findings in degenerative lumbosacral stenosis in ten dogs – A pilot study on the analgesic activity of tramadol and gabapentin.
- Peck, C. (2017). The adverse effect profile of gabapentin in dogs.
- Revington, M. (2005). Improving seizure control in dogs with refractory epilepsy using gabapentin as an adjunctive agent.
- Kukkar, Ankesh & Bali, Anjana & Singh, Nirmal & Jaggi, Amteshwar. (2013). Implications and mechanism of action of gabapentin in neuropathic pain. https://www.researchgate.net/publication/235717366_Implications_and_mechanism_of_action_of_gabapentin_in_neuropathic_pain
- Giudice E., Crinò C., Barillarob G., Crupi R., Macrì F., Viganòd F., Di Pietroa S., (2019) Clinical findings in degenerative lumbosacral stenosis in ten dogs—A pilot study on the analgesic activity of tramadol and gabapentin. https://www.sciencedirect.com/science/article/abs/pii/S1558787819300176
- Worth A, Meij B, Jeffery N. (2019) Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact And Management Strategies. https://www.dovepress.com/canine-degenerative-lumbosacral-stenosis-prevalence-impact-and-managem-peer-reviewed-article-VMRR
- Govendir, M & Perkins, M & Malik, Richard. (2005). Improving seizure control in dogs with refractory epilepsy using gabapentin as an adjunctive agent. Australian veterinary journal. 83. 602-8. 10.1111/j.1751-0813.2005.tb13269.x.
- Connie Y. Chang, Chaitanya K. Challa, Janki Shah, Jean Daniel Eloy, “Gabapentin in Acute Postoperative Pain Management”, BioMed Research International, vol. 2014, Article ID 631756, 7 pages, 2014. https://doi.org/10.1155/2014/631756
- Peck Charlie (2017), The adverse effect profile of gabapentin in dogs A retrospective questionnaire study. https://stud.epsilon.slu.se/13297/7/Peck_C_180424.pdf
- N.H. Choulis, in Side Effects of Drugs Annual, (2012) https://www.sciencedirect.com/topics/medicine-and-dentistry/teratogenicity
- Kenneth M. Martin, (2016) Separation anxiety – Home alone. https://www.canadianveterinarians.net/documents/proceedings-2016-kenneth-martin-separation-anxiety
- Epilepsy Foundation, What Is Refractory Epilepsy? https://epilepsynewengland.org/knowledge-center/refractory-epilepsy
- American Society of Anesthesiologist, Types of anesthesia: IV/Monitored Sedation. https://www.asahq.org/whensecondscount/anesthesia-101/types-of-anesthesia/ivmonitored-sedation/
- D.A. Wells, in Reference Module in Chemistry, Molecular Sciences and Chemical Engineering, (2013), Bioanalytical Applications: Solid-Phase Extraction. https://www.sciencedirect.com/topics/chemistry/plasma-concentration