Gabapentin is a medication that veterinarians are prescribing with increasing frequency, sometimes alone but more commonly in combination with other medications, for the management of pain in dogs. It’s also increasingly prescribed in combination with other medications for canine anxiety. Why has it become so popular? I’ll get to that, but first we have to discuss pain.
TREATMENT OF PAIN IS A MEDICAL PRIORITY
Pain management has become an integral aspect of health care in both human and veterinary medicine. If you’ve ever been hospitalized or had surgery, you will be familiar with the frequent question, “How’s your pain? Rate it on a scale from zero to 10.” So you try to pick a number, again and again, throughout the time you are hospitalized.
It turns out there is a very compelling reason for this. Pain is not our friend. It hurts. But the significance goes much deeper than that. Left uncontrolled, pain causes not only physical damage but also emotional and psychological damage. It delays healing and negatively impacts the immune system. In humans and nonhuman animals alike, it frequently results in harmful, unwanted behaviors like self-trauma, aggression, or withdrawal from the joys of life.
You’ve heard medical professionals say it’s important to stay ahead of the pain. There’s a strong reason for this as well. Untreated pain makes your pain receptors increasingly sensitive, which results in increasingly worsening pain. This is called “wind-up” pain, and it becomes more difficult to control.
We, veterinarians, work hard to prevent pain. When this is not possible, we work even harder to relieve it. This has become easier over the years with the ongoing advancements in science, medical knowledge, and extrapolation from discoveries made in human medicine. Veterinarians now have a whole array of medications and other therapeutics at their disposal for managing pain.
Chronic pain, something that is not expected to go away, is particularly challenging for us. It must be managed, often for the remainder of the dog’s life. For this type of pain, “polypharmacy” (multiple medications) and a multi-modal (more than one treatment modality) approach are usually most effective.
To manage chronic pain, we usually employ prescription medications, as well as safe and potentially effective “nutraceuticals” –nutritional supplements that have positive effects for a medical condition. There are increasing numbers of veterinarians who use Chinese and herbal medicine as complementary therapies to treat pain. Modalities like acupuncture, laser therapy, therapeutic ultrasound, physical therapy, and rehabilitation are all readily available to dog owners in most areas. An increasing number of dog owners now use various forms of cannabidiol (CBD) to treat their dog’s pain.
Pain is a highly personal experience. How one patient perceives pain may be completely different from another. Some have higher tolerances than others. One medication or therapy may work wonders for one patient and do nothing for another. This makes it crucial for owners to be observant, monitor their dogs closely for response to therapy, report accurately back to their veterinarians, and be open to recommended changes in the prescribed pain protocol.
AN UNEXPECTED BENEFIT
Gabapentin has gained popularity in leaps and bounds (hey! that’s what we’re going for: leaping and bounding dogs!) for its potential contribution to pain management in veterinary medicine. But this isn’t what it was initially developed to treat.
Pharmaceutically, gabapentin is classified as an anticonvulsant, or an anti-seizure medication. It works by blocking the transmission of certain signals in the central nervous system that results in seizures. Then researchers learned that some of these same transmitters are involved in the biochemical cascade involved in pain perception, and doctors began exploring its use for pain management.
Today, gabapentin is best known and respected for its ability to manage a specific form of pain called neuropathic pain. Neuropathic pain comes from damaged nerves, either deep in the brain and spinal cord or in the peripheral nerves, which are the ones that extend outward from the brain and spinal cord. It is different from the pain that is transmitted along healthy nerves from damaged tissue. Examples of neuropathic pain include neck and back pain from bulging discs, pinched nerves, tumors of a nerve or tumors pressing on nerves; some cancers; and dental pain.
A perfect example of neuropathic pain in humans is fibromyalgia. You’ve probably seen the commercials for Lyrica, a treatment for this chronic, debilitating, painful nerve disorder. Lyrica is pregabalin, an analog of gabapentin. (By the way, pregabalin is used in dogs as well, so if your dog’s current pain protocol includes gabapentin but isn’t working well enough, ask your veterinarian about pregabalin.)
HOW GABAPENTIN IS USED FOR DOGS
Although gabapentin is primarily thought to work best for conditions with neuropathic pain, it is most commonly used as an adjunctive or “add-on” medication in the polypharmacy approach to managing any chronic pain. It is rarely used alone, as the sole medication for pain, even in neuropathic conditions like neck and back pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) are, and likely always will be, the first-line choice in veterinary pain management. But gabapentin is being added more frequently when an NSAID alone isn’t helping enough. Gabapentin is so safe it can be added to virtually any of the drugs currently used for pain management in dogs. There is a recent study that shows gabapentin has a synergistic effect, which means when it’s used in combination with another drug, such as the opioid pain-reliever tramadol, the effect of both drugs are enhanced.
When adding gabapentin to a current pain protocol, you may see some effect within 24 hours, but you won’t see the maximal effect for seven to 10 days. For this reason, dosage adjustments are usually made only every couple of weeks. Be patient. Gabapentin has the potential to add much value to your dog’s current pain-management plan.
Additionally, adding gabapentin, which has minimal side effects, sometimes allows for dosage reduction of other medications like NSAIDs, which do have potentially dangerous side effects, especially with long-term use. This is a huge plus for both your dog and your veterinarian, who took an oath to “do no harm.”
What are the side effects? Nothing much. There is the potential for mild sedation and muscular weakness, which increases with higher dosages. This side effect is usually minimal at the dosages typically prescribed for pain. Veterinarians actually take advantage of this side effect by using higher dosages of gabapentin in combination with other sedative drugs like trazadone to enhance the calming effect for anxious or aggressive patients in the veterinary clinic setting.
PRECAUTIONS AND SIDE EFFECTS OF GABAPENTIN FOR DOGS
Gabapentin has a huge safety margin in dogs. It won’t hurt your dog’s kidneys or liver and is even safe to use with CBD products, although the mild sedative effect of both products may be enhanced.
There are some important precautions of gabapentin for dogs, however:
- First and foremost, do not use the commercially available liquid form of gabapentin made for humans. This preparation contains xylitol, the sweetener that’s commonly used to sweeten sugar-free gum. Xylitol is extremely toxic, even deadly, for dogs.
- Wait before giving gabapentin after antacids. If you regularly give your dog an antacid like Pepcid or Prilosec, you must wait at least two hours after giving the antacid before giving gabapentin, as the antacid decreases absorption of gabapentin from the stomach.
- Never stop gabapentin cold turkey if your dog has been on it for a while. This could result in rebound pain, which is similar to wind-up pain, in that it’s pain that’s worse than ever. For this reason, always wean your dog off gabapentin gradually.
VETERINARY FAN
As you can probably tell, I am a huge fan of gabapentin for dogs. It helps many of my patients with their pain, it’s safe, and it’s not expensive. I prescribe it most frequently as part of my polypharmacy approach to managing chronically painful conditions like osteoarthritis and cancer. I prescribe it for dental pain. It works wonders for neck and back pain.
While gabapentin is not currently used heavily for post-operative pain as its efficacy in that realm has been questionable, I’m excited right now as there is a study under way to assess its efficacy pre-emptively (before the pain) for dogs undergoing surgery. Many veterinarians already prescribe it for their surgical patients to be started before the procedure, because they have so much faith in it.
Gabapentin is extremely safe for dogs, and it has the potential to alleviate pain for our dogs and improve their quality and enjoyment of life. If you’ve been wondering why so many veterinarians are prescribing this medication more and more, there’s your answer. We see results, plain and simple.
Gabapentin does not have a direct anxiolytic (anti-anxiety) effect, limiting its usefulness for treating the chronically stressed, anxious dog as a stand-alone drug. However, as with its synergistic use alongside pain medications, it is sometimes prescribed in combination with Prozac (fluoxetine, a selective serotonin reputable inhibitor [SSRI]) or Clomicalm (clomipramine, a tricyclic antidepressant [TCA]) for persistent cases of generalized anxiety, panic disorders, compulsive disorders, and true separation anxiety.
The goal when adding gabapentin in these instances is to help the dog relax in the face of his stressors, as you try to help him through his issues with appropriate desensitization and behavior modification exercises. This is particularly useful in cases where the dog is already receiving the maximum dose of anti-anxiety medication, with less than the desired effect.
It’s important to note that medication alone is not likely to relieve anxiety for your dog unless paired with the above-mentioned desensitization and behavior-modification exercises. These exercises can be prescribed by your veterinarian or a veterinary behavior specialist.
Gabapentin’s sedative effect at higher dosages can be used on an as needed basis to help dogs relax and get through specific situations that cause undue stress for them. Examples of this type of situational anxiety are veterinary visits, grooming appointments, long car rides, thunderstorms and fireworks.
I would mention that timing of doses is very important. Gabapentin was prescribed to my wheaten terrier suffering through the hideous disease of PLE. Only when I gave him his twice-a-day medications precisely twelve hours apart did some relief occur.
Timing medications: what most people don’t realize for themselves and their animals that medications work better when timed precisely. For example; when the medication instruction says 3x’s day? Most people will take this during their 3 mealtimes. This actually compresses taking the medicine during daytime hours. NO NO NO. It is MORE EFFECTIVE to take your medicine every 8 hours, this way, you can time your medicine to cover you equally in a 24hr period. It matters not what the hourly schedule is, whatever works best for you and your lifestyle. But timing medicine equally over the 24hrs is the
Most important thing. I’m not a medical professional, however I am a professional patient with a long standing history of researching my own medical care.
My dog presented with back leg pain, and was prescribed Gabapentin. Within days, he completely lost his hearing. Completely. The vet told me that it wasn’t possible, but when he saw the dog, he had to admit the dog had lost his hearing. He was taken off Gabapentin, and eventually the dog regained his hearing, but not completely.
That’s interesting to know. I had a dog that was on Gaba. long-term for spine and back leg pain. She went deaf over time. It never occurred to me to connect the two things.
Nor me. I know that my current dog is on it and is going deaf. She is also like 11 but this is interesting to think about.
My sheltie had bad arthritis in his back legs. Our vet put him on Galloprant & Gabapentin. In a very short time he went deaf. I took him off Gabapentin but hearing did not return. He has however been on Galloprant for years & it has kept him moving with no side effects. I don’t know if his short time on the Gabepentin caused the deafness but it’s very suspect.
My Border Collie is 12 and Gaba was added to help w arthritic pain (he was already on Rimadyl). Being 12, his hearing had decreased due to age but, after he’d been on gaba for a month or 2 it REALLY went bad – practically deaf. I just thought it was a sudden change due to being a senior. He was on Gaba for about6 months. Then, life got crazy and I couldn’t pick up his Gaba for a couple wks. His pain was not worse bcs of it so decided not to refill it. A few wks later, he could hear me whistle to come inside(whereas, when he was on the GABA, I hr could not). Gradually, his hearing improved back to where it had been previous to the gabapentin. Luckily, Rimadyl has been able to manage his old age arthritic pain.
My dog was given a dose of gabapentin solution (compounded for him so not the human liquid) THROUGH HIS IV while in the ICU at a teaching hospital. It put him in a coma with kidney and liver failure and 6 hours later he was brain dead. They admitted it was an error that never should have happened. But, like all meds, the “nothing much” side effects is predicated upon it’s being given correctly.
Oh, I am so sorry to hear this. My sympathies to you and your family.
Omg sorry to hear this 💔
I’m so sorry for your tragic loss. Unfortunately, human errors do occur.
If I remember my research on it it is NEVER to be given through IV. I am so sorry for your loss.
I hope u sued there ass. I would of been heart broken and very pissed. Ready for blood. Ereww just reading this makes me mad 4 you. Ur poor baby
You couldn’t pay me enough
to take Gabapentin (the drug du jour) myself much less give it to my animals. Who knows what kind of mind/personality problems it may cause. Was not surprised to read about the hearing issue mentioned above.
I took gabapentin after my gall bladder was removed, and it was incredibly effective. It reduced the pain to where I was aware of it, but not bothered by it. This allowed me to not do stupid things while recovering, yet remain comfortable. I took it many years ago for nerve pain (the kind of pain you would do ANYTHING to alleviate) and it was the one med that worked. My elderly dog takes it in conjunction with Carprofen, and it has decreased her back and hip pain to the point where she thinks she is a puppy again at times.
All meds have the possibility of having negative effects, but most times the benefits outweigh the risks, especially in the case of a highly effective drug that does not typically produce side effects.
I agree. I’ve been taking Gabe with naproxen for my back and knees. The pain is absolutely debilitating without it. I recently adopted a 9yo, 97 lb pitbull with severe arthritis. I had to help him up and down the 3 steps into my house. After just 2 weeks of Gabapentin and carprofan he’s running and playing with my other dog. The transformation is nothing less then miraculous.
Good to hear both you and your pup recovered well with the help of this pharmaceutical product. It has its place in treatment and we have used it sparingly.
However, it is not correct at all that ”most times the benefits outweigh the risks, especially in the case of a highly effective drug that does not typically produce side effects.”
We are seeing right before eyes, this pattern of affecting hearing.
It is another example of pharma companies obfuscating the truth; and this opaqueness gets filtered down through the medical community that we rely on for help.
And there are a great many examples of cases of benefits NOT outweighing the risks, and yet we are steered towards them.
Anyone needing help with nerve pain, try homeopathic Hypericum Perforatum in the form of 30C or 200C pellets, and see what happens (test in advance of any urgent need).
In addition, check out the usefulness of Arnica Montana and Aconitum.
And, a huge THANK YOU to all the people taking the time to comment on here about their experiences with Gabapentin and the hearing issues!
We need to keep communicating amongst us and sharing our stories.
I took it after abdominal surgery (colon resection) last year. I took it along with plain Tylenol, and never needed even one dose of a narcotic pain reliever. IV morphine or Dilaudid was available but I didn’t need it. Granted, robotic surgery damages much less tissue, but it was still very major surgery.
I had the same type of surgery but I definitely had to have narcotics!
My baby came home from a very complicated surgery on 300 mg gabapentin. She had been taking one at night and was doing well. The 300 every 12 was too much. She was so sedated she was urinating all over herself in her sleep day and night.
But now she has a lot of arthritis pain. Vet has her on rimadyl and tram. Tram I think makes her a little sedate too so I don’t like to give it every 12 because then she doesn’t want to get up and go out. But she cries a lot waking me up all night and I can’t tell if it’s anxiety or pain. Maybe a little of both. She’s a 65 lb 11 yr old afghan hound and I think she’s very sensitive to meds. She takes 2 tram at night with a GABA. I’m wondering if I should add a gaba in the morning. My vet is amazing.
More recent research has shown that Tramadol is not effective in reducing arthritis pain 😟. I’m not a clinician, but I would ask about increasing the gabapentin, weaning her off the tramadol, and considering CBD oil. There’s a Facebook group for CBD oil for pets, very informative.
Yes!
Galliprant is great for arthritic pain and has less severe side effects than the typical nsaids such as carprofen. Tramadol was a short lived pain med for us. Gabapentin has been great in conjunction with galliprant and even as a standalone post acl surgery.
Agree, I found Galliprant along with an improved diet & Dasuquin was enough to relieve any discomfort in osteoarthritic hip in my 6yo foster dog. I also trimmed her down from 62lb to 55lb. She went from screaming & crying when trying to stand up to running & jumping around playing.
How did you trim her down. My 8 yr old has a limp from his right leg. They couldn’t manipulate it because he wouldn’t relax. They want to sedate him to manipulate it to see if it’s the knee. Idk I gave him his first dose of gabapentin today. But really want to help him lose weight. He does t eat a lot so I’m not sure how to do this. Longer walks will aggravate his leg. He Moans when he lays down now as the day goes on. Breaks my heart.
Yes! My old boy has arthritis and he gets Galliprant. I can see that it is some much more effective over a longer period of time than what was available the last time I had a geriatric dog. I do give him monthly injections of Adequan, and daily Dasuquin too. He had surgery last month (not major) and was sent home with just Gabapentin to give in conjunction with the Galliprant and he showed no signs of needing anything more (the surgeon knew that I have Tramadol at home too). He was a bit sedated for the first two days, but at his age I figure it was at least partially anesthesia related. I did however notice that he was walking with an easier gait and asked our regular vet if we could just keep him on a lower dose and he agreed it was a good idea. I am not a veterinary professional- but I am a retired pediatric RN, so I am used to assessing patients who can’t tell you what they feel.
Tramadol has helped my little dog a lot with his arthritis!
Tramadol alone is not very effective according to my vet.
I had to take both gabapentin and tramadol along with Naproxen after 5 consecutive back surgeries. Gabapentin made me very forgetful and sedated but it is outstanding fir neuropathic pain which is very difficult to treat. NSAIDS ( like naproxen or metacam for dogs ) is good for inflammation but limited for severe pain. No clinicians like prescribing tramadol because it’s an opiate derivative so is abused and sold but the fact is- it works. Without it occasionally, I could not work. It dulls the nerve pain and also all the associated muscle and movement pain that accompanies nerve pain and arthritis. I am a clinician as well as a patient and you have to advocate for the (dog) patient. Most people I know with severe arthritis or chronic pain, have to take tramadol at some points.
Ask your vet about galliprant
Galliprant is a great drug for pain relief but it costs me 88.00 for 30 pills!! I just can’t pay that much. I have skipped my own meds to buy this for her. Now I give carprofen and every few days I’ll add a gabapentin. It’s cheaper and works just as well. She’s 10 years old and has some arthritis in her hind legs and middle back.
I get 30 Galliprant for $36 at Costco. It is half the price that the Veterinary Clinic charges. I also have pet insurance that covers it. Galliprant and Gabapentin work well together for my 16 yr 8 mo old dog with arthritis and cervical and lumbar spine degeneration.
If you get a perscriptiion from your vet you can get it online and it’s cheaper
Hi Patricia. You can use the Good Rx card on medications for pets and it helps to cut down the costs. Maybe you already use it but if not, it’s totally free to get one.
you can even use the adult GoodRX which a pharmacist said was better. I used it for one dog’s Cushing Meds and now for my dog’s Gabapentin.
i use tramadol myself and i can tell you i cannot take it at night because it causes the worst nightmares ever . as much as i could use it some nights i will never take it in the evening !
My italian greyhound is 13. And had all kinds of aches and pains and boo boos. He is suppose to get a 100mlg of gab twice a day. But i cut back to only one during the day and hes like a puppy again. It has giving him back his youth. Twice a day made him to sleepy but one a day is wonderful
My Bichon Poo had a disc problem and was prescribed this and Pred. Right now she’s down to every other day to ween off pred. Everyone who knows her has said this is a new dog. She loves the walkers now. she only goes out front not for a walk with her neck problem. she is eating all the snacks. She LOOKS so different too. bright eyed and ready to go.
I know her teeth ARE BAD. they have been afraid of giving her anesthestic. she has other problems. But wow. this is something. I will be calling the vet to see if she can stay on this periodically. maybe every other day or so.
Hmm the writer may be a fan of this but after mass research did you know that these types of drugs can also cause some behaviour issues in animals. My dog was on this but quickly became very aggressive in his nature, I saw the difference after taking him off it. Yes it can also cause kidney and other functional issues. Don’t be fooled.