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.
Why Dog Pain Relief is a 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.
What Does Gabapentin do for Dogs?
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 to Manage Pain in 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.
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.
Is Gabapentin Safe for Dogs?
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 have a 5 year old cavie who developed symptoms of syringomyelia, cervical muscle spasm, hypersentivitiy, not wanting to walk on her right front paw etc…. We found gabapentin 100mg BD didnt work straight away but it kicked in well at 7 days and we stopped dosing prednisone 2.5mg intermittently which did amazing for her in the acute phase she was a new dog after prednisone daily. Anyway now she is off prednisone was only very short term and has maintained being in no pain on gaba twice a day, sometimes she would scratch in that area but otherwise she is running, rolling, all the signs of a happy baby.
Now after a few weeks I want to try to wean and see what she is like off it. Does anyone have experience in this condition in cavs? How long have peoples dogs been on gabapentin for?
Do not take her off once you start. I have a cavalier on gabapentin 3x a day. SM is chronic pain and progresses with time. Your dog will be in so much pain without it. My cav does amazing on gabapentin and is energetic and happy.
My 11 year old American Bulldog is on gabapentin for a bad back ankle. They have the script for 300mg 3 x a day and it’s too much for her. So I give her 1 3x a day and she does fine. If she didn’t have it she couldn’t walk. She has had no problems with it at all. The other thing is she is more relaxed. We went through the Camp Fire in Paradise Ca in 2018 and she has ptsd from the fire and what we went through after. We both do. The gabapentin has helped her totally.
I am so sorry that you went through the fire in Paradise. All love to you and your bully ❤️
I’m so sorry in regards to the fire and your pup. I’m originally from Redding, CA. That was a horrible year for fires. I’m glad your pup made it and that gabapentin seems to be helping it!! Take care and give your pup a good pet and scratch for me!!
My 4 year old English Labrador Retriever is on Gabapentin and CBD oil for seizures along with Levothyroxine for thyroid. She has not had any problems with the Gabapentin and we are in hopes that it will reduce her seizures as they are just starting (2 seizures in 5 months). It is very important to follow the every 12 hrs when giving medication. She is calmer but it’s too early to tell if the seizures are reduced. But I will continue with this protocol because I love her and if you have a pup who has seizures you will try anything. By the way I myself cannot take Gabapentin but that is not the norm as I know several folks who do fir nerve pain and it’s great. You should not make a blanket statement that Gabapentin is a bad drug!
Agreed!
I have a 90lb female GSD who is leash reactive and ready to fight any dog. I do have to use a prong choke collar, which I know how to use, and it is emergency only in the even I have to lead her away from another dog, as she is super strong. She is on a harness, so I have to leashes and she is muzzled to protect other dogs. She is on 48 mg daily of Reconcile, and has had one on one training. Her behaviorist wants to add 100mg 2x daily of GABA. Not going to happen. It’s a crap drug, maybe good for temporary pain, but I don’t see it as a long term fix. I am looking into a vibration collar or a collar that just beeps. I’m at the end of my rope, my dog is a wonderful, sweet, and in the house super obedient. We go on 3-4 mile walks and if we see another dog, I have to be on the alert and sometimes we have to turn around and go the other way. Funny the behaviorist dont like the vibration or beep collars, but ok to load dogs up on drugs.
My daughter trains protection dogs and working dogs (primarily Malinowski and GSD). An E collar and prong are as important as the rewards and positive reinforcement. All of it regulated and deserved.
I couldn’t walk my Am Staff without a prong til we/he learned not to charge after squirrels. He is now on a loose leash with very brave squirrels 3’ from him.
Find another trainer who can show you results without meds.
That’s because the medication treats the underlying emotional state of the dog where a shock, prong, or buzz collar simply suppresses behavior. Suppression can result in fallout behavior worse than the behavior you are trying to suppress. Think of it like jabbing a person with a stick when they have a panic attack vs giving them something that helps them feel more at ease. There is a ton of research showing that dominance/aversive training is less effective than positive reinforcement especially long term
Have you checked out Larry Krohn’s youtube channel? Might find it interesting.
My Scottie had sudden leg pain and I started giving her CBD oil because I had it on hand. Took her to emergency vet hospital for diagnosis. The vet couldn’t find injury or anything, so she said it was probably arthritis. I had suspected that because of her age. Vet prescribed gabapentin and suggested stopping the CBD “because it has not been tested.” I researched the gaba. and decided against it. To me the CBD has been tested by its WIDE USE and it is effective without side effects, while, to me, gaba. has had questionable research. I have continued the CBD and the really painful episode is over. I continue to give it to her when I suspect she is having some pain but not limping or showing visible signs. This of course is from close observation because she is so stoic and doesn’t tell me when she is hurting, she just slows down a lot and sleeps more. After her little dose of CBD she perks up and is more frisky–that’s enough ””testing” for me.
I have found that off-label use of human meds for dogs or pet parrots is based on speculation and I don’t really trust the use of gabapentin in dogs without reading studies that prove otherwise. I understand that it is hard to diagnose pain and judge pain relief in dogs that can be stoic and can’t talk. That all said, most human drugs have been tested on lab beagles before being tested on humans. It would be great if we could see how pain relief was measured in those studies (probably very barbaric involving wounding the dogs in a way that makes something measurable difficult like not-limping after a surgical foot wound). What were the recorded side effects in those studies? What was the percentage of relief measured and for what types of injuries? Even though that data exists, I am sure veterinarians have no access to it and I am pretty sure it still makes this drug and “off-label” application when used on canines.
I have a Bichon that is on gabapentin and has has no issues. I would like to point out, just like anything else in life, just because one dog has had issues with this drug doesn’t mean every dog will. I didn’t go to veterinarian medical school, I can only give my vet as much information as I can about my dog, and I depend on her to give my baby the appropriate treatment. If gabapentin doesn’t work well for your dog, then don’t give it. I had a dog die from tramadol, but that doesn’t mean my current dog will die from it. We need to put everything in perspective.
I agree Cynthia.
I would argue there are no miracle drugs and blanket recommendations for and against need to be looked at as just that – extremes. That from a research physiologist. Love the data 🙂 As for gabapentin, I was given it first following several surgeries to clean up septic arthritis of the thumb after a dog bite because of excruciating nerve pain. Long story short, NO way could I tolerate the gabapentin. Made me totally loopy and did diddly for the pain. Thank goodness scarring has subsequently covered the pissed off nerve. Meantime, my springer has developed lower back pain that has been debilitating and not responsive to herbals, NSAIDS, opioids or acupuncture so we tried him starting with the tablets left from my Rx (hey, waste not want not). It works for him – dosing 1/2 tab a.m.; full tab before bed and if I am tardy with the dose, he is right there telling me in no uncertain terms it is time for his dose. The only side effect for him has been a lessening of his ability to remain on task for extended periods of times when scenting – I am not complaining as at least he is comfortable and still can play one of his most favorite games. I think what I am saying is what always made my Med students go crazy – “It depends”.
While my cat does well on Gabapentin, it was horrible for last dog. She got so wobbly on even the lowest dose that she’d panic, causing worse wobbles and falling over. We tried it over a few weeks per the vets recommendation and she never adjusted. Finally took her off it and she got better after a few weeks. I’m glad it works for most dogs but I wish the wobbly side effects weren’t brushed aside like that aren’t upsetting to the dog.
I am on an 11.5K Facebook group for Megaesophagus (ME) and people are giving their dogs that have a lot of Regurgitation, drugs that are designed for other things. But because there is no good way to fix an stretched out Esophagus and a weak Lower Esophageal Sphincter, other drugs are used. Mostly it’s Sildenafil (Viagra), and Omezaprole, Pepcid (to keep the regurgitated bile from coming up and burning), and Metoclopramide (Reglan), and I’ve also seen, Cerenia, and Gabapentin.
ME can also be secondary to PRAA or MG (Myasthenia Graves).
Most vets have never seen this problem, and recommend putting dogs down. They can be born with it like my puppy or develop it later.
I think the microbiome is messed up from toxins or not good enough nutrition.
A good probiotic is invaluable. Kibble can causes so many gut problems. We had a dog that vomited all the time since he was a puppy and vets said it was his palate bc he had a short snout and was a bully breed. I finally tried sucralfate for a cpl weeks and viola, no more vomiting. Unfortunately by then he was already 8 :(. We give all our dogs probiotics now and they seem to be great!