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.
My English cocker who is 7 and four months has a rare lymphoma of the mouth-not much apparently is known about this as the oncologist explained there is no funding for research as it occurs so rarely.Its been a tortuous month since I learned this and the dog is going for his first radiation tomorrow.We saw the oncologist a month ago and he did prescribe the gabapentin .I did not use it and now reading the article I feel guilty that I didnt .The weather was very hot and I was afraid that the drowsiness from the medication and heat would make it hard for him to take walks etc. and I live in a large apt building where it is necessary .Now its cooler and I will ask if I should use it after his radiation treatments.
I have a problem with pushing off-label use of pharmaceuticals as routine and “safe and effective”. Not because they may or may not be effective, but because it bypasses a system designed to determine wether or not something is actually “safe and effective”. A year ago, my older dog began to experience some back pain. One vet prescribed rimadyl and another prescribed gabapentin. Neither let me know that the use of both drugs is off-label and neither disclosed to me the potential for side effects and long-term damage. Only after doing my own research did I learn that there is scant and contradictory evidence for the efficacy of either. Neither were especially helpful for my dog: rimadyl didn’t seem to work; gabapentin just made him sleep all the time, which I suppose released his pain but hardly addressed the underlying problem. A year of “alternative” treatments and trial and error with various supplements has brought the pain under control. I often wonder what would have happened if I’d blithely gone along with the “professional’s” assertions that he needed to take one or both of these medications. I may not have letters after my name, but as an observant dog owner it is clear to me that this is not helpful and potentially unsafe.
I was on gabapentin for diabetic neuropathy and it didn’t really do anything for me and it made me loopy. I shifted to lyrica and had slightly better results but still made me loopy. I couldn’t walk a straight line and had a client accuse me of being drunk on the job. I don’t drink, it was purely the lyrica. When my Great Dane had amputation surgery due to osteosarcoma, he was prescribed gaba and tramadol. The combination worked but it took a while to dial in the correct dosage. That’s when I learned the vet world has a pretty poor understanding of pain management. I had many back and forth discussions with several vets about what was working and what wasn’t. Left me with the impression that they were guessing. This is when I also learned that tramadol in dogs acts more like a sedative than a pain reliever. So my dog was more knocked out but still in pain. The side effects of the drug mimics signs of pain/discomfort to the point we questioned if the amputation did more harm than good and we went as far as to schedule euthanasia. Luckily that vet upon examining our boy suggested changing up his meds instead and we got another 2years before the OS lung Mets finally did him in
Dutch Shepard’s are very sensitive to drugs. When mine was given a low dose Gabapentin and monitored when he was neutered, he did fine. He was just over 1 year old. A month later he got porcupine quills in his mouth. There were 6 small ones I couldn’t get out, my regular vet wasn’t available so I took Zee to another local vet. He administered a dose that he said should have worn off in 2 hours. Four hours later that vet carried my crying dog out to my car. The vet was saying “he doesn’t like Gabapentin! Don’t let him out of the car till he really wakes up.” At 2:00 am, 10 hours after it was given, Zee woke up. When I reported this to my regular vet, our conclusion is the amount Zee was given was too much. Many vets don’t realize Dutchies and some other breeds should not be given an amount based solely on weight.
Gabapentin used off label for humans is a terrible drug, and no doubt just as bad for dogs. Quit pushing the use of this for our dogs!!!!!!!
It’s been four years since I lost my Ramses. If I recall he was on Gabapentin and another NSAID (possibly Rimadyl?) but don’t recall which. If I recall correctly, Gabapentin alone doesn’t so much but in conjunction with another medication makes it more effective. It relieved his pain enough he could walk again. Its effectiveness may have come from the fact I am very particular about timing and dosage. Every 12 hours is obvious. Three times a day would be every 8 hours.
I think with all medications, prescription or not, it is the owner’s responsibility to be vigilant and note any changes and act accordingly. That may include decreasing or increasing dosages and frequency after consulting with your vet. If it looks like they are doing more harm than good, then you stop, again after consulting with your vet. But be careful in case a medication must be slowly reduced rather than stopped abruptly. For instance in the case of prednisone and some of the opioids which should never be stopped abruptly.
It is we, the owners, that are the first to notice when something is wrong with the companions we are responsible for. We should not relinquish that responsibility to others, even our vets, and simply trust blindly. If a treatment isn’t working we are the first to notice and it is our place to intervene. It is also our responsibility to be educated. Whether it is a prescription my doctor writes for me or one the vet writes for my dogs, I go online and learn exactly what it is, how it works, how it should and should not be given, dosages per weight if available and any side effects I should be aware of.
Gabapentin was a human drug in lyrica that not only debilitated people, injured them or killed them. It was taken off the shelves and banned as a result of lawsuits and court rulings.
Instead of losing money on it, big pharm sold it to veterinarians. A huge side effect is that while it’s used for pain management it strips the nerves of vital regenerative vitamins that the body needs to mend. So you’re trying to heal your pet, but hindering it’s mending abilities. Dogs have suffered from this drug.
Check the court rulings and wrongful death lawsuits; then the drug adverse reaction list; there’s a paper trail if you look; check how much money was lost and paid out to human victims. When a drug goes wrong in the human aspect, they sell it to vets because animals are not seen as living beings, they are just property and can be replaced.
Gabapentin made my dog’s dementia worse and did nothing for his pain. He was more restless and confused at night while taking it. My vet said that was “not an unusual side effect”.
It is well known to cause hallucinations in humans and my mom experienced hallucinations when they put her on it for pain. The confusion and hallucinations were worse than the pain it was supposed to help.
I am sure it helps some people and some dogs but it is not without side effects. Nothing ever is. Always watch your dog to see if any medication truly helps.
You do know the drug manufacturer came out and said that using opioid medication with gabapentin is bad right? They specifically warned that taking those two drugs together was causing a number of humans to die in their sleep do to the respiratory system being supressed from the effects of those drugs when mixed. I have asked multiple pain management doctors about this and they say “Yes we know, but the benefits outweigh the risks”. Are you willing to risk your or your pets life?
Will it help ease my dogs arthritis and how much will it cost