Long-lasting or chronic pain in dogs doesn’t present itself the way we expect it to. An overall slowing down, reluctance to move, or avoidance of activity can all be indications that your dog is experiencing some type of chronic pain.
Acute or short-acting pain, like a fracture, is easy to spot because your dog may yelp and lift up her leg when walking. However, with chronic pain (i.e. pain that lasts more than 6 months) your dog may still use her leg but not want it to be touched.
Our pets can’t verbalize what exactly hurts them so finding treatments for their pain can be challenging. This article will give you a vet’s guide for administering a specific medication, called Gabapentin*, that is used to treat chronic or neuropathic (peripheral or central nerve) pain in dogs, as well as seizures.
What is Gabapentin?
Gabapentin comes in an oral tablet, capsule, and solution. There are several name brands of this medication. It’s been used for decades in human medicine and more recently for dogs (and cats) for treatment of seizures, chronic pain, and neuropathic pain.
Gabapentin and pain in dogs
Pain is a subject studied by numerous scientists, veterinarians, physicians, and nurses because it can be so difficult to treat and interferes with quality of life. There are different categories of pain and different pathways in which pain is conducted, transmitted, and perceived.
Gabapentin works on neuropathic pain, specifically. Examples of neuropathic pain include back pain from intervertebral disk disease, spinal cord tumors, or nerve damage.
In veterinary medicine, we always try to assume that whatever causes pain in humans also causes pain in animals. Since our patients cannot verbally express their pain, it’s important to cover all potential sources and aspects of pain. This is where multimodal pain relief comes in. Multimodal pain relief is the practice of using more than one type of pain medication to act on the different locations where pain is relayed in the body to reduce or prevent the pain from occurring or being perceived.
Gabapentin is used as part of many multimodal pain relief treatments because of its action on nerves. For example, a dog with an injured paw may benefit from having an NSAID like Carprofen and Gabapentin to work on different aspects of the pain.
Pathways involved in producing painful sensations. J.S. Gaynor, W. Muir (Eds.), Handbook of Veterinary Pain Management, Mosby, St Louis (2002), pp. 251-260
How does Gabapentin work?
Gabapentin is an analgesic (pain reliever) that can prevent the sensation of pain resulting from a normally non-noxious (non-harmful) stimulus or an exaggerated response to painful stimuli. Gabapentin, when combined with other anti-seizure medications has the advantage of being an anticonvulsant, meaning it stops and prevents seizure activity.
The way this medication works is not completely understood, but it binds to voltage-gated Calcium channels in the nervous system, inhibiting the release of excitatory neurotransmitters. The excitatory neurotransmitters are involved in pain transmission and in seizures, and thus when inhibited, prevent the sensation of pain.
Gabapentin starts to work within two hours of administration and has a relatively short duration of action with about two to three hours of pain relief.
When is Gabapentin prescribed?
This medication may be useful in dogs as adjunctive therapy for refractory or complex partial seizures and also for chronic pain relief and pain related to the nerves. Since it has an inhibitory effect, it can be used before a distressful event such as a vet visit, to facilitate a calmer experience. Your veterinarian may prescribe Gabapentin with other pain medications such as Tramadol, an opioid, or an NSAID (ex. Carprofen) because they’re covering all the possible pathways of pain.
What are the possible side effects?
The side effects are mild with Gabapentin and include sedation and ataxia (wobbliness). These effects can be diminished or avoided if starting at a lower dosage and then working up to a clinical dose where it still does a good job of managing pain. If you see signs of toxicity such as vomiting, diarrhea, or severe depression, then work with your vet to adjust the dosage.
Warnings and precautions
There are human formulations, such as the oral solution of Neurontin®, that should be avoided in dogs as it contains Xylitol, an artificial sugar that can cause low blood sugar and liver toxicity in dogs. So it’s good to be mindful of only administering the medication prescribed by your veterinarian for your dog.
If you have your dog on this medication for an extended period of time, it’s recommended that you wean your dog off slowly if you wish to take them off of Gabapentin. An abrupt discontinuation or going “cold turkey” could cause withdrawal-induced seizures.
Managing pain is always a challenge for owners and veterinarians since none of us want to see our pets in pain. If you see any signs of potential pain in your dog, let your vet know so you can try out different options for pain relief. Fortunately, we have different types of medications, such as Gabapentin, at our disposal to minimize pain to provide a happy, long life for our pets.
