By Jessica Vogelsang, DVM
Although gabapentin has been around for many years, its use in dogs and cats is fairly new. Your veterinarian may recommend gabapentin for several conditions: as a mild sedative before coming into the veterinary clinic, as an add-on pain medication, or as part of a seizure management protocol.
It wasn’t that long ago when people assumed pets didn’t feel pain as acutely as humans did. Some even thought that a little pain was good for a pet because it kept them from overdoing it during recovery from a surgery. It was a misguided approach, and modern veterinary medicine no longer works that way. Now, veterinarians are guided by the principle of “assuming pain.” That is, if a pet is experiencing something we know to be painful-an injury, a surgery, certain medical conditions—we should give a pet pain medication even if he or she isn’t outwardly crying or limping.
Medicine is an art as much as it is a science, especially when you are treating a patient who can’t tell you in words how he is feeling, or whether a treatment is helping. Veterinarians used to just give one pill and hope that it worked well enough. But now, the idea of multi-modal pain management has finally become the standard in the field. To understand why the use of gabapentin has become popular in veterinary medicine, it’s important to review our current understanding of pain.
Pain Relief for Dogs
The more we learn about pain, the more we realize that it is a complex phenomenon. For example, take a stubbed toe. This painful stimulus activates local receptors in the toe, called nociceptors. The signal then transmits through the nerves up into the spinal cord, and then on to the brain, which is responsible for reacting to the signals and creating the actual conscious perception of pain.
The important take away is that different classes of pain medications work at different levels in this pain pathway. Anti-inflammatory agents like NSAIDs work on the nociceptors, decreasing the inflammatory response that amplifies pain, where opioids bind to receptors in the nervous system to decrease the transmission of the pain signals themselves. Emotional factors such as fear or anticipation can also alter the experience of pain.
Veterinarians have many different gateways they can act upon to affect the pain pathway. What they’ve learned over the years is that it’s better to address multiple areas of this pathway all at once rather than focus on one area with high doses of a single medication. This is known as multimodal pain management, and this is where gabapentin comes in.
Uses of Gabapentin for Dogs
Gabapentin is an unusual pain medication in that it is rarely used by itself. On its own, gabapentin is not particularly effective in preventing pain. However, when used in conjunction with other pain medications such as an opioid or an NSAID, it has shown great potential in amplifying the pain reduction effects of those other medications. Although its mechanism of action is not fully understood, gabapentin is thought to decrease the release of excitatory neurotransmitters by affecting the calcium channels in the nervous system. Think of gabapentin as the noise-canceling headphones of the nervous system; while it doesn’t change the levels of noise being generated, it dampens your perception of it.
Because it appears to work specifically in the nervous system, gabapentin has also shown promise in a variety of nervous system issues, such as seizures and anxiety. It also is a particularly helpful drug for managing chronic pain, which is defined as pain that has been present for over six months. It’s a challenge to find medications that specifically target chronic pain, so it’s reassuring that gabapentin has been helpful for these patients.
Risks and Side Effects of Gabapentin for Dogs
While gabapentin is generally considered a safe drug, there are a couple of precautions pet parents should take. Because the drug is eliminated through the kidneys, owners should use gabapentin with caution in pets with kidney conditions. In addition, it’s vital to ensure the gabapentin is specifically formulated for pets, as the liquid form for people contains xylitol—an artificial sweetener lethal to dogs.
To get the maximum benefit, use gabapentin as directed and in conjunction with any other prescribed medications. The side effects most commonly noted with gabapentin are sedation and wobbliness, which can be mitigated by starting the dosage low, then gradually increasing to the effective dose. The drug should not be abruptly discontinued, as pets may experience withdrawal symptoms if not gradually weaned off the medication.
Pain is one the of the most challenging conditions in veterinary medicine to appropriately manage, so it’s good news that veterinarians have another tool in their arsenal to help pets live long and pain-free lives. If you think your pet is experiencing any sort of pain, don’t wait to talk to the vet. Veterinarians have a wide variety of tools available to them to bring your pet relief.
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