What is gabapentin?
Approved by the FDA for humans, gabapentin (mostly known under the brand name Neurontin®) is a drug used to help with neuropathic pain and epileptic seizures. It is also commonly prescribed off-label to patients with anxiety disorders. Gabapentin has made a strong appearance in veterinary medicine in recent years, to treat the same conditions as it supposedly does in humans. The use of this drug is controversial, as the FDA has not approved it for veterinary use. Other brand names for this drug include (but are not limited to): Aclonium®, Equipax®, Gantin®, Gabarone®, Gralise®, Neurostil®, and Progresse®.
How does gabapentin work?
Gabapentin binds on the calcium channels in the cells. These channels are very important for brain functions and are upregulated (meaning their sensitivity is increased) in conditions such as anxiety, neuropathic pain, and epilepsy. The exact way that gabapentin affects the brain isn’t clear, but the current theory is that it blocks the calcium channels, which might suppress the overly stimulated neurons that are causing these conditions.
Gabapentin is mostly prescribed in combination with other medications, as an adjunctive therapy. It is taken through the mouth, and some forms of it contain xylitol, which is highly toxic to dogs. This is a drug that is quickly absorbed, so its effects are visible very rapidly. They don’t last very long (usually less than a day), as the drug is just as quickly eliminated. As a result, gabapentin needs constant administering to maintain its effects, which can be problematic due to the side effects.
What are the side effects?
The severity of the side effects depends on the dose, but they have been observed in some form in the majority of human and canine patients. The most frequently reported side effects of gabapentin are sedation and ataxia. Ataxia is the loss of motor control over the limbs, the main symptoms of it being weakened limbs (inability to walk, swaying, stumbling), drowsiness, tilting the head to one side, unresponsiveness, vertigo, and nausea. In December 2019, the FDA issued a warning about gabapentin having serious side effects on the human respiratory system. Patients have experienced breathing difficulty, disorientation, dizziness, unresponsiveness, and blue-colored skin.
In dogs, gabapentin is mainly metabolized by the liver and kidneys, which means frequent use can put extra stress on these organs. Dogs with pre-existing liver and kidney problems shouldn’t be prescribed high doses of gabapentin (if at all), and they may also experience stronger side effects. Dogs with epilepsy may suffer withdrawal seizures as a side effect of stopping the drug abruptly, so this is not recommended. They have to be taken off this medication gradually. The use of this drug can cause multiple nutrient deficiencies, such as calcium (therefore negatively impacting the health of bones), folate, and Vitamin D.
Notable Research on Gabapentin for Dogs
Neuropathic Pain
Chronic pain usually has a neuropathic cause, which is why regular pain medication doesn’t always help and why veterinarians prescribe gabapentin alongside it. There is a severe lack of research on how this drug affects dogs with neuropathic pain, so there is no optimistic scientific conclusion on this matter. Two notable studies researched the effects of gabapentin on post-operative pain. The first study, published in 2012, involved 63 dogs and found no significant effects of gabapentin on the pain. The researchers speculate that the dose might have been too low. The dogs also received pain relief medication before being given gabapentin, so this might have affected the results as well.
The second study was published in 2015, and it evaluated the effects of gabapentin on post-operative pain in twenty dogs, ten of which received gabapentin before the surgery (the other ten got placebo). In alignment with the 2012 study, the results showed once again that a commonly recommended dose of 10mg/kg twice a day did not affect the pain. But the results also showed that dogs who received gabapentin needed less pain medication (such as morphine) after the surgery in the first 24 hours. Gabapentin might have the potential of managing post-operative pain, but the right dosage and combination with other pain medications remain unclear. There is also no current evidence that gabapentin can help dogs in chronic pain.
Epileptic Seizures
A study of 17 dogs with epileptic seizures showed no significant decrease in seizures when gabapentin was added to their medical treatment. For some of the dogs, the time between the seizures did increase, and three of the dogs stopped having seizures altogether. Two of the dogs stayed seizure-free long-term, ten of them remained on gabapentin indefinitely. There were no visible long-term side effects. The short-term side effects were hind limb ataxia and sedation. They cleared up within days, or after adjusting the bromide dose (the drug that was given in combination with gabapentin). Dogs involved in this study received a higher dose of gabapentin, between 35 and 50 mg/kg per day, for four months.
Another study (done on mice) showed that gabapentin reduced acute seizures, but it was more effective in male mice. It’s important to note that the effects were only seen at very high doses, such as 200 mg/kg. There are currently no reliable, clinical, and detailed studies on gabapentin’s potential for treating canine epilepsy. The current conclusions show that gabapentin could help with epileptic seizures when paired with other medications, but the dose would have to be very high, and the responses may vary based on the sex.
Problematic Aspects of Gabapentin
The Question of the Dosage
With this drug, the dosage is thin ice. It determines whether or not the drug will have an effect, but there is absolutely no reliable information on what the appropriate starting dose is. Some say it’s 5mg/kg every 12 hours. Others put it at 10mg/kg every 8 hours. This creates a lot of uncertainty amongst veterinarians. If the dose is too low, the drug won’t show any effect, but if the dose is too high, the side effects become a problem. Since frequent dosing is needed to maintain the drug’s effect, the dose shouldn’t be left up to experimenting. Except, this is exactly the case.
There is no way to know how a dog will respond to a specific dose of gabapentin, so veterinarians need to rely on dog owners for feedback. Before the dose is determined, the desired result of the drug needs to be discussed between the owner and the vet. What is the endpoint? What are the signs that will let you know the medicine is working? Are you prepared for the side effects? Once the medication is prescribed, the dog should be monitored closely. If you’re noticing severe side effects and suspecting an overdose, contact your emergency veterinarian immediately!
The Lack of Reliable Research
There is an obvious lack of reliable and unbiased research on gabapentin for dogs. It’s not an easy drug to study. The drug is mostly prescribed in combination with other medications, so it’s hard to isolate its effects. Relying on human and mice studies isn’t a secure option either, as it has been proven that dogs metabolize gabapentin differently.
Assuming that the dosage (or the efficiency) of the drug that was established in human studies could easily be applied to dogs is troubling and risky. The few canine studies that do exist are too small, inconclusive, or have questionable reliability – for example, they are done in retrospect and rely on the owners to evaluate and report the symptoms, or they are otherwise biased.
Unregulated Status of Gabapentin
Gabapentin is not FDA-approved for veterinary use. There is no regulation for this drug when it comes to administering it to dogs. Some veterinarians are prescribing gabapentin precisely because of the side effects, such as sedation. Dogs are given gabapentin before a stressful situation, such as traveling or a vet visit. The owners don’t realize that the sedation is actually a side effect of a strong drug that is normally given to epileptic patients.
As mentioned several times throughout this article, the appropriate dose (which is the most critical aspect of any medication) remains a complete mystery and is entirely up to each veterinarian to decide on their own, aside from some general guidelines that were lifted from human studies. The use of this drug is experimental at best and can (in most cases) be classified as a questionable choice.
Sources
Cirribassi, John. Ballantyne, Kelly. “The Use of Gabapentin to Help Manage Anxiety in Dogs.” DVM 360, 07/09/2019.
Grubb, Tamara. “Gabapentin and Amantadine for Chronic Pain: Is Your Dose Right?” Today’s Veterinary Practice.
Govendir, M. Perkins, M. Malik, R. “Improving Seizure Control in Dogs with Refractory Epilepsy Using Gabapentin as an Adjunctive Agent.” PubMed, 2005.
Crociolli, Giulianne Carla. Cassu, Renata Navarro. Barbero, Rafael Cabral. A Rocha Thalita Leone. Gomes, Denis Robson. Nicácio, Gabriel Montoro. “Gabapentin as an Adjuvant for Postoperative Pain Management in Dogs Undergoing Mastectomy.” PMC, 29/03/2015.
Comi, Anne. Traa, Beatrix. Mulholland, Justin. Kadam, Shilpa. Johnston, Michael. “Gabapentin Neuroprotection and Seizure Suppression in Immature Mouse Brain Ischemia.” PMC, 07/2008.
“Loss of Balance (Unbalanced Gait) in Dogs.” Pet MD.
Aghighi, SA. Tipold, A. Piechotta, M. Lewczuk, P. Kästner, SB. “Assessment of the Effects of Adjunctive Gabapentin on Postoperative Pain After Intervertebral Disc Surgery in Dogs.” PubMed, 10/08/2012.
Peck, Charlie. “The Adverse Effect Profile of Gabapentin in Dogs.” Swedish University of Agricultural Sciences, 2018.
“FDA Warns About Serious Breathing Problems with Seizure and Nerve Pain Medicines Gabapentin (Neurontin, Gralise, Horizant) and Pregabalin (Lyrica, Lyrica CR).” FDA, 30/01/2020.
Gollakner, Rania. “Gabapentin.” VCA, 2019.
Verrotti, Alberto. Coppola, Giangennero. Parisi, Pasquale. Angelika, Mohn. Chiarelli, Francesco. “Bone and Calcium Metabolism and Antiepileptic Drugs.” ResearchGate, 11/2009.
M, Linnebank. S, Moskau. A, Semmler. G, Widman. B, Stoffel-Wagner. M, Weller. Elger, CE. “Antiepileptic Drugs Interact with Folate and Vitamin B12 Serum Levels.” 19/01/2011.
Luna’s passion for learning about canine psychology and behavior began when she adopted a severely reactive puppy from a local shelter. She is now a big advocate for positive reinforcement and compassionate training. As a writer, she strives to spotlight the topics that fly under the radar and be the voice for all who cannot speak for themselves.
My dog is not improving with Gabapentine, she hobbles on 3 legs and is in pain when walking. Seems ok when resting. She has a hard time to poop, now she is terrified to go Jumps up as if in pain. No problem when urinating. Appointment with Orthopedic surgeon not until Apr.12
Gabapentine does nothing for her pain. XRays did not determine if she has a torn ACL. Had a broken femur when rescued 6 years ago. Reinjured that leg when she tumbled down some hard wood stairs. When outside she constantly sits down and licks that leg. Gave her pumpkin, milk, Benafiber and can dog food. Loosened her stool for a few days now she will not even try to poop. Tries but than panics and sits down to lick her leg
My 12 year old Border Collie / Aussie mix, Vader has been on Gabapentin for 2 weeks. Vader was showing signs of pain in his lower back, just above his tail. This was the reason for the gabapentin. After a few days Vader became constipated and could not poop. He also started wetting the blanket and pooping little poop balls and dribble pee when he got excited. These are signs of bowel incontinence. When I contacted the vet they didn’t have an answer for me on what I should or should not do.
Please be careful before giving your canine gabapentin.
Hi Eric, did your vet refer you to a canine orthopedic specialist or maybe run some tests to see what is causing the pain? If not, I recommend you find a holistic veterinarian instead and take your dog in for an orthopedic consultation. It’s important to find the cause of this pain asap, especially in a senior pup.
In the meantime, there are far better options for managing pain than gabapentin. CBD is my #1 recommendation. You can learn more about CBD’s pain-relief properties in this article: https://blog.ultimatedog.com/cbd-for-dogs-with-hip-dysplasia-an-optimistic-look/
Other options include Devil’s Claw, turmeric, glucosamine, and Boswellia/frankincese. Some quality joint supplements already include some of these ingredients!
Best of luck to you & your pup! Hope he recovers soon. I have a border/aussie mix too, they’re the sweetest, most sensitive souls!
Not fond of this drug. Had numerous side effects on my pug. Incontinence, social isolation, pacing, anxiety, and ataxia worse then the condition it was prescribed. Vet attributed to disease progression and doggie dementia. It was to the point we were told to start thinking about euthanasia. My wife and I actually agreed as his quality of life became non-existent. After reading numerous peer reviewed journals indicating the the questionable use of the drug to relieve pain and there were more human like side effects than being advertised, I weaned him off. In a matter of a week his demeanor changed, the psychosocial issues being exhibited during the use of the drug disappeared. His demeanor was back to previous before Gabapentin administration. In the AAHA in 2022 chronic pain management guidelines, it is stated there is no evidence this drug works for pain management in canines. Pain management was what it was prescribed for.
As his chronic conditions still existed, we found a Vet who is addressing with a different treatment plan. We shall see how it goes, Lucky (his name) is 16, has typical geriatric pug chronic conditions. My wife and I, both medical professionals realize he is end stage, there’s no illusion to that. Though his QoL over the years has degraded from what it what was, the Gabapentin in his case made it non-existent.
John, Sorry to hear about your pet’s poor response to Gabapentin. We have experienced the same thing, where it was prescribed for pain likely caused by spinal issues resulting in hind leg weakness but it made that issue dramatically worse.. We tried a variety of different doses for our dog – low, average and finally high doses, which resulted in her not being able to walk at all. We have stopped the drug a few days ago but she still can’t walk. Her personality, alertness and clear eyes are back but not the walking. How long did it take for your dog to return to the mobility they had pre gabapentin? Thank you.
Our 3 year old Frenchie, Frank went into the Vet this past Saturday for blood in his stool, and he was showing some hesitancy at using the stairs. The vet did a complete exam with bloodwork and X-Rays, his bloodwork was normal and the X-Rays showed minor Hip Dysplasia on his right side.
They prescribed Gabapentin 100mg/12hr for pain. I gave him 1 dose at 11 am Saturday Morning when we got home from the Vet and by 5 pm he was showing signs of Ataxia, as the night progressed thing s went down hill from there, Glassy eyes, hyper panting, hyper salivation, and loss of the use of his hind legs. By yesterday morning and zero sleep for any of us all the side effects had subsided except for now he has no use of his hind legs and he is incontinent. We bathed him and changed his bedding last night. We are calling our vet as soon as they are open and taking him right in, this has been a nightmare of epic proportions and if I would have known this could have happened there is no way I would have given him that awful medicine. My wife and I are beside ourselves with grief and guilt.
Hi Brenda I was wondering did your dog get better walking after this drug? Ours had Gabapentin for pain, but he’s always had bad legs and a deformed spine but could get around ok and walk. On this medication he went completely down hill, lost coordination completely couldn’t walk etc, so I took him off it and he got a bit better but basically never fully recovered. I am so mad at the vet for prescribing this medicine knowing his condition already with weak legs!
I wanted to add to this conversation should anyone come across it later. My senior shih tzu underwent much of the same. Prescribed gabapentin and antibiotics for a case of pneumonia. The gaba was merely to help him rest from the exhaustion of high respirations. After just two doses he began going downhill quickly. All three versions of ataxia, wouldn’t eat, walk, could barely stand, or hold up his own head. It was a painful week after immediately discontinuing the medicine, not knowing if our dog would ever fully recover.
Luckily we could still get him to drink while seated but nothing else. We had to administer his antibiotics through a syringe. After not peeing, or hardly moving for that matter, for two days we had to manually express his bladder for him to prevent a kidney infection. Slowly each day we saw small percentages of improvement. By the third day you could tell it was truly “our dog” again behind those eyes but still physically in awful shape. We celebrated even the smallest victories when he first urinated on his own on day 4. Walking ever so slightly despite many tumbles on day 5. Willing to eat even just a treat on day 6. Finally stable enough to put his head down into his bowl and eat his dry food on day 7. Lastly on day 8 having his first bowel movement since starting the medication. By day 9 I’d say our boy was mostly back with us with exception to the large amount of weight lost over that week given his already smaller size. So many sleepless nights.
We too are medical professionals no stranger to end of life care for both humans and animals. Anyone who wasn’t aware of these side effects would have been well within their rights to contemplate euthanasia as their dog suffered and declined to what would seem an unreturnable state. So if you’re going through this, have hope and don’t let your vet convince you these symptoms are normal or your dog’s time has come. Mine is no spring chicken but he’s still running, jumping, snuggling ball of happiness before and now thankfully after gabapentin. We will be ready to do what’s needed for our dog when that day comes but it wasn’t going to be this infuriatingly under regulated medication that takes him out. Stay strong friends.
Hi Rivea,
Did your dog get better after discontinuing the prescribed gabapentin or by still taking gabapentin with antibiotics for pneumonia? I’m at the exact same spot right now for my 2 year old dog. She was prescribed antibiotics with gabapentin in order to help him rest from the exhaustion of high respirations. I’m giving my dog the antibiotics but not the gabapentin yet since I am worried. Please tell me your experience with it, thank you!
Avoid this medicine / vets love it/ dogs hate it. Our 12 year old Sophie was prescribed Gabepentin for spinal pain. Today, she collapsed after taking it outside. Before that, she wandered around aimlessly and didn’t potty.
I looked up side effects and realized right away ! We are discontinuing this drug immediately- so upsetting to see! I carried Sophie in and hand fed her dinner. She tried to stand and was practically doing the splits with her back legs while eating chicken 🙁 never again. Also avoid Rimadyl- terrible for throwing up and GI track.
Also avoid Apoquel. It completely destroys the immune system. Basically, if it’s a drug for a non emergency, where a natural approach can be used, just don’t take the drug. Period.