Background
The original use of this medication was for treating partial seizures in humans, but not long after its introduction it was found to have use in treating neuropathic pain (the burning and tingling sensations that come from damaged nerves).
As with many human drugs, this one has found its way into veterinary medicine where it is also used as a seizure control drug, either alone or in combination with other anti-seizure drugs, or as an adjunct in the control of chronic pain, especially arthritis pain. Gabapentin is also used in animals preoperatively to minimize pain experienced after surgery.
How this Medication is Used
For pain control, gabapentin is typically started at once daily dosing but can be increased to two or even three times daily. It may be used on its own or in conjunction with other pain relievers that may later be tapered away.
Unfortunately, it is common to develop tolerance to gabapentin so that the pain relief dose must be increased as time goes on. How long a dose is adequate before it must be increased is highly individual.
Side Effects
Sedation and weak or wobbly hind legs are the chief side effects of concern although these are usually temporary and resolve in a few days after the patient’s body gets used to the medication. As a result, we often recommend you start this medication in the evening so the impact of this side effect is minimized. Diarrhea has also been reported.
We sometimes take advantage of this side effect and prescribe higher than normal doses of gabapentin for sedation prior to stressful events such as veterinary visits. Patients usually become sedate, may stare into the distance and will lose coordination in their hind legs – this may appear alarming but is not harmful and the effect is only temporary, usually lasting 4-6 hours but residual sedation may remain for up to 24 hours. It is important that your cat be kept indoors and away from stairs or elevated surfaces while sedated with gabapentin.
Interactions with Other Drugs
- For chronic pain relief, gabapentin is best started in combination with other pain relievers but after a time often the other pain relievers can be discontinued and gabapentin is effective as a sole agent. This may not be possible for conditions where the pain is progressively worse.
- Oral antacids will hinder absorption of gabapentin into the body by up to 20% so it is important to separate administration of these two medications by at least 2 hours.
- Concurrent use of the morphine-type drugs (such as buprenorphine) with gabapentin can increase the effectiveness of gabapentin.
Concerns and Cautions
- Gabapentin may be given with or without food.
- Cats require a very small dose for pain control so a compounded tablet may be prescribed rather than the human capsule. The human capsule is typically used for sedation.
- Gabapentin is removed from the body through the kidneys. If it is to be used in a patient with kidney insufficiency the dose may need to be modified, however sometimes we need to accept the increased risk to the kidneys in order to provide an acceptable degree of pain control. Please speak with us if your cat has kidney disease and you are concerned about using this medication.
- Gabapentin is not safe for use in pregnancy but should be safe for use in lactation.
- Gabapentin should not be abruptly discontinued after long-term use. Instead, gabapentin should be gradually tapered off over a couple of weeks.
Please do not hesitate to get in touch if you have any concerns about giving your cat gabapentin.