Gabapentin for dog back pain (IVDD), is a drug that is often prescribed for dogs suffering from intervertebral disk disease (IVDD). In the veterinary field, many advances have been made in providing dogs affected by neck or back pain, or other types of significant pain, effective pain management drugs. Dog suffering from intervertebral disk disease often require surgery, but depending on the grade of the condition and several other factors, medical management can be an option. Medical management, also known as conservative management for dog back pain, consists of rest and medications (often including gabapentin) to reduce the associated pain and inflammation.
Conservative Management for IVDD in Dogs
Not all dogs are ideal candidates for conservative management of IVDD, Several factors will need to be kept in mind by the vet when evaluating whether the dog is a good candidate.
The affected location, how severe the condition is and how long the dog has shown symptoms are all factors that will need to be considered. Grade of severity though appears to be the most significant factor.
Dog IVDD classification is based on different grades of severity. In grade 1, dogs are affected by pain but they do not show any signs of loss of sensation. These dogs are still able t walk. In grade 2, affected dogs are still able to walk, but they appear not coordinated because they have lost control of their bodily movements (ataxia). Affected dogs may also show loss of sensation. Pain may or may not be present.
In grade 3 IVDD, dogs are unable to walk, they show signs of full or partial paralysis and may suffer from fecal and urinary incontinence. Grade 4 IVDD causes paralysis of the legs and incontinence, while in grade 5 there is loss of deep pain sensation.
Your vet is the best person to determine how severely affected your dog is and whether he is a good candidate for IVDD conservative management. If your dog is a good candidate, your vet may prescribe several medications and gabapentin may be one of them. Gabapentin may also be prescribed for control of pain after a dog undergoes surgery.
"With increasing severity, patients will have less of a chance of responding to conservative therapy and, as the grade worsens, the success rate of conservative management goes down 10% to 15%."~Dr. Pancotto, veterinary neurologist.
Medications and Rest
In dogs who are suffering from a slipped disc, medical management consists of cage rest and several medications to help reduce inflammation and help the dog feel better. Medical management works best for grade 1 and grade 2 patients as other grade patients may do better hospitalized, as they need more advanced care.
It's important that the dog is kept strictly crated for two weeks and the only exception to the crate use is when the dog is carried out to to potty.
After the first two weeks, then the dog should still be kept on restricted activity orders but for two more weeks, this time though the owners should start walks along with physical rehabilitation exercises.
Along with rest, dogs undergoing medical management are often prescribed medications. Commonly prescribed medications include non-steroidal anti-inflammatory drugs (NSAIDs) such as Rimadyl (carprophen) or Metacam (meloxicam). Some dogs are given steroids but never along with NSAIDs. It's either the steroids or the NSAIDs, never together. If steroids need to be prescribed to a dog who has taken NSAIDs, they can only be given after several days (wash out period).
Tramadol may be prescribed as well for pain relief. Additionally, gabepentin or methocarbamol may be added for dogs with grade 2 IVDD, explains Dr. Pancotto. She suggests medicating affected dogs for a full two weeks and then tapering off the medications one by one. Follow your vet's advice for specific guidelines for your individual dog.
Gabapentin for Dog Back Pain
As mentioned, the drug gabapentin may be prescribed along with other drugs in the management of canine IVDD. Gabapentin, also known as neurontin, is an anti-seizure medications (anticonvulsant) that in humans has been found to also help treat the pain from irritated or damaged nerves following a case of shingles.
Gabapentin is not approved for use in dogs or other animals by the Food and Drug Administration, however, it can be prescribed legally by veterinarians as an extra-label drug.
It's not completely understood yet how gabapentin actually works for pain, but a theory is that it's because gabapentin closely resembles the neurotransmitter gamma aminobutyric acid (GABA) which is responsible for reducing neuronal excitability throughout the nervous system .
Gabapentin for dog back pain can be used in combination with NSAIDs (when added, it potentiates the NSAIDs' effects) and it has been found that gabapentin also works well in synergy when combined with tramadol. For this reason, the addition of gabapentin is often suggested when there is need for more effective pain control. This explains why gabapentin is considered an adjunctive analgesic drug (add-on pain medication).
In order to notice its potentiating effect, gabapentin for dog back pain must be given regularly. It may take quite a few days for gabapentin's effect to become noticeable, explains veterinarian Dr. Michael Salkin.
Many dogs with IVDD are prescribed he drug famotidine (Pepcid A/C) to prevent stomach problems from the use of NSAIDs such as Rimadyl. However, the use of famotidine may reduce the absorption of gabapentin. In such a case, it may help to give the affected dog the gabapentin an hour prior to the famotidine administration, further explains veterinarian Dr. Salkin.
"The synergism of tramadol with a nonsteroidal anti-inflammatory drug (NSAID) such as carprofen might offer the best pain relief of all. When even that combination of drugs isn't effective enough, however, we might consider adding a neurogenic pain reliever such as gabapentin to the mix. ~Dr. Michael Salkin
Gabapentin Side Effects in Dogs
Side effects of gabapentin for dog back pain include sedation, lack of coordination, fatigue and tremors. Some dogs may develop dizziness with nausea and vomiting. If you notice side effects, consult with your vet. A dose adjustment may reduce such side effects.
Something to be aware of is what is known as this drug's rebound effect. Basically, if the dog has been on it for some time, withdrawing it suddenly may cause what's referred to as a rebound of pain which is pain at a level that is higher then the original level. If your dog has been on this drug for some time, consult with your vet before stopping it abruptly.
Gabapentin for dog back pain should be used with caution in elderly dogs suffering from kidney impairment. On the other hand, this drug is not metabolized as readily by the liver and can be therefore easier on a senior pet, explains veterinarian Dr. Altman.
Human formulations (especially liquid forms) should be avoided as they may contain the sweetener xylitol, which is highly toxic to dogs. Xylitol can cause very low blood sugar and liver failure triggering seizures and death.
"Do NOT stop gabapentin abruptly as this can result in rebound pain worse than the original pain state. Escalate the dose as needed every 3 – 4 weeks to the dose that gets the job done without causing sedation. Once the patient is at a stable state and stays there for several months, you can consider reducing the dose over a VERY long time — many months. If the patient begins to get painful again, simply take the dose up one "notch".~ Dr. Robin Downing
- DVM360: Saved from the sidelines: Conservative management of intervertebral disk disease
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- DVM360: Adjunctive analgesics for chronic pain (Proceedings)