Tramadol vs. gabapentin for dogs: which drug works faster and better for pain control? Often times, when dog owners are faced with their own dog's pain, they don't know which drug to reach for. Their dogs may have been prescribed both drugs in the past, but owners are not sure which one will work better. When looking at the difference between tramadol and gabapentin for dogs, it's important to consider both drugs' mode of action, what these drugs work best for, how quickly the drug works and which one carries the less risks for side effects. As usual, it's best to consult with a veterinarian any time a dog is dispensed medications.
Tramadol for Dog Pain
Tramadol is a drug that is often prescribed for moderate to severe pain. This drug is known to be effective for both general and nerve-related pain. Among humans, tramadol (Ultram) has a history of being used for the pain associated with fibromyalgia, osteoarthritis, diabetic neuropathy and neurotic pain (the burning and tingling sensations associated with damaged nerves).
What's tramadol's mechanism of action? Tramadol works as an inhibitor of norepinephrine and serotonin reuptake. Generally, serotonin and epinephrine give a feeling of pleasure and relief; therefore many painkillers are crafted in such a way as to temporarily increase serotonin or epinephrine levels in the brain. Tramadol works especially well when used in synergy with a non-steroidal anti-inflammatory drug such as Rimadyl or Metacam.
Oral dosing of tramadol results in rapid absorption with a bioavailability of 75 percent (the degree and rate at which a medication is absorbed by the circulatory system). Giving tramadol with food does not appear to significantly affect its rate of absorption, therefore, it can be given with or without food. How quickly does tramadol work in dogs? Generally, tramadol starts working in the first hour or two.
Tramadol may cause respiratory depression, a reduction in motility (digestion of food in the small intestine is delayed), reduction in biliary and pancreatic secretions, nausea and vomiting (although unlikely when given at recommended doses), constipation or diarrhea (infrequent in dogs and and more likely seen with long-term administration).
Did you know? A recent study has shown that the use of tramadol was not associated with improvement in dogs with chronic osteoarthritis when compared to the use of a NSAID (Rimadyl).
"“When I prescribe tramadol, I tell my clients that it’s not used directly for pain reduction, but more like a glass of wine. Sometimes you need one; sometimes you need two or three to get calmed down a bit. But if we’re leaning on a very high dose for more than one to two nights, we have a quality of life issue and need to have a separate conversation.”~Dr. Dani McVety.
Gabapentin For Dog Pain
Gabapentin, also known as neurontin, was first introduced as an anti-seizure drug. This drug is helpful for controlling pain related to osteoarthritis, neuropathic conditions such as diabetic neuropathy, incisional pain (hence, its use in acute post-surgical pain in humans) and cancer.
In humans, gabapentin appears to work better for managing burning and lancinating pain rather than dull, aching pain. For this reason, gabapentin for dog back pain is often prescribed.
What's gabapentin's mechanism of action? Gabapentin 's mechanism of action is quite unclear. It's analgesic effects (ability to remove pain) are likely unrelated to inhibition of norepinephrine and serotonin re-uptake, binding of opioid receptors, blockage of sodium channels or alteration of cyclooxygenase activity. While it's unclear exactly how gabapentin works, a theory is, that, because gabapentin closely resembles the neurotransmitter gamma aminobutyric acid (GABA), it helps in reducing neuronal excitability throughout the nervous system .
Gabapentin appears to work best when used in conjunction with other non-steroidal-anti inflammatory drugs when attempting to control osteoarthritic pain. This explains why gabapentin is considered an adjunctive analgesic drug (an add-on pain medication). In order to notice its potentiating effect when used in conjunction with NSAIDs, gabapentin for dog pain must be given regularly. It may take quite a few days for gabapentin's effect to become noticeable, explains veterinarian Dr. Michael Salkin
According to a drug leaflet found on the The Royal College of Anaesthetists website, initial benefits of Gabapentin may be noticed as early as within a few days, however it may take up to 2 months for a full effect. Of course, this is just a range, just like in people, each dog may react differently to medications.
Dog owners report seeing effects almost immediately, while others report it may take days or even 1 to 2 weeks. Dosage also matters. Some dogs may feel pain relief at low levels, while others need a higher dosage. Consult with your vet should your dog not seem to respond to the medication as expected.
Gabapentin is highly bioavailable in dogs and is mostly excreted by the kidneys. Because of this, gabapentin for dog 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. Antacids can decrease the absorption of gabapentin up to 20 percent and therefore, it's important to separate these two medications by at least 2 hours.
Side effects of gabapentin for dog 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 gabapentin for some time, withdrawing it suddenly may cause what's referred to as a rebound of pain which is pain at a level of intensity that is higher than the original level.
Warning: Human formulations (especially liquid forms) of gabapentin (Neurontin) should be avoided as they may contain the artificial sweetener xylitol, which is highly toxic to dogs. Xylitol can cause very low blood sugar and liver failure triggering seizures and death.
Can You Give a Dog Tramadol and Gabapentin?
The answer is yes: you can give a dog tramadol and gabapentin together for pain as long as given under the guidance of a vet and therefore in correct doses. Used together, both drugs seem to generally work better than when used separately.
However, when taking both tramadol and gabapentin for dog pain, there is an increased risk of side effects, explains veterinarian Dr. Tom Crippen. You'll therefore be more likely to see primarily sedation and gastrointestinal side effects in dogs.
In what cases is gabapentin added to tramadol for painful dogs? "Generally, we add gabapentin as well when they are clearly in pain and even the Tramadol doesn't seem to get the job done," points out veterinarian Dr. Andy. However, it may be best to first just try to stick to one drug if it is proven to be sufficient alone.
Tramadol vs. Gabapentin for Dogs
Owners of dogs in pain may therefore wonder whether it's better to use Tramadol or Gabapentin. The answer is that it depends. Your veterinarian of course is the best person to answer this question, considering that he or she has access to your dog's medical records and the condition your dog is suffering from.
While tramadol works more like a glass of wine, helping with mood and acting as an emotion-modifying drug, if we look at studies on gabapentin, things don't get much rosier. According to a study conducted on the efficacy of gabapentin use in dogs for post-surgical pain, there was no short-term benefit.
With such discouraging results on both studies evaluating the pain relieving effects of tramadol and gabapentin, dog owners are likely scratching their heads even more wondering what to do to help their achy best friend. Most likely, the ideal solution may be to use these drugs in synergy with NSAID drugs as a form of complementary therapy, but only a vet can really suggest that.
However, if you have a night-time emergency when all vets are closed and are looking for something that may give faster relief and are wondering about tramadol vs. gabapentin for dogs, then tramadol may work best. "As far as what works most rapidly that would be the tramadol. Gabapentin builds up a bit in the blood stream for full effect for pain management," points out veterinarian Dr. Altman.
- Handbook of Veterinary Pain Management, James S, Gaynor, William W. Muir III, Mosby Elsevier
- Journal of the American Veterinary Medical Association February 15, 2018, Vol. 252, No. 4, Pages 427-432 Lack of effectiveness of tramadol hydrochloride for the treatment of pain and joint dysfunction in dogs with chronic osteoarthritis, Steven C.BudsbergDVM, MS; Bryan T.TorresDVM, PhD; Stephanie A.KleineDVM; Gabriella S.SandbergBS; Amanda K.BerjeskiBS
- DVM360: Study shows tramadol has no effect on osteoarthritis pain scores
Journal of the American Veterinary Medical Association April 1, 2010, Vol. 236, No. 7, Pages 751-756
Clinical evaluation of perioperative administration of gabapentin as an adjunct for postoperative analgesia in dogs undergoing amputation of a forelimb, Ann E.Wagner, DVM, MS, DACVP, DACVA; Patrice M.Mich, DVM, MS, DABVP; Samantha R.Uhrig, DVM, MS; Peter W.Hellyer, DVM, MS, DACVA