UPDATE-seeking beans who have used Gabapentin/4pain

I'm researching pain meds for my acromegalic kitty, and am limited because of other drug interactions with the aspirin he takes for his heart. Gabapentin seems like an interesting possibility, but I don't think it is widely used. I would love some feedback from anyone who has used it. Thanks!

 

Re: seeking beans who have used Gabapentin on cat for pain

I added to your heading Nancy to indicate that you are looking for its use in cats.

I personally have used Gabapentin for pain, but on reading your post, I don't think that is the experience you were looking for.

 

Re: seeking beans who have used Gabapentin on cat for pain

thanks!

 

Re: seeking beans who have used Gabapentin on cat for pain

Ele and Blackie on Lantus uses it for arthritis, I'll leave her a note to come over. I believe Lynette and Meow Meow used it too, for Omaha (GA), again for arthritis.

Does your vet have access to VIN? There are a couple of pharmacology consultants on that board who may be able to guide your vet, since you're concerned about interactions.

 

Re: seeking beans who have used Gabapentin on cat for pain

Nancy, I pm'd you about this a couple of days ago. I also wanted to add that both of the vets I've had looked it up in one of their resources/books and found the dosage for cats for pain. If you need more info that I can provide, please let me know.

 

Re: seeking beans who have used Gabapentin on cat for pain

Ele,
I think I remember you said you split up a capsule to get his dose, or is it a tablet? Is the liquid an option? I knew you used it but I'm wondering if there are others out there.....or is it still too 'off label'.

Do you get it from a local pharmacy or from your vet ?

 

Re: seeking beans who have used Gabapentin on cat for pain

Hi Nancy

My dog is on it, FWIW. He has liver disease and can't take NSAIDs either, so we use it because he seems to have low back pain. It has helped, as far as I can measure by his ability to do stairs Also FWIW, for the first three weeks or so he seemed to get the munchies at night while on it. I don't know if he felt actual hunger or just agitation. This subsided after a while.

For cats it should be compounded, and I'd compound it into chewies or capsules if you can. I am always nervous with liquid suspensions because if the suspension is uneven (due to settling, or less-than-vigorous shaking), you can end up underdosing or overdosing a drug that is worrisome to overdose.

 

Re: seeking beans who have used Gabapentin on cat for pain

in addition to jess' excellent point about suspensions, also wanted to caution that i'd read sometime back about concerns over xylitol being one of the ingredients in commercially-available (as opposed to compounded) oral gabapentin suspension. just fyi in case your vet isn't aware of that and thinks you can just use the commercially-available version.

 

Re: seeking beans who have used Gabapentin on cat for pain

Hi Nancy
I'ts Patti - funny you are asking about this as I too am going to the vet soon about gabapentin for a couple of my older kitties (altho not with acro).

Here are links to articles from Lynette about pain management that I recently gave to MaryJo asking about buprenex in another thread:
Here are some great articles Lynette (and MeowMeow) found and passed on about pain management. Most are from 2007 but I found them to be quite interesting/informative. They discuss various medications and treatments including Adequan, Gabapentin, etc. Maybe they can help you too:

Analgesic drugs for arthritis:
http://www.veterinarypartner.com/Conten ... &A=587&S=1


Winn funds study on gabapentin in 2007:
http://www.winnfelinehealth.org/Pages/W ... _final.pdf


AAFP pain management guidelines:
http://www.aahanet.org/PublicDocuments/ ... elines.pdf

I would be curious like you - about dosages people have used in their cats - and Jess what dose you give your dog - as our Blue can't do NSAID's either.

I hope the articles at least give you a little info.

 

Re: seeking beans who have used Gabapentin on cat for pain

Our vet told us that the liquid Gabapentin has xylitol in it and we should never use the liquid. At first we did have it compounded into the right size dose into capsules, but it was quite expensive. Now I get 100mg capsules and I split them into 4 parts (now 3 because we increased the dose). I add it to a small amount of wet food to make sure that Blackie is getting it all. A bottle of 30 100mg only costs about $10, but the compounded were almost a $1 each. Your vet should be able to look up the dose per lb/kg. When our dog was on it (she had bone cancer) we were able to get it in tablets, but I don't think they make it that way anymore.

 

Re: seeking beans who have used Gabapentin on cat for pain

I'm sorry - I learned that my links didn't work that I gave above. I have a new computer and I'm still learning how to use it. Please if you could go to Feline Health and read the thread on buprenex - the links are there to the pain articles and they all work over there.

 

Re: seeking beans who have used Gabapentin on cat for pain

Georgie, (mammary cancer), used gabapentin for pain. It was a compounded suspension in fish oil. It seemed to help him quite a bit and did not have a lot of side effects on him. He was not lethargic, or lacking of appetite, or anything like that. He was just Georgie not in pain.

~M

 

Re: seeking beans who have used Gabapentin on cat for pain

Thanks everybody. This all is very helpful!

Ele, I know Blackie is pretty "mature" (didn't we celebrate 17?) How long has has he/she been taking it, and how's the larger dose doing? Did you start at 25mg? How do you store the doses you divided but don't use? How much does Blackie weigh?

Patti, I'm so glad to see you posting again! While you were off the vet gave us bupe for the non aspirin days, (kind of a pain test thing) and it seemed to lower his BG also, but I hate the DILATED eyes and worrying if he's going to fall off the counter or something , plus its pretty expensive, so I never asked for more. Haven't even used it all. I will check out those links. thanks

WCF- I didn't know that xylitol thing- THANKS!

Initially I was interested in adequan and then read that it also can interfere with platelets and cause bleeding if overdosed and shouldn't be used with NSAIDs (aspirin). Metacam is also an NSAID i think, Bupe- narcotic, and that leaves us gabapentin, so ...

I hate the compounding pharmacy- its a drive and soooo expensive- I think I can handle the razor blade and mirror trick (like the movies) :lol:

 

Re: seeking beans who have used Gabapentin on cat for pain

Hi Nancy

I hope you didn't get the impression on this board that Adequan was unsafe or could not be used with Metacam. (Though you're not planning on using Metacam anyway, it seems?) Aspirin can cause clotting issues and so it's better not to use it (theoretically) with Adequan because Adequan is has some structurally similarities to a drug that inhibits clotting. Would I start Adequan the week that my cat was going to have major surgery? No, to be cautious I wouldn't. If my cat was on Adequan long term and had to have surgery would I freak out? No, I wouldn't do that either. There just isn't enough evidence that there *are* or *have been* significant issues. If I could do it logistically (I have no one to help at home) I would give it to both Dillon, my old civvie, and Elliott, my old dog with hepatitis.

Other options for treatment for OA in cats include fish oil supplementation and antioxidant therapy (including SAMe, Adequan may also have antiox action).

 

Re: seeking beans who have used Gabapentin on cat for pain

Yes, Blackie is 17 and he weighs right at 13 pounds. I think he was closer to 12 lbs when we started. We started the Gabapentin in January of 2009 when we took him off pred. He is doing great on 33mg, no sleepiness, he's alert and not limping now. We did start at 25 mg and just went up to the 33. I use the razor blade & mirror just like the movies and I put each dose in a foil packet that I make up. I thought of using butcher paper, but I didn't have any on hand and the foil works. I fold it in half to make a triangle, and put the Gabapentin in the fold and then fold up the edges and the top. I can usually reuse the foil packets at least once before making up new ones. I mix up about a week at time and store in a ziplock bag along with Blackie's other meds.

I hope this helps Cody.

 

Re: seeking beans who have used Gabapentin on cat for pain

I'm sure we could make some cocaine jokes but probably not without looking stupid :lol: Yes, Ele this is very helpful.

Jess, I'm sure Adequan is safe and I looked into it a bit after reading good things here, but Cody takes aspirin for his heart and I noticed on other sites that they don't recommend doubling up Adequan with another antiplatelet type drug. I understand your point that it may not be an issue, but if there is something else like Gabapentin that (no one has said anything bad about) it may be a better choice for a cat who gets aspirin every 3days for the rest of his life.
Its just surprising to me that it hasn't caught on like wildfire due to the lack of choices for pain meds in cats.

And metacan... well I read that study that said under some low dose (.2?) that it may be safe, but again, he already takes aspirin. and bupe seemed ok but heres cody: :shock: He's not in obvious pain like an arthritic cat, but his bg readings drop everytime he gets pain meds, so... I think its related to bone overgrowth from the acro. or possibly headache from the tumor.

Thanks everyone, I'll try to see the vet next week and let you know. Today Cody threw me a loop and got his first ever green number, so I may just have to see where that takes us- tumor always keeps me on my toes.

 

Re: seeking beans who have used Gabapentin on cat for pain

Hi Nancy

I didn't realize he was on aspirin too. If you were in desperate straits (major QOL issues), you might consider it more strongly, but since you have other options I agree they are worth a try. Actually, gabapentin works synergistically with NSAIDs and opioids so it might help the aspirin help more with pain relief.

Well, it has to be compounded, and it's also just not well known so a lot of vets may be reluctant to prescribe it without better info on side effects and such. Do let us know how it works out for you, ok?

Jess

 

Re: seeking beans who have used Gabapentin on cat for pain

Thats awesome!
Thanks so much for the info. He's suddenly doing better, so I'm not sure whats going on or what's next. the joy of acro
viewtopic.php?f=24&t=14740

 

Re: seeking beans who have used Gabapentin on cat for pain

How interesting that you mention SAMe. I was just musing over in LL a couple of weeks ago over whether Meowzi's recent ability to hop up the kitty tower (video here) was related to the doubling of her fish oil, like I had initially thought, or to her starting on Denosyl a little before that. I think I did mention to you about Dr M on VIN suggesting SAMe for Meowzi, Jess, but I'd thought he was addressing her CKD. I hadn't linked it to arthritis. Out of curiosity, I looked SAMe up on Wikipedia (gold standard for research - not! :mrgreen not long ago, and there was a reference to OA. I wonder why Nutramax doesn't mention the possible benefit to OA on their Denosyl page.

 

Re: seeking beans who have used Gabapentin on cat for pain

Hi Choy Foong

Probably because they'd have to back it up with research. THere are studies showing SAMe is beneficial for OA pain but I am too lazy to look them up Antioxidants in general can help to slow arthritic changes and seem to increase comfort in humans with OA; it's just difficult with feline patients who do not take meds willingly, like humans do!

 

Re: seeking beans who have used Gabapentin on cat for pain

It's ok, I'll take your word for it! :mrgreen:

I didn't know that about antioxidants. To think of all the other stuff I've looked up, and this one never crossed my mind. It was suggested to us last Sept and we didn't start it till this March! ohmygod_smile

Thanks, Jess! And my apologies to Nancy and Cody for the thread hijack.

 

Re: seeking beans who have used Gabapentin on cat for pain

Hi Nancy,
I've been looking into pain med alternatives to metacam and other NSAIDS, and posted some links and info on gabapentin, buprenorphine and tramadol here:

viewtopic.php?p=63616#p63616
-- includes info links re: drug interactions, drug metabolism in liver & kidneys, a gabapentin monograph, etc; also link to the 2007 AAHA/AAFP Pain Management Guidelines

viewtopic.php?p=61827#p61827
-- includes VASG info on bupe, link to the Winn gabapentin study news, a gabapentin dose (compounded) being used by a CRF civie-mom*, notes from a Penn Vet Confc last yr, and a link to Dr Lisa post re: tramadol cautions

*note* about the dosing and concentration used by the CRF listmember in my post (Carolyn and I are members of the feline-crf-info yahoo list)...

Laura described Seth's dose (I think was made from 100mg gabapentin mixed in VAL syrup):
"...Our vet compounds this for us, and it 50mg/ml gabapentin, crushed and mixed into 10cc Val syrup. The doseage is 0.2 ml by mouth, once a day..."

After re-reading, I'm pretty sure she meant to say that she gets a 10 ml vial of syrup that is compounded at a concentration of 50 mg/ml. (if 50 mg/ml were mixed w/ 10 ml syrup, I think it would be diluted to 1/10th strength). If my math is right, at a 50 mg/ml concentration, her 0.2 ml dose is 10 mg, which if given 1x/day, is ~ half the VASG's minimum starting dose for a 10 lb. cat (2 mg/kg BID).

Some notes from the VASG website:
http://www.vasg.org/newer_options_for_c ... ment_2.htm
http - www - (vasg.org/newer_options_for_chronic_pain_management_2.htm)
http://www.vasg.org/chronic_pain_management.htm

>> Gabapentin - use alone or adjunct;
Possible side effects - weight gain, transient sedation;
Particularly effective in neuropathic pain and cancer related pain [and arthritis];
Dosed at 2 to 5 mg/kg BID PO;
Due to xylitol content, the 50mg/ml liquid not recommended;
Partially metabolized by liver; excreted unchanged by kidneys; dose reduction for renal patients;
Short half life; fast clearance, requires frequent dosing;
---> (so if had an adverse reaction, the drug might clear from body quickly)
Oral antacids may decrease the bioavailability of gabapentin, so should be given at least two hours apart
- - - - - - - - - - - - - -

If you end up using a med that only comes in small tablets that need to be cut up, it can be tricky to do it accurately. Here's an excerpt from an IBD article, that describes one vet's method for accurate low dosing with a "human-sized" med:

Inflammatory Bowel Disease and Intestinal Lymphoma in Cats
http://www.vin.com/VINDBPub/SearchPB/Pr ... R00427.htm
http - www - (vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00427.htm)

"... Azathioprine is currently only available as 50 mg tablets. The low dosage used in cats requires that the tablet be broken into small fragments (i.e., 1/30 - 1/50 tablet depending on body weight). Since this is a very inaccurate and potentially dangerous way of administering azathioprine to cats, this drug must be administered in suspension form.
I have used a preparation which allows for accurate dosing of azathioprine and less chance of accidental toxicity. A 50 mg tablet is pulverized and mixed in 15 ml of V.A.L. Syrup (Ft. Dodge Laboratories). This is a flavored vitamin preparation which is quite palatable to most cats. Powdered medication mixes well with the syrup and does not seem to precipitate out appreciably. The dosage in ml is then calculated based on the cat's body weight (e.g., 0.33 ml once every 48 hours for an 8 pound cat). The client is instructed to shake the medication well before administering it. Alternatively, a suspension preparation can be made by a compounding pharmacy service. A major advantage of administering azathioprine in this manner is that any required increase in dosage can be done very accurately. ..."
- - - - - - - - - - - - - -

I only come around occasionally, but all the sugarcats and their civie families are in my thoughts and prayers. Hope this helps a bit
Deb, angel Evie, and the boys (civies)

 

Re: seeking beans who have used Gabapentin on cat for pain

Thanks Deb, I'll take a close look at all this tomorrow when my eyes aren't crossed . Looks like some great links and info.

 

Re: seeking beans who have used Gabapentin on cat for pain

this is just an update for those of you who posted on this thread back in May. Cody's vet went to a big vet conference last week, and inquired about the use of gabapentin. The speaker strongly endorsed it, and so my vet called in a compounded Rx, which Cody started on Sept 5. His first day, he seemed immediately more bright eyed and social, but it seemed to wear off in the evening and the next day he woke up Very thirsty and with high BG. Today has not been great, so maybe it was a coincidence or his aspirin day one that made him better yesterday. I know Ele said it took a few days to kick in.

His dose is 30mg 1x/day, compounded with water and tuna powder- yummmm (30mg/ml, dose = 1 ml)
Hoping for my old kitty back- I was really excited yesterday as he seemed so much like his old self, that I hadn't seen in years.

 

Hi I'm afraid I have only used it for a human, My Mum was prescribed it. We havd to increase the dosage until we got it to the right level. It took a while increasing it slowly, we ended up deciding to use a different pain method as it really made her a bit spaced out, not used it for a cat though. Good luck!

 

Cody has been on 30mg compounded gabapentin for one week and I am very pleased. He does not seemed drugged or buggy eyed and he has been much more like his old self.

Instead of spending all his time in a dark closet he has started spending time with us. He's jumped up and sat with me on the couch. He is sleeping on my bed again, he is lounging less often in a frog leg position and more often in a head upright normal cat position. He started cruising around outside for almost an hour. He is still stiff, and highly food motivated (growing acro boy), but I think his huge acro belly and his suspected light avoiding headaches are definitely improved. And even when he's sleeping, he frequently looks like he's smiling again. I know its not curing his acro, but he is acting like he's feeling much better.

Hope this update is of help to someone else.