I didn’t know we should start low on the dose and it makes sense because of the range. (I’m a vet nurse.) This video is loaded with helpful information-thank you!
Hi Claire, what are your thoughts on Gabapentin for inflammatory pain (as in surgical pain) in cats , I see there is one study from 2018 where gaba was added into the regime prior to OVH and those cats required less rescue analgesia, is this likely from the effects on the desending pathway as you suggested? I feel we may overuse it for acute pain , but often we have less options for oral analgesia in cats aside from nsaids
For cats preoperative gabapentin has the advantage that it reduces anxiety and so for a routine procedure like a spay in a healthy cat it could help reduce anxiety in the hospital and reduce pain. It is definite advantage in a fearful animal. Pre-operatively this would mean having to tablet a cat without the aid of a food treat. Worth checking out the ISFM guidelines for cats journals.sagepub.com/doi/full/10.1177/1098612X18781391 Postoperatively it is useful as a oral analgesic agent anecdotally. there is also evidence useful perioperatively in other non neurological procedures in dogs eg mastectomy (dogs) www.ncbi.nlm.nih.gov/pmc/articles/PMC4565804/ Orthopaedic surgery (dogs) chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/wsava.org/wp-content/uploads/2020/01/Orthopedic-surgery.pdf hope this helps ! Clare
Many have reported it caused extreme weakness in their dogs’ hind legs to the degree they could not stand. The dogs reportedly were dragging their hind quarters. Some reported stopping the drug and seeing an improvement. Alarming.
thanks for mentioning this. In my experience, this is not an issue if the drug is dosed appropriately and for a dog / cat that is suffering with neuropathic pain. However I have seen it as an issue when given high doses and when the dog/cat did not have pain and / or had another issue such as weakness from polyneuropathy.
I would check 1) is the dog in pain or is there some other issue which is being misinterpreted for example weakness making it difficult to rise which is misinterpreted as pain or superimposed on pain. The classic and common would be a older dog with osteoarthritis and some lower back discomfort BUT also has a polyneuropathy making them weak 2) is there another drug that would work better and not cause sedation eg NSAID or Librella. Adding this might allow a dose reduction and the two would work together 3) have you been started at a low dose 10mg/kg every 12 hours and titrated up to the therapeutic dose 4) is there are reason why this dog might be very sensitive eg kidney disease or - in my experience - a sight hound. I would go back to your vet and discuss your concerns @@troismals
Interesting! You explain everything so well. I have been on gabapentin myself for 2 years due to a necktrauma so I found this really informative both as a vet and as a patient myself.
this is so informative. they want my cat on this because she's declawed and has wind up and flicks her front paws and chews on them. is this something it should be used for. if not, what else will help?
Absorption trans-dermally will depend on the compound and the blood supply to the region and whether the solution stays on the site. There is an article here www.ncbi.nlm.nih.gov/pmc/articles/PMC8295683/ suggesting some success. In general transdermal is regarded as a less reliable method of drug administration but then some people have a daily battle with medication so one might argue worth a try in those situations.
@@clare-neurovetThank you for the reference material! ❤ Animals with severe oral or dental disease may need another delivery method. This is very helpful.
My dog was just prescribed pregablin for seizures or possible dyskinesia. He was on generic keppra, but his anxiety has greatly increased since he started that drug. Do you think I should be concerned in using pregablin as an alternative treatment for his seizures?
Really a conversation to be had with your vet - I am afraid that I cannot comment on the management of individual animals although I am always happy to contact me via usual channels to ask advice on challenging cases.
Thank you for sharing your wealth of knowledge. My dog is on a Gabapentin trial on a high suspicion of CM/SM prescribed for 2 weeks before we determine to proceed to MRI. He’s prescribed 100mg, twice a day (every 12 hours). I like your three times a day logic, so would you advise if giving CBD oil in the late evening before bed would give my dog the extra coverage so he doesn’t dip into the pain zone. To clarify, the plan would be Gabapentin every 8 hours for two times a day, followed by CBD oil at the 24th hour. Yay or Nay?
Sorry ethical guidelines mean that I cannot advise on animals that are not under my care. So I would discuss this with your veterinary surgeon. Hope that things work out!
Both can cause sedation which will have an additive effect. In cats in particular CBD oil results in increased liver enzyme activity and you need to monitor the ALT (whether or not giving gabapentin) and reduce the dose if hepatic impairment (whether or not giving gabapentin). That is assuming giving CBD oil at a dose that is effective for pain relief which is 0.25 -3mg/kg every 12 hours. Adverse effects are seen in cats at doses of CBD oil above 0.5mg/kg every 12 hours and the effectiveness of CBD oil for pain at doses below 0.5mg/kg have not been established. Bottom line I cannot make a good case for giving CBD oil in cats. Of course there are always people that might say they give lower doses and all is well and prefer giving this "drug" because they think "natural" (but CBD is still a drug - with drug side effects).
@@clare-neurovet Thank you for replying, I have a cat who is being treated for squamous cell carcinoma on the nose, for various reasons we did not go the surgical route and tried Imiquimod cream for a while. I am trying CBD oil for possible ant-cancer effects and general well-being and pain relief.
I didn’t know we should start low on the dose and it makes sense because of the range. (I’m a vet nurse.) This video is loaded with helpful information-thank you!
thank you - glad you found it interesting
In people the dose has an incredible range. In the pharmaceutical industry this is known as a wide therapeutic window. Also as a dirty drug.
Hi Claire, what are your thoughts on Gabapentin for inflammatory pain (as in surgical pain) in cats , I see there is one study from 2018 where gaba was added into the regime prior to OVH and those cats required less rescue analgesia, is this likely from the effects on the desending pathway as you suggested? I feel we may overuse it for acute pain , but often we have less options for oral analgesia in cats aside from nsaids
For cats preoperative gabapentin has the advantage that it reduces anxiety and so for a routine procedure like a spay in a healthy cat it could help reduce anxiety in the hospital and reduce pain. It is definite advantage in a fearful animal. Pre-operatively this would mean having to tablet a cat without the aid of a food treat. Worth checking out the ISFM guidelines for cats journals.sagepub.com/doi/full/10.1177/1098612X18781391
Postoperatively it is useful as a oral analgesic agent anecdotally.
there is also evidence useful perioperatively in other non neurological procedures in dogs eg mastectomy (dogs) www.ncbi.nlm.nih.gov/pmc/articles/PMC4565804/
Orthopaedic surgery (dogs)
chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/wsava.org/wp-content/uploads/2020/01/Orthopedic-surgery.pdf
hope this helps !
Clare
Many have reported it caused extreme weakness in their dogs’ hind legs to the degree they could not stand. The dogs reportedly were dragging their hind quarters. Some reported stopping the drug and seeing an improvement. Alarming.
thanks for mentioning this. In my experience, this is not an issue if the drug is dosed appropriately and for a dog / cat that is suffering with neuropathic pain. However I have seen it as an issue when given high doses and when the dog/cat did not have pain and / or had another issue such as weakness from polyneuropathy.
I experienced it with my dog. Can you comment on how to reverse those effects? It has been very alarming. I appreciate it.
I would check 1) is the dog in pain or is there some other issue which is being misinterpreted for example weakness making it difficult to rise which is misinterpreted as pain or superimposed on pain. The classic and common would be a older dog with osteoarthritis and some lower back discomfort BUT also has a polyneuropathy making them weak 2) is there another drug that would work better and not cause sedation eg NSAID or Librella. Adding this might allow a dose reduction and the two would work together 3) have you been started at a low dose 10mg/kg every 12 hours and titrated up to the therapeutic dose 4) is there are reason why this dog might be very sensitive eg kidney disease or - in my experience - a sight hound. I would go back to your vet and discuss your concerns @@troismals
Yes, this happened to my dog quite severely with two doses he could not even stand.
Interesting! You explain everything so well.
I have been on gabapentin myself for 2 years due to a necktrauma so I found this really informative both as a vet and as a patient myself.
so glad that it was useful ! Hope that your pain is controlled
this is so informative. they want my cat on this because she's declawed and has wind up and flicks her front paws and chews on them. is this something it should be used for. if not, what else will help?
I've read that transdermal gabapentin is not well absorbed., does it depend on the specific preparation method?
Absorption trans-dermally will depend on the compound and the blood supply to the region and whether the solution stays on the site. There is an article here www.ncbi.nlm.nih.gov/pmc/articles/PMC8295683/ suggesting some success. In general transdermal is regarded as a less reliable method of drug administration but then some people have a daily battle with medication so one might argue worth a try in those situations.
@@clare-neurovet Yes, thank you for replying. I try liquid and or transdermal medications if possible.
@@clare-neurovetThank you for the reference material! ❤ Animals with severe oral or dental disease may need another delivery method. This is very helpful.
@@CikisHelyzet thank you !
My dog was just prescribed pregablin for seizures or possible dyskinesia. He was on generic keppra, but his anxiety has greatly increased since he started that drug. Do you think I should be concerned in using pregablin as an alternative treatment for his seizures?
Really a conversation to be had with your vet - I am afraid that I cannot comment on the management of individual animals although I am always happy to contact me via usual channels to ask advice on challenging cases.
Thank you for sharing your wealth of knowledge. My dog is on a Gabapentin trial on a high suspicion of CM/SM prescribed for 2 weeks before we determine to proceed to MRI. He’s prescribed 100mg, twice a day (every 12 hours). I like your three times a day logic, so would you advise if giving CBD oil in the late evening before bed would give my dog the extra coverage so he doesn’t dip into the pain zone. To clarify, the plan would be Gabapentin every 8 hours for two times a day, followed by CBD oil at the 24th hour. Yay or Nay?
Sorry ethical guidelines mean that I cannot advise on animals that are not under my care. So I would discuss this with your veterinary surgeon. Hope that things work out!
Excellent video, we have been using 30mg /kg on some highly stressed cats with good results as recommended by a veterinary anaesthetist.
that is good to know - I guess that you titrated up to that dose based on (previous inadequate) effect.
can the 100mg capsules be split into half to use twice to get two 50mg uses?
fiddly and time-consuming to put the powder back into empty capsules and you will lose some but yes it can be done.
teleion!!!!
thank you!
Superb
thank you!
Does gabapentin interact with CBD oil?
Both can cause sedation which will have an additive effect. In cats in particular CBD oil results in increased liver enzyme activity and you need to monitor the ALT (whether or not giving gabapentin) and reduce the dose if hepatic impairment (whether or not giving gabapentin). That is assuming giving CBD oil at a dose that is effective for pain relief which is 0.25 -3mg/kg every 12 hours. Adverse effects are seen in cats at doses of CBD oil above 0.5mg/kg every 12 hours and the effectiveness of CBD oil for pain at doses below 0.5mg/kg have not been established. Bottom line I cannot make a good case for giving CBD oil in cats. Of course there are always people that might say they give lower doses and all is well and prefer giving this "drug" because they think "natural" (but CBD is still a drug - with drug side effects).
@@clare-neurovet Thank you for replying, I have a cat who is being treated for squamous cell carcinoma on the nose, for various reasons we did not go the surgical route and tried Imiquimod cream for a while. I am trying CBD oil for possible ant-cancer effects and general well-being and pain relief.
Amazing content. Thank you so much.
thank you so much for you kind comments