June 1, 2023

How does Gabapentin work? Pet pain expert Dr. Robin Downing explains how the pain medication Gabapentin is used for both managing post-operative acute pain and providing long-term pain relief in dogs and cats? Learn more at

Tell me a little bit about gabapentin in post-operative setting how how is it used so gabapentin is a really useful pain tool really really useful pain tool and unfortunately we’re still a really early stage in veterinary medicine in understanding how it should be used meaning acute pain versus chronic pain and how it should be used in terms of dosing and we have

Just not god blinded studies that really let us know how we should be dosing this medication but as someone who’s been using gabapentin as a tool for both acute and chronic pain based on the human work and extrapolating that to animal use i can assure you that over a greater than 15-year period i haven’t seen this drug be a game-changer for both acute pain as well

As chronic pain so let’s talk about gabapentin in the acute pain phase what gabapentin does is it works on the dorsal horn of the spinal cord where pain signals are modulated as they go up to the brain to the pain perceiving centers of the brain and it helps the body just modulate those signals so in the human literature gabapentin actually was shown to decrease

The use of patient administered patient controlled analgesic that’s the pump that people talk about where they push a button and they get a dose of morphine or they get a dose of oxycodone as a part of their post-operative orthopedic recovery immediately post-op well in those studies that were done patients who were having a total knee arthroplasty acknowledged

To be the most painful orthopedic condition that people have total knee replacement in those patients who got gabapentin as part of their post-operative pain relief they used less of the opiate so in my post-operative patients i don’t reach for gabapentin for every post-operative patient but if they’re having a big procedure an orthopedic procedure like a teep

Yellow or a spinal decompression because they’ve had an intervertebral disc rupture or they’re having an amputation where i’m cutting a nerve i want to target that nerve pain so i’ll use gabapentin if they don’t have other orthopedic issues that might imply that they would benefit from gabapentin chronically what i will do is use it at a fairly aggressive dose

In the first two to four weeks postoperatively and then wean them off we do not have to wean them off the same way we wean patients off of steroids for instance it can be a little quicker than that if the only time we’re using that gabapentin is for that immediate post-operative time my colleagues will often ask me well how high a dose should i use and my answer

Is we want to use an big enough dose to control the pain and just a little bit less than what makes the patient sedate the patients are gonna vary so i have some dogs that are what i refer to as cheap drunks and they cannot hold their liquor so they actually need a much lower dose of gabapentin to keep them comfortable and not make them sedated then other dogs

That i deal with who need a bigger dose in order to be comfortable and still not sedated so the dosing range might be as low as 10 milligrams per kilogram the dose might be as high as 50 milligrams per kilogram per dose it really depends on the patient that’s for acute pain let’s look at chronic pain management with gabapentin again understanding the chronic pain

Means that there have been changes in the nervous system that allow pain to become a self-perpetuating state that place in the nervous system that is responsible for that is the dorsal horn of the spinal cord gabapentin has an exquisitely specific place in the dorsal horn that it were and what it does is it takes the threshold for firing of the nerve from minimal

Stimulation back up to where it belongs i talked about this as though we are resetting the thermostat on a hot-water heater so i want that thermostat to be back up where it belongs i don’t want it to be way down here so i don’t want a light touch like this to cause pain if i have a nervous system and that’s not working properly a very light touch will actually

Cause pain and suffering in that animal but if i can use gabapentin to take the threshold for discomfort from a light touch to a more normal firm pressure that is a way for me to take that pain state and restore what should be perceived as pressure and not be perceived as a painful touch

Transcribed from video
Managing Pain in Pets with Gabapentin By Tripawds