Dosage Overview

Although Gabapentin has not been officially approved, it has a wide range of uses in feline medicine and the dosage required varies with the use. This article reviews the relevant literature and aims to provide the most practical dosing information you are likely to need in your practice.

Gabapentin in Cats with Acute Pain

An early one Case reports highlight the benefits of gabapentin as part of a multimodal analgesic strategy in cats dealing with major trauma when nonsteroidal anti-inflammatory drugs (NSAIDs) are inappropriate. 1 The report concluded that gabapentin should be considered for use in such situations in clinical settings, but noted that more research support is needed.

A follow-up study evaluated the analgesic effect of gabapentin in cats undergoing ovariectomy surgery. 2 The study details dosage and groupings (see Table 1) and also compared correlations between two pain scoring systems, the Multidimensional Composite Pain Scale and the Glasgow Pain Scale. Among them, the unvalidated multidimensional composite pain scale was used to assess the need for additional analgesic measures, which is a key indicator for evaluating analgesic effectiveness.

This study reveals that buprenol alone does not provide adequate analgesia in 50% of cats, reinforcing our understanding of the importance of a multimodal treatment approach. When meloxicam was added to the treatment, we observed improved comfort in cats, with cats in this group having the lowest need for further analgesia. This implies that combining gabapentin with opioids is more effective than using opioids alone when NSAIDs are not available, which is an important message to take home. The dose used in this study was 50 mg per cat. However, because the study was small (only 52 cats), a larger sample size was needed to demonstrate a statistically significant difference. It would also be an interesting direction to study the combined effects of opioids, NSAIDs, and gabapentin.

Table 1:

Conclusion of additional analgesia based on group dosage requirements

Buprenor 0.02 mg/kg IM 50% has insufficient analgesic effect when used alone

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Buprenor & Meloxicam 0.02 mg/kg IM /0.1 mg/kg SC 13% improved compared to buprenor alone

Buprenor & Gabapentin 0.02 mg/kg IM /50mg PO 26% superior to buprenol alone

Gabapentin application in chronic pain in cats

Given that we already have NSAIDs and frunevetmab approved and effective treatment options, it is surprising that gabapentin is the most prescribed feline musculoskeletal (MSK) pain treatment on VIN. Currently, there is very limited research on gabapentin as a chronic analgesic treatment in cats.

In a study involving 20 cats, researchers used a dose of 10 mg/kg of gabapentin every 12 hours and compared it with a placebo. 3 Outcome measures studied included client-specific outcome measures (CSOMS), mobility assessments, and cat owner-rated quality of life (QoL). Cats in the study received either gabapentin or a placebo for two weeks, then switched groups to continue treatment for another two weeks.

Owner-rated quality of life improved in cats treated with gabapentin. Mobility was assessed using an accelerometer mounted on the cat's collar, which showed a decrease in activity, a change that was attributed to sedation.

This small study suggests that gabapentin may be beneficial in treating chronic pain in cats, but an appropriate dose needs to be determined to avoid inducing sedation. Therefore, it is recommended to start with a lower dose - 5 mg/kg twice daily - and gradually increase the dose as needed. At the same time, we cannot ignore the influence of the placebo effect, and relying solely on gabapentin as the sole treatment for chronic pain in cats may not be the best option given that there are other approved treatment options on the market.

Gabapentin Use in Feline Anxiety Relief

There are currently two Studies have examined the effects of using gabapentin as a sedative in healthy cats.

The first study used 100 mg gabapentin capsules for all participating cats. This results in a wide dosage range due to differences in cat weight. Researchers

found that a dose of 20 mg/kg was most effective when administered 1-2 hours before a visit to the veterinarian, which became the basis for the recommended dosage. 4

Another study evaluated the effectiveness of gabapentin in reducing stress in the Catch, Neuter and Return program. 5 Because fixed-size capsules were used, the researchers used a dose range of 9-47 mg/kg for cats of different body weights. Studies have found that the effects are most significant two hours after administration.

By using gabapentin in liquid form, the optimal dose of 20 mg/kg can be delivered to cats precisely. In a recent study, researchers evaluated the effects of giving 20 mg/kg gabapentin 1 to 2 hours before visiting the clinic in hyperthyroid cats. 6 This was a placebo-controlled study, and the results showed that cats in the gabapentin group were significantly more relaxed during the trip to the hospital and more cooperative during examinations (exams, blood draws, blood pressure measurements).

Still, we need to be aware of the side effects of gabapentin at this dose, including sedation that may last up to 8 hours. Therefore, this higher dose of gabapentin is primarily designed to treat anxiety in a single dose. If you plan to bring a cat home, you must tell the cat owner to keep the cat indoors to prevent it from jumping around.

Dose Overview

Acute pain: 5-10 mg/kg twice daily.

Chronic pain: The starting dose is 5 mg/kg twice a day, which can be increased to 10 mg/kg if necessary.

Sedation: If necessary, give a one-time dose of 20 mg per kg of body weight 1-2 hours in advance.