What is gabapentin?
Gabapentin is a medication that was originally developed to treat epilepsy in humans. It works by altering electrical activity in the brain and nerves. The mechanism of action is not fully understood, but gabapentin appears to bind to calcium channels and reduce calcium influx into nerve cells, which inhibits abnormal excitement and transmission of nerve signals.
While not FDA approved for veterinary use, gabapentin is commonly prescribed by vets to treat nerve pain, epilepsy, and anxiety disorders in dogs. It can be used for chronic conditions like arthritis, intervertebral disc disease, and chronic pain after injuries or surgeries. Gabapentin is also sometimes used alongside other medications to control seizures in epileptic dogs. At higher doses, it may have a sedative effect that relieves anxiety in stressed or fearful dogs.
According to the AKC, gabapentin is well-tolerated by most dogs when given at the appropriate dosage under veterinary supervision [1].
How does gabapentin work?
Gabapentin works by binding to voltage-gated calcium channels in the brain and spinal cord, which helps reduce abnormal electrical activity that causes seizures and neuropathic pain (1). Specifically, it binds to the α2δ subunit of calcium channels, resulting in a reduction in synaptic transmission of pain signals (2).
Gabapentin can cross the blood-brain barrier and has been found to increase GABA biosynthesis and inhibit glutamate release in the brain through its interaction with calcium channels (3). This modulation of neurotransmitters is thought to be responsible for gabapentin’s anti-seizure effects.
In summary, gabapentin reduces abnormal electrical activity in the brain by binding to calcium channels and altering GABA and glutamate activity. This mechanism of action gives gabapentin both anticonvulsant and analgesic effects.
Why would you want to stop giving gabapentin?
There are a few reasons why you may want to stop giving your dog gabapentin:
Side effects – Gabapentin can cause side effects in some dogs such as sedation, incoordination, increased appetite leading to weight gain, and increased thirst and urination. If the side effects are severe or negatively impacting your dog’s quality of life, you may want to stop the medication.
According to Wedgewood Pharmacy, gabapentin side effects in dogs can include “lethargy, incoordination, increased appetite and mild temporary sedation” (source).
Your dog’s condition improves – Gabapentin is often prescribed for pain relief or to control seizures. If your dog’s pain or seizures have resolved or greatly improved, continuing the medication may no longer be necessary.
Transitioning to another medication – Your veterinarian may recommend transitioning your dog from gabapentin to another medication that could potentially work better or have fewer side effects.
According to Innovet Pet, “Your vet may want to transition your dog onto new medications that better fit your dog’s needs” (source).
Risks of Abruptly Stopping Gabapentin
There are several risks associated with abruptly discontinuing gabapentin without properly tapering off the medication first under veterinary guidance. The most common risks include withdrawal symptoms, rebound pain, and potential seizures.
Withdrawal symptoms from gabapentin occur because the body has become dependent on the medication. Common withdrawal symptoms in dogs include restlessness, anxiety, shaking, sweating, diarrhea, vomiting, muscle cramping, and rapid heart rate. Withdrawal symptoms can begin within 12 hours of the last dose but may take up to 7 days to appear. The severity and duration of withdrawal depends on factors like how long the dog was on gabapentin and the dosage.
Rebound pain is also common when stopping gabapentin, as the dog’s original nerve pain returns, often worse than before. Gabapentin works by altering chemical signaling in the nerves, so when it is removed, neuropathic pain can come back in full force.
Finally, dogs being treated for seizures with gabapentin are at risk of recurrence or cluster seizures if the medication is stopped abruptly. Lowering the dosage gradually helps avoid this.
Due to these significant risks, pet owners should never stop giving gabapentin to their dogs without veterinary guidance. Abruptly quitting gabapentin can be dangerous and uncomfortable for the dog. Working with the vet to slowly taper the dosage over a period of weeks or months is crucial.
How to safely taper gabapentin
When discontinuing gabapentin, it’s important not to stop the medication abruptly. Gabapentin should be gradually tapered off under veterinary supervision over the course of weeks or months to avoid withdrawal side effects. The general guideline is to reduce the dosage by about 10-25% every 1-2 weeks.
Your vet will advise you on the exact schedule for tapering based on factors like your dog’s condition, current dosage, and how long they’ve been on gabapentin. For example, a typical tapering schedule may start with reducing the dose from twice daily to once daily. After 1-2 weeks at this lower dose, your vet may then reduce the single daily dose by 10-25%. Your vet will monitor your dog closely during the taper and may slow the reduction if withdrawal symptoms appear.
Some vets recommend an even more conservative taper over 2-3 months. The slower the reduction, the less likely your dog will experience withdrawal effects. Patience is key when discontinuing gabapentin. While eager to get your dog off medication, tapering too rapidly can cause unnecessary suffering. Working closely with your vet to slowly taper the gabapentin dosage is crucial for your dog’s welfare.
Withdrawal symptoms
If gabapentin is abruptly stopped, dogs can experience withdrawal symptoms due to their bodies being dependent on the medication. Some of the common withdrawal symptoms include agitation, anxiety, tremors, and hypersensitivity. The agitation and anxiety can present as restlessness, pacing, whining or destructive behaviors. Tremors may occur in the limbs or body as shivering. Hypersensitivity refers to heightened reactions to normal sensory stimuli such as touch or sound. These symptoms occur because the dog’s nervous system has to readjust to functioning without the effects of gabapentin. Gradual tapering allows the body time to adapt to lower doses and avoid severe withdrawal symptoms.
Duration of withdrawal
The duration of gabapentin withdrawal can vary between dogs, but usually peaks within 48-72 hours after stopping the medication. According to this medical answer on Drugs.com, gabapentin withdrawal can last for 5 to 10 days or potentially longer in some cases. The duration depends on factors like how long your dog was on gabapentin, the dosage, and how quickly the medication was stopped.
One study found that the median duration of gabapentin withdrawal symptoms in people was 7 days, with a range of 1-21 days. However, withdrawal may be more prolonged in pets since they are often given higher relative doses of gabapentin than humans. It’s important to consult your vet if your dog’s withdrawal symptoms persist beyond 1-2 weeks after tapering gabapentin.
Overall, expect gabapentin withdrawal to potentially last weeks in dogs, with symptoms peaking within the first few days after stopping the medication. Work closely with your vet to provide supportive care and monitor your dog during this time.
Supportive care during withdrawal
It’s important to provide supportive care for your dog during the withdrawal process from gabapentin. Regular vet checks can monitor your dog’s health and allow the vet to prescribe medications to help with specific withdrawal symptoms. Anti-anxiety medications may help relieve any anxiety, restlessness, or agitation during withdrawal. CBD oil has also shown promise in relieving anxiety and pain in dogs, which could help manage withdrawal symptoms (1). Keeping your dog comfortable, staying patient, and giving lots of love and reassurance can also help your dog get through this transition period.
With proper tapering of gabapentin, supportive care, patience, and TLC from you, your dog can successfully come off gabapentin. Don’t hesitate to call your vet if you have any concerns during the process.
Sources:
(1) https://www.innovetpet.com/blogs/medications/5-steps-to-get-dogs-off-meds
When to call the vet
If your dog experiences severe withdrawal symptoms, it’s important to contact your veterinarian right away. Some signs that require urgent veterinary care include:
- Severe anxiety or restlessness – constant pacing, panting, whining
- Refusing food for more than 24 hours
- Seizures
Seizures in particular can be life-threatening, so get veterinary help immediately if you notice your dog having tremors, collapsing, chomping their jaw, or showing other signs of a seizure. Even a single seizure warrants an urgent vet visit to get your dog stabilized.
Additionally, contact your vet if nausea, diarrhea or other digestive issues persist beyond 48 hours, as dehydration could occur. Seek help if any symptoms seem extreme or debilitating for your pet. Your vet can provide fluids, anti-seizure medications, anti-nausea meds, or other treatments to ease discomfort and make withdrawal safer.
Don’t hesitate to call day or night if you have concerns about how your dog is handling the gabapentin taper. Your vet would much rather see your pet for a progress check than have you wait until your dog’s health deteriorates further.
Long-term outlook
With slow and gradual tapering over days to weeks under veterinary guidance, most dogs recover fully after discontinuing gabapentin without long-lasting effects. The key is slowly reducing the dosage to allow the body to adjust and avoid withdrawal symptoms.
One study showed that after 9 months of gabapentin treatment in dogs with epilepsy, gabapentin could be discontinued without ill effects in 81% of dogs. Only 6% showed potential worsening seizure control. This demonstrates that long-term use does not lead to dependence in most dogs and that discontinuation is well tolerated if properly tapered [1].
Regular veterinary monitoring, owner vigilance, and slow tapering of the gabapentin dosage allows dogs to successfully transition off the medication. While some minor setbacks are possible during the transition, dogs fully recover normal functioning after gabapentin withdrawal with proper veterinary guidance.