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Gabapentin And Tramadol Together For Back Pain:dosage?


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I had posted a few days ago regarding Garry (11) and his bad spine..can't get up stairs, holding left hind leg up, walking all crooked...so much pain. Has been on dexa steroids..now decreased to one time a day. tramadol 100 mg 2 times a day.

we started gapapentin yesterday. My vet wants him to have 100mg twice a day, but said the combo with tramadol would make him too sleepy, so i decreased tramadol to one tablet and spaced out the administration of both. He hasn't appeared sleepy to me.

 

He weighs about 70 lbs..has lost nearly 5 due to the steroids. ( I am feeding him extra to help with that).

 

I am seeing him struggle more, rather than less. I will call my vet tomorrow for an update, but I am wondering if from experience, how have your greys done on a combo of tramadol and neurontin and the dosage?

 

I also started adequan shots and he has had two acupuncture treatments..will schedule another for this week.

 

We talked about muscle relaxers as well. she favors valium..but wanted to wait to see how he did on the neurontin.

 

Thanks!

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Gabapentin may require 48 hours or more to get up to speed on your boy. General advice on gabapentin is smaller doses, more often, rather than large doses a couple of times a day--but sometimes you just have to work with the hours you've got away from your job.

 

My 65-pound, 12-year-old, Sam, is not taking an NSAID. He took meloxicam for a while but started having stomach trouble.

 

Sam's prescriptions (aside from his regular thyroxine and metronidazole and an occasional pepcid for other issues):

  • one or two 50mg tramadol, up to three times a day
  • one or two 100mg gabapentin, up to three times a day
  • one 500mg methocarbamol, up to three times a day

What Sam actually takes:

  • one 50mg tramadol, two or three times a day
  • two 100mg gabapentin, two or three times a day
  • one 500mg methocarbamol, two or three times a day

When it's pills twice a day, Sam takes them at breakfast and at dinner. On a long day--or a chilly day--there'll be a third round of pills at bedtime. Some days, I work until after 9 at night and leave for work about 6:30 the next morning; on those days, we skip bedtime pills because bedtime falls so closely on the heels of dinner, and the breakfast is chasing both of them. Sam's a lot more comfortable in warmer weather. In cold weather, I keep a lightweight coat on him even in the house; he sleeps better (and wakes me less) when he isn't chilled.

 

Methocarbamol is a muscle relaxer (aka Robaxin) and helps when pain is making Sam tense the muscles of his back (Sam has arthritis in his spine and a slightly herniated disk at L5). I know the methocarbamol has made Sam more mobile--made it easier for him to stand up and lie down--than the other two pills. I think the tramadol and gabapentin are what's keeping him comfortable when he's lying around in the evening. Without them, he doesn't sleep as well. But he never seems loopy or groggy on this pill pile. So far, we've completely avoided steroids--saving that for an emergency. The vet said we could go up on the gabapentin dosage, but it hasn't been necessary. Sam still plays with stuffies, eats like a horse, and does zoomies in the living room. He also raids the kitchen trash can at distressingly frequent intervals. ;)

 

 

7105905469_ec62ba69cc_n.jpgHe gets all his pills at one meal rolled burrito-style into a single slice of turkey lunch meat, which he gulps right down.

 

I've found the best prices for Sam's drugs at Walgreen's. His scripts are all generic and written so that I'm getting at least a 30-day supply of everything. I have the Walgreen's Prescription Savings Club card. It's $35 a year, and it saves me that much on one 180-pill fill of the gabapentin.

 

I've blocked the stairs, so that Sam stays downstairs all the time now. I've moved downstairs for sleeping because I'm certain that climbing the stairs--and leaping onto my bed--wasn't doing Sam's back any good. I also don't want to risk him having a problem on the stairs when I'm not home. I run upstairs for showers and for getting ready for work in the morning, and he's content to lie at the foot of the stairs and wait for me. (I shift a spare ex-pen in front of the stairs to block them off.)

Edited by KF_in_Georgia

15060353021_97558ce7da.jpg
Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

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Guest lizmego

With Dell's (age 14, 70 pounds) rear end and spine issues, he can no longer do stairs. He's had issues with NSAIDs, so can't take them - Rimadyl causes him to have blood in urine, and tramadol makes him high strung and kinda wigs him out (he can't relax, its odd). So we have him on Gabapentine and Amanditine. We're currently at the max for both medications and I'm not sure what we'll do if his pain worsens. Gabapentin 400 mg, twice per day and Amantidine 100mg, once per day.

 

I wanted to add that Dell gets acupuncture and Chiropractic treatments once a month. He definitely does better after those treatments (sleeps better and through the night).

 

Good luck with the pain management you opt to do.

Edited by lizmego
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Thank you both for your very helpful responses! I actually went through this a few years back..(2-3) with my Missy, who is now 13..and also no longer does stairs...but otherwise "holds her own"...running in the backyard for short spurts and carrying her giant stuffed bone around all day...went to a different vet then...not grey saavvy. missy has had acupuncture since this started for her...I think it is very helpful for her.

she takes tramadol and meloxicam.along with supplements.

 

I know it takes time...but I feel so bad for him..

 

Garry: I wish we could end the steroids..he is not handling them well. he has a couple more days of every day..then every other day for i think 5. . I will go back to 2 tramadol this evening and give a second gaba spaced at 12 hours..tomorrow will do 100mg every 8 hours..that will be his third day.

He is stubbling more today, I know gaba can cause this. does they typically adjust to it?

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Just wanted to add that our Spencer is on both and started a couple months ago with 300 mg. gabapentin twice a day plus the tramadol. The very first night he was unsteady on his feet, but that cleared up by the next day. We've been able to reduce his dose to 100 mg. three times a day, plus tramadol twice a day, and it's working very well. So I don't know about the need to build up, since we started at a high dose, but I wonder if your dog's getting enough. Just a thought and something to discuss with your vet if there's no improvement soon. Good luck!

 

I should mention that Spencer weighs 75 lbs more or less, and his tramadol dose is only 50 mg. each time. His diagnosis is LSS and three herniating disks in his middle spine.

Edited by greyhead
Mary with Jumper Jack (2/17/11) and angels Shane (PA's Busta Rime, 12/10/02 - 10/14/16) and Spencer (Dutch Laser, 11/25/00 - 3/29/13).

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As stated before, current thinking is that gabapentin metabolizes out of greyhounds more quickly than other breeds, so lower, more frequent doses are better than two higher doses.

 

My Toni is on 300mg twice a day for siaticca (sp?) nerve pain in her leg. She does great for about eight hours and then I can see her begin to have trouble - limping, irritable from pain, difficulty moving. Once this rx is done, I'll be asking ehr vet for 100mg pills we can give her every eight hours.

 

Toni also gets rimadyl, and she's never had any sedative effect from either drug that I've been able to see. In fact, she's back to being her old self!

Edited by greysmom

Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora)

52592535884_69debcd9b4.jpgsiggy by Chris Harper, on Flickr

Angels: Libby (Everlast), Dorie (Dog Gone Holly), Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby), Whiskey (KT's Phys Ed), Atom, Lilly

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Guest LindsaySF

The Gabapentin takes a little while to build up into their system too.

 

Andy (74 lbs) was on 100 mg Tramadol 3 times per day and 200 mg Gabapentin 3 times per day. His vet started him out on these higher doses and then we decreased them slowly over time.

Edited by LindsaySF
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Sorry. Deleting my original post here.

 

 

If you can get your vet to increase the gabapentin dosage, you might want to increase over a couple of days. Try 100mg three times a day, for a day or two. If that doesn't seem like enough, make one of the three doses be 200mg. If that doesn't help, increase another dose to 200mg. Gabapentin will take time to build up; it also takes some time to wear off, so that if you increase too much too quickly, Garry might have different problems.

 

Some dogs seem to show symptoms of anxiety on larger doses of Tramadol. I'm not saying Garry will. I'm just saying that if he seems to be panting a lot or stressed or suddenly in more pain, you might want to cut back on Tramadol before you get too concerned.

Edited by KF_in_Georgia

15060353021_97558ce7da.jpg
Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

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Some dogs seem to show symptoms of anxiety on larger doses of Tramadol. I'm not saying Garry will. I'm just saying that if he seems to be panting a lot or stressed or suddenly in more pain, you might want to cut back on Tramadol before you get too concerned.

Spencer got more anxious on the tramadol. Normally pretty bomb proof, a lawn mower started up and caused him to bolt to the end of his leash, which led to his falling down and needing staples on the resulting cut! He also panted more on walks (and only on walks), which made me wonder if it increases body temp at all (or just the perception of it). When I take an opoid painkiller for a migraine, I notice that I feel uncomfortably warm if I move around too energetically. Both the panting and anxiety for Spencer have diminished to the vanishing point over the two months he has been on them. Not meaning to hijack the thread but to elicit info that may help the OP know what her dog is experiencing too.

Mary with Jumper Jack (2/17/11) and angels Shane (PA's Busta Rime, 12/10/02 - 10/14/16) and Spencer (Dutch Laser, 11/25/00 - 3/29/13).

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Guest snakes

FedX at one point was up to 200mg gabapentin three times a day and was getting tramadol 50mg twice a day (occasionally 3) and was fine. He is 78-80lbs. He is now on 200mg gabapentin twice a day and tramadol only on 'bad' days. I actually found gabapentin to be a wonder drug for FedX but that is on OS pain, we barely use the tramadol nowadays.

As others have said it does take about 48hrs for gabapentin to go into full effect and most dogs can go on fairly high dosages and incoordination/wobblyness is the first sign of a dose being too high.

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I think your vet's comments about tiredness at those doses was frankly off base. Every dog will respond differently, but generally it seems people don't see issues with Tramadol aside from a small percentage of dogs that suffer from restlessnes or anxiety at higher doses. Gabapentin can cause sedation, but more likely will cause the dog to be dizzy or off balance at higher doses. It seems that you can reduce the chances of that by giving smaller doses every 8 hrs rather than larger every 12 and by slowly building up the dosage over a few days or longer.

 

Neyla at her highest doses was on 125 mg Tramadol 3x/day and 300 mg Gabapentin 3x/day with no noticeable side effects. 400 mg of Gabapentin made her woozy so we backed off. Not saying you should necessarily need those high doses (this was to treat pain from osteo), but you certainly have room to move. She only weighed slightly under 60 lbs.

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I just reread your first post and saw that your vet wanted to add valium. Valium is the only drug that actually wiped out my boy. He couldn't sleep well (was still in pain), but he had absolutely no coordination on a fairly low dosage. I told my vet: we cut the valium (usually not stopped cold-turkey, but Sam hadn't been on it for long), and that's when we added the tramadol.

15060353021_97558ce7da.jpg
Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

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Thank you. .I am calling the vet today. Garry is getting worse. I have seen no signs of improvement with any of the meds: dexa steroid, gabapentin and tramadol. He had been on tramadol in the past and it helped him.I am very worried about osteo as he cannot put his leg down and is stumbling. now he is not interested in his dog food, only wants boiled chicken or pasta. today was the last of daily steroids.

I want to ask her do some x-rays. He is miserable and so am I...actually feel sick over watching him struggle.

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:(

 

Sending prayers for your boy.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Garry is going in tomorrow morning for x-rays..vet feels he is too resistant to pain meds...and since he is favoring only one leg....need to rule out osteo. I have a bad feeling. I wish we didn't have to wait until tomorrow..but my vet doesn't come in until 2pm today and he ate this morning...not a lot. I am so sad and scared...

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Holding out hope that it is soft tissue injury or arthritis and just a matter of rest or finding right medication combo. Sending hugs for yourself -- can imagine how dreadfully worried you must feel.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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thank you so much. even though we have gone through this before...it is so hard..I am hurting so much for him...he had such a tough start...track..returned..very very fearful. at his foster home, he hid in the closet. it took us years to have him join our family rather than hide in my bedroom. He turned out to be such a great, happy guy. I am not ready to lose him yet. I am so hoping it is something else. thank you again.

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thank you again. One of my sons is coming over to visit him...makes me sad, yet happy they all care so much. the other two don't live close..but asked if they could see him...just in case...maybe I am thinking too much....I am praying for an injury or something...anything...

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