Gabapentin/deramaxx

[NeylasMom]

Sorry for yet another thread, I'm being an H&M hog this week.

 

Wondering if you've given Gabapentin to your dog, at what dosage and what effects you saw, both good and bad. Particularly interested in those of you who have used it for palliative care for osteo and for LS.

 

Also wondering about timing of meds.

 

We've increased Neyla's meds to 25 mg Deramaxx 2x/day and 75 mg Tramadol 3x/day. I didn't feel that was quite enough so the vet said we could add a 4th 75 mg dose of Tramadol or add Gabapentin, but she didn't want us to do both at the same time. I opted for the Gabapentin b/c I thought it would be tough schedule wise to administer 4 doses of Tramadol spaced apart, adn b/c Gabapentin should address a different component of the pain. She prescribed 200 mg 2x/day. I picked it up today and gave her 100mg tonight to start.

 

The bottle said 2 tablets every 12 hours, which made me realize that I give things 8 hours apart b/c some things are given 3x, so basically meds are given at 8 am, 4 pm, & midnight. Would it be better to space the Deramaxx and Gabapentin further apart you think, say 8 & 8 instead to maintain a more even level of pain control throughout the day? If I do that, do I give dinner with the Gab/Der at 8 or with the Tramadol and other holistic meds at 4.

 

Am I making any sense here? Do you think I over think everything?!

[Brindles]

You might be overthinking, but I'm right there overthinking with you.

 

Echo is on 50mg Deramaxx once a day. I asked my vet if I could give it twice a day and he said the results are better when given only once. She is also on 100mg Tramadol 3x/day. She had a good first couple weeks on both meds but the effects declined. Two months later she is in as much pain as she was before. Le sigh.

 

I ran out of Tramadol and opted not to refill it. Again, no change.

 

I'm really interested in Gabapentin so I'll be keeping up with this topic.

[tbhounds]

I would give the Gab/Der at 8.& 8. The Deramaxx should be given with a meal the tramadol can be given on an empty tummy if needed. I think you'll find that the Gab will help a lot.

[Sambuca]

I don't have experience with dogs, but I'm on gabapentin. I know I was prescribed 900mg 3x a day. I now only take 600 1x a day. So you can go pretty high. As for side effects, the only one I've had is that when taken with my sleeping meds it helps me sleep a bit better. On it's own though I had no side effects. My father was on it to help with palliative care for fibrosarcoma. It was the only thing that helped, even morphine and other high power stuff weren'thelping him. It is really only good for nerve pain, if he isn't having nerve pain, I wouldn't bother giving it to him.

[NeylasMom]

I had always heard once a day for Deramaxx too, but my oncologist said I could do either and after further discussion we agreed twice a day was more likely to maintain an even level.

[krissn333]

Generally speaking, deramaxx is prescribed as a once a day thing. I spoke with my vet about giving it to Sutra twice a day because I wanted to maintain an even level of med in his system. Dr. Berger got out the information packet from the bottle and noted that for things like post-operative pain, it's recommended to be given twice a day, for that very reason (maintaining a good level). His professional opinion was that the pain from osteo rivals/exceeds post-operative pain, so we decided to give the post-operative dosage, which was basically doubling up on the recommended dosage for mild pain (in Sutra's case, 50mg once a day...so I gave him 50mg twice a day).

[Trihounds]

Last summer, Bumper was on a full spectrum of pain meds, including gaba and tramadol. I noticed no side effects with gaba, but did with tramadol...some woozy walking (well, it made his woozy walking worse) but the gaba simply helped a different spectrum of neurological pain. It worked well for Bump. I can't recall the dose, though, I'm sorry...

[jenn8]

Neylasmom, if the Gabapentin doesn't work, I would opt for the extra dose of Tramadol. I know you mentioned that it didn't seem to help Neyla's pain earlier but that could be due to the smaller dose. To me, it's kind of like taking aspirin for a migrane. You would definitely want something strong enough to knock out the pain first and then try to stay ahead of it.

 

Onyx's pain increased very quickly and I noticed a big difference between 100 mg and 150 mg when it got to that point. I did not know he had cancer until the last day. This was pain management for his arthritis which he had for over a year. When first diagnosed, I tried all kinds of different NSAIDS and supplements and nothing seemed to help much until we added Tramadol (a much lower dose then, of course).

 

I did a lot of research on Tramadol and really found nothing harmful in the way of side effects, etc. Maybe your vet would consider letting you increase each dose instead of adding the extra one. I think you would still be under the maximum dosage.

 

We used Rimadyl twice a day and Tramadol three times... 8AM, 4PM, & midnight. I just gave the Rinadyl with each meal. After seeing his last x-ray and the damage done by his cancer, I was just so grateful that I had already been giving him the right meds to ease his pain.

 

Jenn

[Charlies_Dad]

Jen,

 

We have Charlie on Gabapentin after his amp, we did not notice any ill effects. He was also on Tramodol as well and found it caused the panting and nervousness we noticed. I'll have to check the dosage but I do remember twice a day, 12hrs apart.

[NeylasMom]

Neylasmom, if the Gabapentin doesn't work, I would opt for the extra dose of Tramadol. I know you mentioned that it didn't seem to help Neyla's pain earlier but that could be due to the smaller dose. To me, it's kind of like taking aspirin for a migrane. You would definitely want something strong enough to knock out the pain first and then try to stay ahead of it.

 

Onyx's pain increased very quickly and I noticed a big difference between 100 mg and 150 mg when it got to that point. I did not know he had cancer until the last day. This was pain management for his arthritis which he had for over a year. When first diagnosed, I tried all kinds of different NSAIDS and supplements and nothing seemed to help much until we added Tramadol (a much lower dose then, of course).

 

I did a lot of research on Tramadol and really found nothing harmful in the way of side effects, etc. Maybe your vet would consider letting you increase each dose instead of adding the extra one. I think you would still be under the maximum dosage.

 

We used Rimadyl twice a day and Tramadol three times... 8AM, 4PM, & midnight. I just gave the Rinadyl with each meal. After seeing his last x-ray and the damage done by his cancer, I was just so grateful that I had already been giving him the right meds to ease his pain.

 

Jenn

Thanks for all of the info. I think your statement above is where we're at. The vet had said she didn't want me to give 50 mg 2x/day for more than a day or so so we agreed on 50 mg/day plus adding the Gabapentin to the Tramadol, but I decided last night that I would do 50 twice today to try to get ahead of it, then go back to the 50 daily tomorrow. Tonight she'll have her first full dose of Gabapentin so hopefully by tomorrow that will have kicked in and we'll be able to stay ahead of it like you mentioned.

 

My oncologist seemed to really want me to give 4 doses of Tramadol if we increase rather than giving more 3x and she also didn't want me to do that and the Gabapentin at the same time, but we'll do what we have to do to address her pain. Hoping the extra boost from the Deramaxx and the addition of Gabapentin will be good for now.

[Wonder]

Is the Gabapentin the same for humans? If so, I have some of that as well

[NeylasMom]

Is the Gabapentin the same for humans? If so, I have some of that as well

Pretty sure. I have some that I got when a dr suspected I had carpal tunnel, 100 mg caplets as well, but don't worry about it, I have a lot and it's not expensive. Thank you though!

[jenn8]

I am gonna keep my fingers crossed for you and you pup. She is lucky to have such a caring and thoughtful mom.

 

Jenn

[cmc333]

My Gypsy was just diagnosed w/ osteo yesterday and she is on deramaxx once a day, 125 mg tramadol 3 times a day and DH is picking up gaba at Walgreen's for her. I don't know what the dosing will be on that. The vet gave her a shot yesterday for her pain and then I gave her the trama and deramax last night. This morning she had 100 mg. tramadol and then again at 2 pm. I don't think the meds are enough. She is laying here panting.

 

We/ve been fighting thyroid cancer and have done really well with that and then to be hit with the osteo dx yesterday is just devastating. The vet recommended not amputating, just pain control until ..... this is so hard.

[Trudy]

I don't recall any side effects from the gabapentin with Ryan but also didn't notice any effects period with it when he had that huge clot in his neck and screaming in pain.

[cmc333]

My vet said there are very few side effects from the gabapentin, apparently drowsiness is one, but I'm not really worried about that. She also said tramadol has a wide range before it overdoses. I'm hoping with all 3 meds in her, we can keep her relatively happy. The injection for pain yesterday was something-morphine. It seemed to work pretty good; wish I could get that to do at home for her.

[tbhounds]

My vet said there are very few side effects from the gabapentin, apparently drowsiness is one, but I'm not really worried about that. She also said tramadol has a wide range before it overdoses. I'm hoping with all 3 meds in her, we can keep her relatively happy. The injection for pain yesterday was something-morphine. It seemed to work pretty good; wish I could get that to do at home for her.

 

I'm sorry

[Guest mhall]

We used Gabapentin, Tramadol and Rimadyl for Tarmac. The only side effect we noticed from adding in Gabapentin was drowsiness. Actually I'm not even sure if it was drowsiness or more Tarmac finally being able to sleep deeply after getting his pain under control.

 

[quote name='jenn8' timestamp='1288202211' post='4734895'

My oncologist seemed to really want me to give 4 doses of Tramadol if we increase rather than giving more 3x and she also didn't want me to do that and the Gabapentin at the same time, but we'll do what we have to do to address her pain. Hoping the extra boost from the Deramaxx and the addition of Gabapentin will be good for now.

 

I'm curious - did the oncologist say why she advised against upping the Tramadol and adding in Gabapentin? We used Tramadol at higher doses than you are and none of the several vets we saw seemed concerned about a high dosage of Tramadol/Gabapentin combo. We did not opt for amputation and chemo with Tarmac though - which might be the difference.

 

Hope you can get Neyla comfortable!

[NeylasMom]

 

I'm curious - did the oncologist say why she advised against upping the Tramadol and adding in Gabapentin? We used Tramadol at higher doses than you are and none of the several vets we saw seemed concerned about a high dosage of Tramadol/Gabapentin combo. We did not opt for amputation and chemo with Tarmac though - which might be the difference.

 

Hope you can get Neyla comfortable!

At the point where we were discussing this, Neyla's Deramaxx and Tramadol had already been increased so her pain was under control although not gone. So I believe her feeling was that we could probably control her pain by doing one or the other and if we did both, there was a much greater chance of it knocking Neyla out. So it wasn't a "you can't ever increase either again" it was just a "for now, try one or the other and see if that's sufficient". Hope that makes sense.

 

Gypsy's mom, please come join us in teh osteo thread if you haven't already. I hate to have to "welcome you" to it, but you'll get a lot of support there.

 

I don't recall any side effects from the gabapentin with Ryan but also didn't notice any effects period with it when he had that huge clot in his neck and screaming in pain.

[Gary]

Hi,.folks.our.primary.vet told.us.gaba.400 mg.3x day.was.the max.for.our.beloved.GSD,.about.75-80 lbs w/ osteo.issues. About.to.put.her.down.when.pain.increased,.other.vet.whom we love said.she.can.have.800 mg.3x.day? Any.input,.folks?

[NeylasMom]

Gabapentin has a huge safety range so that amount is not out of the question, but if you jump from 400 to 800 you're going to have horrible side effects. I wrote a long post before about how to increase Gaba, will have to check back later to find it or explain again, but quick version, change one dose at a time, not all three, by 100 mg, wait for any side effects to subside, change another dose. When all 3 are increased by 100 mg, and side effects have subsided, start again if needed.

Fyi, dogs can build up a tolerance to Gabapentin so another reason increasing the dose is reasonable. 

Fwiw, my male (70ish lbs) was up to 500-600 per dose with his osteo before I euthanized him. And my current greyhound just has back issues and seh gets 300 am, 400 pm, but when she has to be sedated she gets 500 the night before and 500 the morning of to keep her calm. This is a 60 lb max female. 

ETA:  I'm really sorry you're dealing with this. My other comment, coming completely from a place of knowing your pain is to remember that you're dealing with a very painful terminal disease. If you can't control his pain, or he's having noticeable side effects from the med increases it's probably time. I'm also assuming he's already maxed out on a NSAID and is making taking Tramadol?

Edited June 15, 2020 by NeylasMom

[tbhounds]

An 80lb dog can absolutely be given 800mg every 8 hours of gabapentin but, perhaps one should re-think their drug of choice for a dog in that much pain.  Codine/Tylenol should be considered or amantadine.......

[greysmom]

Agree with all the above.  Though I've used it for several dogs and had absolutely no side effect issues, even at high doses, so it's very individualized.  There's no need to be conservative with medication, as pointed out.  You're looking for relatively short-term relief from pain, not a long duration maintenance dose. 

I am also not a fan of Tramadol, and there is recent information that it really doesn't work very well - for humans or for dogs.  We use codiene sulfate here with very good results.

[NeylasMom]

On 6/16/2020 at 8:57 PM, tbhounds said:

An 80lb dog can absolutely be given 800mg every 8 hours of gabapentin but, perhaps one should re-think their drug of choice for a dog in that much pain.  Codine/Tylenol should be considered or amantadine.......

Fwiw, the palliative specialist we worked with was the one who guided us to increase the Gabapentin dosage to manage Zuri's osteo pain as a first line of defense (NSAID was already at max dose). I think the benefit is the general lack of side effects and it does seem to manage osteo pain quite well. 

I've never had luck with Tylenol/codeine or Amantadine, unpleasant side effects with the former and completely useless with the latter, but obviously that's an n of 2 and just anecdotal. It's worthwhile to try different things and see what works best, but I think Gabapentin can be quite effective.

I do agree with Greysmom on the Tramadol. Not sure what vets are doing these days with it. We had Zuri on it, but that was several years ago now and at they time the folks in the know we're saying it wasn't that effective for dogs.

Edited June 19, 2020 by NeylasMom