After oral administration, gabapentin is absorbed from the gastrointestinal tract via an L-amino acid transport system, which is saturable, meaning that as the dose of gabapentin increases, the serum concentration does not increase linearly. Dose-dependent ataxia and weakness can occur, especially in older patients with decreased muscle strength. On day 7, all dogs received meloxicam (approved dosing regimen) for 5 weeks. In humans, as the dose increases from 900 to 3600 mg/day, the bioavailability of gabapentin drops from 60% to 33%.In addition to escalating doses, more frequent administration may be necessary. For adequate control of moderate to severe chronic pain, multimodal analgesia (i.e., use of more than 1 mode of treatment) is almost always necessary.Neuropathic pain is commonly defined as “pain caused by a disease or lesion which leads to damage or dysfunction of the somatosensory (pain) system.”These pathologies in the pain pathway can lead to abnormal pain sensations such as hyperalgesia (exaggerated pain sensation from a mildly painful stimulus) and allodynia (pain sensation from a nonpainful stimulus). Unfortunately, lack of research is a common problem for most methods of chronic pain treatment in veterinary medicine. Epub 2018 Oct 27.Hunt JR, Goff M, Jenkins H, Harris J, Knowles TG, Lascelles BDX, Enomoto M, Mendl M, Whay HR, Murrell JC.Pain. Amantadine is supplied as tablets and capsules of various strengths and can be compounded as a liquid without xylitol.Ketamine, which is used as an infusion to provide analgesia, is used for acute pain relief, and reports from human medicine show that it can be used to treat some forms of chronic pain.Although research evidence is currently lacking, the scientific mechanisms of gabapentin and amantadine support their use as part of analgesic protocols for chronic pain relief in dogs and cats.
2018 Apr 10;5:74. doi: 10.3389/fvets.2018.00074. Data from recent pharmacokinetic studies indicate that twice daily dosing is probably more effective than the traditional once daily dosing in dogsLess information is available about the use of amantadine than use of gabapentin for the treatment of chronic pain in veterinary patients, but 1 controlled research study of dogs with chronic refractory hindlimb osteoarthritis has been reported.No adverse effects or drug interactions in dogs or cats receiving amantadine have been reported.Amantadine is moderately expensive. This side effect is generally dose-related and usually alleviated by decreasing the dose. She is a certified acupuncturist and a consultant in a private small animal veterinary practice. Gabapentin is not a DEA-controlled drug and is not expensive.Pregabalin is FDA-approved for the treatment of numerous neuropathic pain syndromes in humans. Hypothesis: The use of amantadine in addition to NSAID therapy will provide improved pain relief when compared with the use of nonsteroidal analgesics alone in naturally occurring OA in dogs.
The drug is structurally similar to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), which explains its name but not its mechanism of action.
This article describes the types of pain, the reasons why chronic pain can be difficult to treat, and the use of gabapentin and amantadine for treatment of chronic pain.Acute pain in response to tissue damage is often called protective pain because it causes the patient to withdraw tissue that is being damaged to protect it from further injury (e.g., a dog withdrawing a paw after it steps on something sharp) or to become less active to protect tissue that is already damaged but healing (e.g., a cat sleeping frequently after abdominal surgery). When to choose one drug over the other? Common side effects include agitation and gastrointestinal effects.
Gabapentin and amantadine are used as part of analgesic protocols for chronic pain relief in dogs and cats. Either or both can be part of initial therapy for chronic osteoarthritis pain.
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