Gabapentin goes by the trade name Neurontin and is originally an anti-seizure medication. Veterinarians are used to adapting human drugs for the pets they treat. Gabapentin has many other useful properties for treating cats beyond use as an anticonvulsant. It is used off-label in cats to reduce situational anxiety, provide pain relief, and is the preferred treatment for a condition called feline hyperesthesia syndrome.
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Gabapentin to reduce fear and anxiety at the vet
In cats, the drug is excellent as a “pre-visit pharmaceutical”. It helps to lessen the fear, anxiety and aggression in cats that visit the veterinary office. These calming effects can also be harnessed for other stressful events like car and plane travel.
Feliway Spray was tested in cats passing through the airport. It is a calming feline pheromone that can be sprayed inside your cat’s carrier before travel.
Fearful cats exhibit certain postures and behaviors that can be interpreted. For example, fearful cats will crouch to make themselves small. Their ear placement can indicate as well their level of fear. Ears that are directed backwards or flattened are a good indication of their level of fear. Cats that flick their tails are displaying a high level of arousal and agitation. With increased defensiveness cats will crouch, hold their ears sideways so down and growl or vocalize loudly. When the ears swivel sideways and the pupils enlarge, aggression may be coming. If a cat exhibits these types of behaviors at a veterinary visit, it may be best to consider a pre-visit dose of gabapentin. You can discuss this with your veterinarian.
The dose of gabapentin recommended for a premedication for an anticipated stressful event (veterinary visit or car/plane travel) is 50mg to 100mg per cat up to every 8 to 12 hours. Most 10 lb cats do well with at least 100mg of gabapentin given 1- 1.5 hours prior to the stressful event. Best effects are achieved if the gabapentin is given the evening prior to the event and again 60-90 minutes before the vet visit or impending travel. The half life of gabapentin is 3 hours, so this means 3 hours after the dose is given 50% of the drug remains in the system. Typically it’s best to handle cats within a 3 hour window from when the medication was last given. This is why the medication is dosed at least every 12 hours and it is okay to give it up to every 8 hours as needed.
Gabapentin for reducing fear and stress in feral and shelter cats
Gabapentin has also been studied for it’s fear-reducing effects in feral cats that are trapped for neuter programs. Fear responses were quantified with a feline stress scale.
Feral cats given gabapentin and not placebo had improved stress scores based on a detailed score based on facial and body posture. It was noted that the anxiolytic effects of the drug lasted about 3 hours from initial administration.
Veterinarians that specialize in analgesia and pain management have studied clues provided by body posture and facial expression to “grade” a level of stress or pain a cat may be experiencing. The presence or absence of certain behaviors can also help determine a cat’s overall welfare in a shelter or other environment and also stress or pain level.
Signs of poor welfare or stress in a cat:
- Reduced exploration of their environment or absence of activity
- Reduced eating or drinking to no eating or drinking
- Decreased urination or urination outside the litter box
- Decreased defecation or no defecation
- Increased vigilance instead of normal resting
- Reduced sleep
- Reduced grooming or overgrooming or self mutilation
- Reduced or no playful activity
- Absence or negative response to human initiated interaction or redirected aggression
- Hostility, aggression or avoidance of interaction with other cats
- Reduced scratching/facial marking
- Increased urine spraying
- Compulsive behavior
- Hiding
- Excessive vocalization
Gabapentin to relieve feline anxiety during car or airline travel
Reduce stress of travel in the plane or car. A study of cats showed significant reduction in stress with car travel when cats were given gabapentin 90 minutes prior to departure.
For plane travel it’s important to note that if an airline suspects your cat is sedated, they may refuse to have your cat onboard. Gabapentin does not have any significant cardio respiratory suppression effects, so the benefit of reducing extreme anxiety produced by travel may be necessary for a comfortable and safe journey. The American Veterinary Medical Association does note that it’s generally not recommended to sedate your pet for airline travel. However, drugs used with the intended effect to produce a sense of calm is called tranquilization. They acknowledge that some animals may benefit from tranquilization for air travel.
The following is from the AVMA website regarding pet airline travel :
Q: Should I tranquilize or sedate my pet for long flights?
https://www.avma.org/resources-tools/pet-owners/petcare/traveling-your-pet-faq
A: Tranquilization reduces anxiety and induces a sense of tranquility without drowsiness, while sedation has a more profound effect and produces drowsiness and hypnosis. In most cases, it’s not recommended that pets be sedated for air travel. However, it may benefit some animals to be tranquilized for air travel. Discuss this with your veterinarian well in advance of your expected travel date. If your veterinarian recommends tranquilization for your pet, be sure to follow the veterinarian’s exact dosing recommendation. In many cases, the same drug used for tranquilizing can result in sedation at higher doses.
Airlines may require a signed statement that your pet has not been sedated prior to flying
Gabapentin for pain relief in cats
Gabapentin is also a very good pain reliever. It is currently the most commonly utilized pain reliever prescribed for musculoskeletal pain in cats in most small animal practices. Traditional pain relieving drugs that are in the non steroidal anti-inflammatory (NSAID) class of medication are not well tolerated in cats. In fact, there is only one NSAID drug approved for cats for longer than 1 day at a time because of risks for kidney damage. This drug (Onsior) is still only approved for 3 days. Gabapentin is a safe alternative for our feline friends, however the dose should be reduced in cats with kidney disease.
Gabapentin for acute pain in cats
Gabapentin can be used for acute pain (short term painful episodes) but is best studied when given long term for painful conditions like chronic osteoarthritis. There have been some encouraging studies on the use of gabapentin for post surgical pain relief in cats. Oftentimes gabapentin is used in combination with other drugs such as opioids or non steroid anti-inflammatory drugs for acute post surgical pain. In our practice we send home gabapentin for post surgical pain following dental extractions. These cats have been treated with opioid analgesics and local intraoral nerve blocks prior to the surgery and they are sent home with only gabapentin for post surgical pain relief.
When gabapentin was given immediately following a spay surgery in cats, those cats that received gabapentin ate more at every meal than cats that were not given gabapentin.
Gabapentin for musculoskeletal and arthritic pain in cats
When gabapentin was given to cats with arthritis, owners noted that although activity levels were lower than in the placebor group, cats on gabapentin were able to do more activity that was previously imparied due to their arthritis.
Owners may be unsure if their senior cat is in pain at home. Clues that are more obvious include stiff or altered gait, diminished or absent jumping, no longer climbing or descending stairs and difficulty getting to elevated areas such as a couch or countertop. Cats that have arthritis may find it difficult to bend around to groom well so they often develop coats that are more prone to mats and they may have more dandruff that is not groomed away .
Facial cues to determine pain levels in cats
However, facial cues can indicate whether a resting cat is experiencing any pain. The pictures below show the progression of facial changes that occur with discomfort. With increased pain the ears start to separate and the muzzle becomes more oblong from rounded. Whiskers will start to pull apart and lift up and their eyes may start to squint. The feline Grimace scale is published below by Evangelista et al.
Gabapentin for feline hyperesthesia syndrome
Gabapentin’s pain relieving properties were originally designed for neuropathic pain. Neuropathic pain is generated from the peripheral nerves, spinal cord or brain. Gabapentin is a calcium channel blocker and targets a specific region of the spinal cord. A particular disease entity in cats that gabapentin is useful for treating is a condition called “feline hyperesthesia syndrome” . This syndrome is also referred to as “rolling back” syndrome. Cats exhibit sudden rippling and twitch the skin over their back. They have sudden reactive signs such as whipping around to look at their hind end, chasing their tail and biting and licking their lumbar spine. Some cats race around in response to the perceived noxious sensation. These events can happen multiple times a day and may cause much distress to your cat. Gabapentin’s neuropathic pain relieving properties are useful to treat this condition. The dosing of gabapentin is similar for other conditions and may be titrated to effect.
| weight | 20mg/kg dose of gabapentin in mg | Volume of af 50 mg/ml solution of gabapentin |
| 5 lbs | 50 mg | 1 ml |
| 10 lbs | 100 mg | 2 ml |
| 15 lbs | 150 mg | 3 ml |
Original studies of gabapentin used 6.5mg/kg up to 10mg/kg every 8 hours orally in cats. Some specialists use much higher doses in cats to achieve the best effects. Dr. Kelly St. Denis in the VIN (Veterinary Information Network) community recommends 15-20mg/kg. She likes to start a cat out once daily in the evening for 5 days and then move to every 12 hours thereafter.
Side effects in cats from gabapentin:
The most common side effect initially is sedation. Your cat may act more quiet and tired and may spend more time sleeping.
Another side effect can be incoordination or wobbliness in the back legs when walking. These side effects generally only last 1-4 weeks until the cat adjusts. It’s also worth mentioning that cats being tranquilized for a veterinary visit should be monitored so that they do not fall down a staircase or any other elevated surface.
Occasionally a cat may hyper salivate when receiving the medication.
If gabapentin is being given long-term in a cat (over 3 weeks) then it is best to taper the medication instead of stopping abruptly to avoid precipitating a seizure. Always speak to your veterinarian about this.
Gabapentin is removed from the body by the kidneys. Cats with kidney disease should receive a lower dose based on recommendations from your veterinarian.
Gabapentin comes as a liquid and in capsules
Gabapentin comes as a 50mg/ml solution or as 100mg and 300mg capsules. Some of the human preparations are made with xylitol, an artificial sugar which is toxic to dogs. It has not been proven to be toxic to cats, but our hospital only stocks the xylitol-free manufactured gabapentin solution. There are also capsules available typically in 100mg and 300mg sizes. For a cat receiving 50mg, half the powder can be sprinkled over a tasty small amount of food like tuna. The remaining capsule can be plugged into the opening of a pill pocket or wrapped inside the pill pocket for later.
Your veterinarian can always compound gabapentin into a tiny tablet or into a stronger strength solution so less volume is needed per dose. Flavored chews can also be made. I generally have less luck getting cats to eat a flavored chew medication.
How much gabapentin is safe for cats?
Gabapentin is generally a very safe drug to use in cats. It has a wide dosing range and most typical doses are between 10mg/kg to 20mg/kg. Occasionally cats will need even higher doses for overcoming anxiety (as much as 40-50mg/kg!). This should always be titrated to effect and the dose determined by your veterinarian.
Conclusion:
Gabapentin is an anti-seizure medication which is used off-label for a variety of other conditions in cats. The drug now is rarely used for it’s anticonvulsant effects and more commonly for its use for reducing situational stress and anxiety in cats from veterinary visits and travel, treatment of chronic degenerative osteoarthritis and other musculoskeletal pain, post-surgical pain and for a neurological condition called feline hyperesthesia syndrome. Gabapentin has a wide dosing range and is well tolerated with relatively few side effects in cats and a very good safety index.