Transdermal gabapentin in cats | VETgirl Veterinary Continuing Education Podcasts (2022)

In this VETgirl online veterinary continuing education podcast, we review the use of transdermal gabapentin in cats. I suspect many of you agree that giving gabapentin to fractious kitties prior to veterinary appointments has been an absolute game changer! However, as you can imagine, tasking owners with pilling their emotional feline friends may be asking a lot. Transdermal drugs have made administration of certain medications substantially easier, though these formulations present their own challenges with absorption and bioavailability. Careful testing is required before we can rely upon these therapies enough to recommend and prescribe them. Therefore, in a study by Slovak et al entitled A pilot study of transdermal gabapentin in cats, the authors evaluated gabapentin in a proprietary base called Lipoderm to determine if this transdermal formulation could penetrate feline skin and improve pain scores. The authors explain that this particular base was selected based on previously published literature on its consistency and stability (Zhang; Shakshuki).

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To evaluate skin penetration of the medication, the authors performed both in vitro and in vivo testing. Let’s start by discussing the in vitro experiments they performed. In this arm of the study, the authors collected skin from 6 fresh feline cadavers. The gabapentin formulation was applied to two separate regions. One was a shaved area of skin located in the cervical region, 2 cm cranial to the scapula. The other area was a 2.5 cm section of inner ear that was shaved and harvested, which included the epidermis, dermis, and subcutaneous tissue excluding cartilage. Gabapentin (0.1 mL) was applied using a gloved finger to the two locations. It was administered in two concentrations (10% and 20%) after the tissue had been mounted to a diffusion cell. The application occurred at time 0 and again 12 hours later. Samples were then collected from the diffusion cell’s receptor chamber at 0, 2, 4, 12, and 24 hours after the first application of gabapentin. The collected samples were next submitted for gabapentin quantification.

For the in vivo portion of the study, the investigators recruited 8 healthy cats. All were less than 6 years of age. The cats were randomly divided into 4 study groups, based on the dose of gabapentin (5 mg/kg versus 10 mg/kg applied every 8 hours) and the location of gabapentin application (e.g., the ear pinna versus a shaved area of skin in the cervical region). The cats’ owners were provided with gabapentin (250 mg/mL), as well as either disposable finger guards or gloves. The owners were instructed to apply a set volume of the gabapentin to the appropriate location, depending on the cat’s group. The investigators collected blood samples from each cat prior to the first dose, and then at 1 and 5 days after receiving the transdermal gabapentin. Serum was then submitted for gabapentin concentration analysis. One limitation of the in vivo portion of this study is that cats were allowed to groom freely, so it remains possible that cats ingested gabapentin, thereby affecting serum levels. This study also relied on owners to administer medications and adhere to instructions as provided by investigators.

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Finally, let’s talk about how the investigators performed the final arm of this study, which was to evaluate pain scores. In this portion of the study, 15 cats diagnosed with either chronic kidney disease (International Renal Interest Society Stage 1 or 2), osteoarthritis, dental disease, or obesity were enrolled. All cats were over 8 years of age and not receiving other medications. The owners of these cats were given gabapentin to apply every 8 hours for 5 days to the inner ear pinna (10 mg/kg per dose). In this portion of the study, the owners alternated between ears for each dose. Then investigators evaluated 2 validated pain assessment scales in each cat. The pain assessment was performed prior to gabapentin administration, then at days 1, 5, and 8 after starting gabapentin. Gabapentin was only given for 5 days total, so for the pain assessment on day 8, the cat had not been receiving medication for 3 days. The authors again collected blood for concentration analysis prior to the first administration of gabapentin, and at days 1 and 5 after starting treatment. Importantly, in this second portion of the in vivo study, the gabapentin administered was compounded by a different pharmacy than the formulation used in the initial in vitro and in vivo phases of the study. The authors later discuss how using compounded gabapentin from two different pharmacies is a limitation of this study.

Okay, let’s talk about some results! First of all, the investigators did detect quantifiable gabapentin at all time points from both ear pinna and cervical skin experiments in the in vitro portion of the study. This also held true in the first arm of the in vivo study. In all 4 experimental groups, gabapentin was detected at both day 1 and day 5. Interestingly, the concentration observed did not differ by dose or skin location. Those results appear quite promising, but of course we also need to know if gabapentin is actually going to improve our feline patients’ pain! That brings us to phase 2 of the in vivo portion of the study. Gabapentin was still detected at days 1 and 5 in these cats, but unlike the initial experiments, the concentration detected was significantly higher at day 5. When the authors evaluated the pre-gabapentin pain scores to pain scores at day 1 and day 5, they found significant improvements on both pain scales between predose to day 5, as well as between day 1 and day 5. Again, these are promising results! Note that the predose pain score did not significantly differ in any cats when compared to day 8, which was 3 days after discontinuing gabapentin administration. In other words, the analgesic effects of this transdermal formulation were no longer observed within three days of stopping therapy.

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So what can we take away from this VETgirl podcast? Well, these investigators determined via in vitro and in vivo experiments that administration of transdermal gabapentin will permeate feline skin (both cadaver and live skin) at different anatomic sites, and this treatment was also successful at reducing feline pain scores. Fantastic! The authors discuss various limitations of the in vitro studies, such as small sample numbers and the fact that such experiments cannot perfectly replicate true physiologic conditions. However, by pairing these in vitro experiments with in vivo studies, the investigators were able to provide a bit more clinical insight. Quantifiable gabapentin was detected in the serum of all cats, regardless of site of application, after transdermal administration. The authors do point out that the concentrations detected were quite variable and from a small number of cats, and that reference intervals are not available. However, hopefully such results could be validated in larger studies moving forward. The authors also acknowledge that due to the exploratory nature of the study, no control cats or placebo groups were included for the in vivo portions of the study, and evaluators of pain scores were not blinded. That said, perhaps the most exciting finding in this study was that the authors observed improvements in two separate pain scores following transdermal gabapentin administration (10 mg/kg q8h). Of note, the analgesic effect was no longer present after stopping therapy for 3 days. Despite this study’s limitations, this VETgirl thinks that overall these are promising results. Transdermal administration of gabapentin may be a valuable tool when managing cats with chronic pain, and hopefully we will see more studies like this that advance our knowledge on this important topic.

References:
1. Slovak J, Costa A. A pilot study of transdermal gabapentin in cats. J Vet Intern Med. 2021;35: 1981-1987.
2. Zhang Q, Song Y, Page SW, et al. Evaluation of transdermal drug permeation as modulated by lipoderm and pluronic lecithin organogel. J Pharm Sci. 2018;107:587-594.
3. Shakshuki A, Yeung P, Agu RU. Compounded gabapentin for neuro-pathic pain: stability and beyond-use date (BUD) in some commonly used bases. J Am Pharm Assoc. 2019;59:514-520.

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Today’s VETgirl podcast is sponsored by Blue Buffalo, makers of BLUE Natural Veterinary Diets. With a research & development team made up of PhD nutritionists, veterinarians and food scientists with more than 300 cumulative years of experience in the pet food industry, Blue Buffalo is committed to partnering with the veterinary profession and providing the best science-backed care for the pets we love. To learn more about Blue’s commitment and about the Blue Buffalo 6-Point quality process, visit BlueVetConnect.com.

Transdermal gabapentin in cats | VETgirl Veterinary Continuing Education Podcasts (1)

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FAQs

How much gabapentin should I give my cat before going to the vet? ›

In smaller, older or sick cats, we generally prescribe 50-75 mg; in larger cats, 75-100 mg. This is given 3 hours prior to a visit, so 2-2.5 hours prior to leaving your house.

Can gabapentin be used long term in cats? ›

We conclude that long-term treatment with gabapentin is of potential benefit in controlling pain in cases of head trauma, as well as musculoskeletal disease. It may provide a valuable adjunct for the management of chronic pain in cats and should be investigated further for its clinical use and safety.

How much gabapentin can you safely give a cat? ›

Gabapentin dosage information for cats

Some cats can go up to 10mg per pound every six hours. The doses for cats range from 1.5 to 5 mg per pound every 12 hours to manage pain. Again, there are cases when higher doses (up to 50 mg, 1 to 3 times daily) are used.

Can gabapentin be Transdermal for cats? ›

Conclusions and clinical relevance: Gabapentin in a transdermal base penetrates feline skin in vitro, is absorbed systemically in cats, and may help decrease pain scores.

What happens if you don't refrigerate gabapentin? ›

What Happens if Gabapentin Is Not Refrigerated? Unrefrigerated gabapentin isn't dangerous, but it might not be as potent. That means that it might not benefit your pet much as pain medications or anti-seizure agents.

Can you give a cat too much gabapentin? ›

If my animal gets too much of this medication (an overdose), what should I do? One-time overdoses of gabapentin are unlikely to cause more than sleepiness, loss of coordination, and diarrhea.

How long should I give my cat gabapentin? ›

Gabapentin should not be discontinued abruptly in cats with epilepsy, especially after long-term use. It is ideal to wean off the medication over a period of about two to three weeks in order to reduce the risk of withdrawal seizures. Always consult your vet before stopping any medication.

Can I give my cat gabapentin every day? ›

If you are giving your cat Gabapentin every day for epilepsy or chronic pain, it's important to not miss a dose. Especially in epileptic animals as sudden withdrawal can cause seizures. But, if you do miss a dose – and you're close to the time for the next dose – skip the dose you missed.

Can gabapentin cause ataxia in cats? ›

Gabapentin in Cats

The common side effects observed in cats are often mild. The main side effects cats can experience are weight gain, ataxia (clumsiness or stumbling) and lethargy. Diarrhea can result in some cases but is not as common as the other symptoms.

Is 100mg gabapentin safe for cats? ›

From a safety perspective, a gabapentin dosage for cats will typically not exceed 50-100mg per cat to address pain or when being used as a sedative. As a sedative, it is often given a couple of hours prior to an examination at the vet clinic or before getting in the car or on a plane.

Can I give my cat gabapentin the night before? ›

Gabapentin is a medication that provides some anti-anxiety/calming effect. This is usually given the night before either by sprinkling it on food or given orally. After the previous night's dose, it is administered again about 1-2 hours prior to the appointment in the same way.

Can I give my cat 150 mg of gabapentin? ›

For pain control in cats, doses range from 1.5 to 5 mg per pound (1.25 to 2.5 mg/kg) every 12 hours. Higher doses (up to 50 mg per cat 1 to 3 times daily) are recommended by some vets.

Can gabapentin be absorbed through the skin? ›

Gabapentin Absorption Peaks Quickly Before Stabilizing

As shown in Figure 3 , gabapentin was able to penetrate into and through ex vivo human trunk skin. Its absorption profile was similar across the two compounded drug formulations.

How do I apply transdermal gel to my cat? ›

How to apply transdermal gels to your pet. - YouTube

Is transdermal faster than oral? ›

In addition, because they are absorbed directly into the bloodstream, and avoid initially passing through the intestinal tract and liver, drugs that are administered transdermally may be more effective or work faster than some oral medications, allowing for better treatments.

Does gabapentin for cats need refrigeration? ›

Capsules and tablets should be stored at room temperature around 25°C (77°F), away from moisture. Follow the directions on the label for compounded liquid medications.

Does gabapentin make cats sleepy? ›

The most common side effects observed with gabapentin are sedation (drowsiness or sleepiness) and ataxia (loss of coordination). In cats, an increase in drooling and vomiting has been observed. If you believe your pet may be experiencing any side effects of gabapentin, consult your veterinarian.

Can cats have withdrawal from gabapentin? ›

Gabapentin should be used with caution in animals with decreased liver or renal function. Gabapentin should not be stopped abruptly because withdrawal can precipitate seizures or rebound pain. The dosage should be decreased over the course of two to three weeks.

Can you give a cat 200 mg of gabapentin? ›

Yes, you can give your cat Gabapentin but only when the medication is prescribed by the vet. In veterinary medicine, Gabapentin (brand name Neurontin) is used extra-label, but when given correctly with the right dose and frequency, it is both safe and efficient for cats.

How long does it take for gabapentin to kick in for cats? ›

Some ataxia, hypersalivation, and vomiting were reported, all of which resolved within 8 hours. Owners reported the peak effect of the medication occurred 2 to 3 hours after administration, suggesting that dosing the cats 90 minutes in advance, as was the case in the study, may have been less than optimal.

How do you wean a cat off gabapentin? ›

Gabapentin should not be stopped abruptly because withdrawal can precipitate seizures or rebound pain. The dosage should be decreased over the course of two to three weeks. In laboratory animals, Gabapentin was associated with fetal loss and teratogenic effects. It also is present in milk.

Is 100mg gabapentin safe for cats? ›

Gabapentin is a safe and effective medication for cats that have chronic pain or anxiety disorders.

How quickly does gabapentin work on cats? ›

Do not stop this medication abruptly in pets with epilepsy, as this can cause withdrawal seizures. This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

Can I give my cat 150 mg of gabapentin? ›

For pain control in cats, doses range from 1.5 to 5 mg per pound (1.25 to 2.5 mg/kg) every 12 hours. Higher doses (up to 50 mg per cat 1 to 3 times daily) are recommended by some vets.

How long does 100mg gabapentin last for cats? ›

gabapentin. Prepare owners for this!! The sedative effect lingers for ~12 hours and will contribute to woozy behavior – and risk of falling – after the cat has returned home.

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