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Holly
8th July 2011, 04:49 PM
I'm pretty sure I read that Gabapentin typically metabolizes in their systems in about 8 hours-- is that correct? I know with Scarlett that she definitely needs a dose every 8 hours, if not sooner, as her symptoms (scratching her neck area, air guitar, etc) will get worse. If that is true, why do some neurologists prescribe it 2/day, rather than 3? It doesn't seem like that would be effective.

Also, I get Gabapentin at Sam's Club-- a 30 day supply for $15. The last time I went to pick it up, they took it off a specific list and the price doubled!!! Luckily, they are going to "grandfather" me in and let me continue to get it for $15. They did say that they price match if you find it cheaper elsewhere.

Nicki
8th July 2011, 05:35 PM
It's actually 6-8 hours. To start with the usual recommendation is twice daily and that is increased when necessary. Some people do give it four times daily. I think you have to discuss it with your veterinary professionals and decide what best suits your dog.

Some people move their dog to Lyrica, which although far more expensive, requires a lower dose and usually only 12 hourly.



a 30 day supply for $15 is actually very cheap!!

I hope that you can get Scarlett more comfortable - often it is a combination of drugs that works best, obviously including a CSF inhibitor such as ZItac, [Cimetidine]

Holly
8th July 2011, 05:40 PM
$15 is really cheap- that's why I was so surprised that it had doubled to $30.

I think Scarlett is pretty comfortable- I
monitor her closely. She also gets Omeprazole 1/day. I can tell when it's time for another dose of the Gabapentin, as she scratches more, though not terribly.

That is what I don't understand... If it is gone from their system in 6-8 hours, why would a neuro only prescribe it twice a day?

Blondiemonster
8th July 2011, 07:10 PM
True. Its why my neuro put blondie on 3 times a day right away. For that reason. It doesnt make sense to leave them drugfree for about half the time does it?

Holly
8th July 2011, 07:22 PM
True. Its why my neuro put blondie on 3 times a day right away. For that reason. It doesnt make sense to leave them drugfree for about half the time does it?

Exactly! It seems like I see people post on this and other forums that their newly diagnosed pup was prescribed Gabapentin twice a day. I was just curious why they wouldn't just start at 3.

Kate H
9th July 2011, 10:52 AM
Interestingly, Claire Rusbridge on her treatment algorithm (recommendations for vets treating SM) says: Start gabapentin at 10-20mg/kg orally 2-3 times daily (typically a 8-12kg CKCS would be started on 100mg capsule twice daily) with or without NSAIDS

I would guess (and those more knowledgeable will correct me) that this is because gabapentin is not primarily a pain killer (in the way that we take an aspirin to zap an existing pain), it is a pain preventive, which maintains a level of pain control in the body. If SM symptoms are mild, twice a day may be enough to prevent pain surfacing, even if the amount of gabapentin in the body drops for a few hours. When pain increases, blanket coverage becomes necessary. The same system is used in hospices to control pain in humans - the level of pain drugs is kept constant so that actual pain never surfaces, rather than allowing pain to develop and then dealing with it. And 8.5 hours between gabapentin doses is the average - so some dogs will need tablets more frequently than that, and some will continue being able to manage on twice a day. I think the twice a day dose is the basic starting point for seeing what is the right dose for a particular dog - which can only be discovered by trying it.

Kate, Oliver and Aled

Holly
9th July 2011, 01:53 PM
Kate, you always give such good, logical answers. That makes sense. Thank you!