Question about gabapentin

Hi...I haven't posted here in quite some time. Lily, my 3 year old, was just recently diagnosed at Auburn University Vet School here in Alabama with SM with a very small syrinx, but with moderate symptoms, and PSOM. The neurologist said she was borderline for surgery, so we have opted to treat her with medication at this time. She is on 50 mg gabapentin twice a day, and 1/2 prilosec 2 times per day. There is been a tremendous improvement in her symptoms since we started the medication. I have noticed that about mid afternoon when her morning dose of gabapentin is wearing off, she begins to face rub and scratch. I asked the Dr. at Auburn about increasing her medication to 3 times per day. She said they like to give the lowest dose possible, and because she will be on the medication for the rest of her life, they would prefer not to increase the dose unless her symptoms worsen. My question is, for anyone giving gabapentin 3 times per day, did you increase the dose, or did your nuero? What would it hurt if I increased to 3 times per day? Would you do this without your nuero's recommendation? Also, is it difficult for you to get gabapentin in your area? I had to have it compounded, at a compounding pharmacy because it does not come in a 50 mg dose. It was pretty pricey. What are you paying where you live?

Any info would be apprecited. :thnku:

Shay I'm assuming your neurologist is Dr. Shores at Auburn. Abbey had decompression surgery by him last march. She also was on the liquid form and it is pricey. After a couple bottles of it I asked if I could up her to the 100 mg capsules and I get them at Costco for practically nothing. Abbey was on 75 mg when I asked him so she was on a higher dose than your baby.

Sharon:

I just had a brainstorm and I know you. lol. We spoke on the phone. geesh I guess I was in lala land when I wrote that yesterday.

When we were having it compounded Sharon I believe it was around 75 bucks.

I get gabapentin 100mg capsules at Costco.com for less than $20 for 200 capsules. I was paying more than twice that amount at drugstore.com until I priced it at Costco.

Jeszel was on 100mg 3x per day, but still had a scratching episode once or twice a day, so my neuologist raised it to 200mg 3x per day. I have not noticed any significant improvement with the increase, but left it at 200mg. My neuologist said that we can raise it 300mg, but that is the max. I decided to leave it at 200mg so that I have room to raise it later if it becomes less effective.

I hope that Lyrica will get less expensive some day soon, so that I could afford to try that, but it may takes years to get a generic for that drug.

I personally wouldn't raise the dosage until you talk to her neuro. This is something that probably could be handled over the phone though. 50 mg/twice a day is a pretty low dose of gabapentin. My Riley has SM but is not on gabapentin. She had decompression surgery last year and was on 100mg/three times a day for about three months after surgery, but we took her off since pain and scratching were not issues for her. Ithink that the effects of the gabapentin wear off pretty close to 8 hours after the last dose, which is why you're probably noticing that she's uncomfortable. I would think that at the least she should be on a three times a day dosing schedule. So, I would call your neuro back and ask about increasing the dosing schedule. There are many dogs on this forum who have been on a much higher dose of gabapentin for quite a while (years).

Best to call the neuro first. It will need to be explained to you what to look out for if your dog can't tolerate that higher dose, that's what happened to us. Some neuros are happy to discuss things over the phone. Also your vets may expect the neuro to contact them notifying them of the increase.

Sharon I e-mail Dr. Shores alot and he replies usually within a day. If you need his e-mail addy just e-mail me and I'll give it to you. Like I told you I asked him before I upped Abbey's dosage so I agree with the others about that.

Thanks all for the replies. I did call the neuro before I posted this, well actually his assistant, who is the resident student on her case. She is the one who told me that they want her on the lowest dose possible, if or until her symptoms worsen. They are calling her case mild SM, but with moderate symptoms. The reason I was asking is because I know that most dogs I have read about are on a greater dose. It could also be the PSOM that is causing similar symptoms, which of course the gabapentin won't relieve. She is so much better with the medication, and I am grateful for that.

Hi Linda.....I talked to. Dr Akin not Dr. Shore. I will call him next time, if she continues scratching after her morning dose wears off. I may just have my Vet call him, because he would have to write a new script if we increase to 3 times per day. My regular Vet only wrote the script for 3 months, so we will need to talk to Dr.Shore when it's time to re-fill. How is Abby? Hope you are both doing well.

That's a low dose -- generally the recommendation is trial for two weeks, and if the dog starts to have symptoms within the time of a dose, to increase the dose or frequency (in your case I'd quess the frequency before the dose).

I'd split capsules rather than compound -- that's what I did when Leo was on your dose. Leo is now on 150mg 3x so I get the 600mg tablets (as in this size you can avoid the capsules) and use a pill cutter to split in 4. The shape wouldn't suit cutting into 12 pieces though.

Ruby started on Gabapentin 3 x daily 100mg but she was quite painful at the time. After 4 months and still seeing scratching/rubbing episodes and she was wobbly on her feet also we transitioned in to Pregabalin.
She is now on 50mg 2 x daily and she hasnt scratched once or rubbed her head once in the 2 weeks she has been solely on it. She is much steadier on her feet now as well.

Karen

Karlin said:

That's a low dose -- generally the recommendation is trial for two weeks, and if the dog starts to have symptoms within the time of a dose, to increase the dose or frequency (in your case I'd quess the frequency before the dose).

I'd split capsules rather than compound -- that's what I did when Leo was on your dose. Leo is now on 150mg 3x so I get the 600mg tablets (as in this size you can avoid the capsules) and use a pill cutter to split in 4. The shape wouldn't suit cutting into 12 pieces though.

Click to expand...

My Vet has called around for me and found a compounding pharmacy who will compound it in capsules for almost half the price of the one I got it from last week :w**h**:. That is a huge difference, and I can't believe the one pharmacy has charged me almost double. My little rescue is on two heart medications for the rest of his life, so I have a large pharmacy bill every month. I am thankful that there are medications that give them both a better quality of life, and they are happy and healthy otherwise. No sign of SM in my 6 year old rescue, maybe he missed the curve based on his age, who knows??? He was heart clear at 4 when I got him, and now he has MVD. Just wish my pet insurance paid for medication :bang:.

Before surgery Levi was on Neurontin. I the first time I bought it at Wal-Mart, it was liquid, and it was $37. However, before I gave it to Levi, my vet caught the fact that it had Xylitol/Malitol (I think) which is deadly to dogs. I hadn't opened it but Wal-Mart wouldn't take it back or refund the money. I do understand why but I still didn't like that.

The next time I bought it was from a compounding pharmacy, it was liquid, and it was $143 for a month's supply.

At LIVS after surgery Levi was started on neurontin capsules which they sent home with us. If I need to continue him on them after the amount they sent home is gone (They don't seem to think he will need it, though. I am keeping my fingers crossed.), I will probably buy them from a good internet pharmacy. He is given 100 mg three times a day. The Drs Foster and Smith internet pharmacy (which is a real veterinary pharmacy, not some internet fake pharmacy) sells the capsules for $.49 each or $44.10 for 90 capsules. They have free shipping in the US. I don't know about the policy for shipping outside the US. There might well be other internet pharmacies which sell to outside the US and might be even lower. I bought Levi's Tramadol for $.30 per 50 mg tablet and the dose is 1/2 tablet three times a day. That would come to $13.50 for a month. They do require a veterinarian's Rx but will fax your vet for you and can sell medicines directly to you if your vet faxes a Rx back to them. Just FYI.

Kathy

I'm not in the US, but I believe Costco is supposed to be particularly good for gabapentin. It is cheaper to get generic gabapentin than neurontin (brand).

The issue of xylitol has come up before here for liquid neurontin. If I recall it isn't actually an issue as the amount is so tiny but I am not positive about this so don;t rely on that as an OK. Maybe LIVS knows.

I wish I could get cheaply compounded neurontin as I get the 600mg and split four ways, a bit of a pain. My chemists gave me a pill cutter for free for Leo! :lol: On the other hand I am sure I have put their child through college now with my expenditure on neurontin.

Ok I googled and found this which looks reliable. This is from a vet site:

Gabapentin oral suspension is sweetened with xylitol which has toxic properties in the dog. The doses used to control pain should not contain enough xylitol to be problematic but anti-seizure doses might. The issue can be avoided by having liquid formulations compounded rather than using the commercially available oral liquid.

Click to expand...

full info: http://www.veterinarypartner.com/Content.plx?P=A&A=2764&S=1&SourceID=52

I am glad to see this drug is now listed with info for giving it to animals.

Hi Shay-- I read on one of the lists that CVS has Gabapentin on it's $10/3 month supply list but you have to enroll in their prescription program. You may want to look into that. Good to "see" you again-- I'm sorry that you are dealing with this!