Gabapentin as Adjunct Therapy for Feline Atopic Skin Syndrome

In the Literature

Morency J, Troncy É, Delsart A, et al. Effect of gabapentin administered with prednisolone, ciclosporin or a placebo on clinical outcomes and motor activity in cats with atopic skin syndrome: a prospective, blinded, placebo-controlled study. Vet Dermatol. 2025;36(6):814-824. doi:10.1111/vde.70000

The Research …

Central sensitization has been reported in humans with chronic pruritus, and gabapentin has been shown to decrease pruritus in these patients.^1-7 Although gabapentin is commonly used for sedation in veterinary medicine, use for managing chronic pruritus in cats has not been explored.

This blinded study^a assessed the effects of prednisolone, cyclosporine, or placebo with and without gabapentin in laboratory colony cats diagnosed with feline atopic skin syndrome (FASS) (n = 26). All cats exhibited mild to moderate clinical signs and were divided into 3 groups. Prednisolone (1 mg/kg PO every 24 hours) was administered to 9 cats, cyclosporine (7 mg/kg PO every 24 hours) was administered to 8 cats, and placebo (every 24 hours) was administered to 9 cats. All cats were assessed with lesional assessment scores using the feline dermatitis extent and severity index (FeDESI) at baseline and again at weeks 2, 4, and 7. At week 4, gabapentin (10 mg/kg PO every 24 hours) was added to all groups for 2 weeks, after which the dose was increased (15 mg/kg PO every 12 hours) for 1 week.

Prednisolone alone significantly improved FeDESI scores. Cyclosporine did not significantly improve scores until gabapentin was added. Gabapentin significantly improved FeDESI scores in all groups.

Actimetry (ie, accelerometer-based motor activity monitoring) was used to monitor itch-related activities based on the premise that the intensity would correlate with severity of pruritus-related activities (eg, scratching, licking). Cats treated with prednisolone and cyclosporine exhibited a significant decrease in motor activity compared to baseline. Motor activity decreased in all groups once gabapentin was introduced (suggesting a beneficial effect on pruritus) and increased in all groups once gabapentin was withdrawn.

Some limitations to this study included small sample size and lack of healthy controls. The authors noted the laboratory setting may have altered natural feline behavior, potentially limiting full expression of itch behaviors. Whether results with gabapentin stemmed from reduction of central sensitization or sedation may be difficult to determine, although the authors noted there were no signs of ataxia, altered mentation, or behavioral changes. Patient factors (ie, colony cats; mean age, 7.8 years [range, 5-13 years]; 22/26 sterilized females) may not be generalizable to the true pet population.

… The Takeaways

Key pearls to put into practice:

• Prednisolone alone demonstrated a rapid and consistent decrease in FeDESI scores, with additional improvement seen at both of the administered gabapentin dosages.

• Cyclosporine did not demonstrate statistically significant changes in FeDESI scores until gabapentin was added, possibly due to the slower action of onset of cyclosporine, the addition of gabapentin, or both.

• Gabapentin significantly improved FeDESI scores in all groups, suggesting therapeutic viability for management of cats with FASS.

^a This research was funded by an operational grant of Zoetis.