Gabapentin for Canine Stress at the Clinic

In the Literature

Stollar OO, Moore GE, Mukhopadhyay A, Gwin W, Ogata N. Effects of a single dose of orally administered gabapentin in dogs during a veterinary visit: a double-blinded, placebo-controlled study. J Am Vet Med Assoc. 2022;260(9):1031-1040. doi:10.2460/javma.21.03.0167

The Research …  

Drugs used to alleviate stress in dogs during clinic visits should be fast-acting and have a short duration of action.^1,2 Gabapentin may be ideal for this use because it has a half-life of <4 hours, and maximal blood levels occur <2 hours after administration.³

This double-blinded, randomized, placebo-controlled crossover study evaluated the effects of a single administration of gabapentin (50 mg/kg PO) on stress in dogs at the clinic. Twenty-two healthy, client-owned dogs were administered either gabapentin or placebo 2 hours prior to 2 separate clinic visits.

Behavior responses before, during, and after physical examination were video recorded, and physiologic variables (ie, eye surface temperature, salivary cortisol concentration) measured before and after examination, were compared. Greeting behavior was assessed at the beginning of each visit. Behavior test results and physiologic variables did not differ between groups; however, frequency of lip licking was significantly lower in the gabapentin group before, during, and after examination. Owners reported no serious adverse effects 24 hours after each visit. 

Although previously published oral doses of gabapentin range from 10 to 30 mg/kg,⁴ this study showed a single dose of 50 mg/kg is well tolerated in clinically healthy dogs. There was minimal difference between placebo and treatment groups compared with similar studies in dogs receiving trazodone or oral transmucosal dexmedetomidine and in cats receiving gabapentin^5-8; however, these prior studies only included patients with a history of anxiety during clinic visits. Patients in the current study may not have experienced enough stress during the visit to demonstrate treatment effect. In addition, some dogs in this study exhibited onset of sedative effects 3 to 4 hours after receiving gabapentin, thus individual variation in onset of effect should be considered. 

Because this and prior studies did not include dogs with a history of aggression, there is a lack of evidence on benefits of oral premedication in dogs exhibiting aggression related to veterinary care.^5-8 In the author’s opinion, oral premedication is optimal for administration of injectable sedation in dogs with a history of aggression in the clinic.

… The Takeaways

Key pearls to put into practice:

• Gabapentin (20-30 mg/kg, up to 50 mg/kg) to manage stress in the clinic can be beneficial in clinically healthy dogs.

• A test dose should be given on a day prior to the scheduled clinic visit to gauge time of onset and level of effects.

• If gabapentin alone is inadequate, a combination of gabapentin (starting at 20 mg/kg) and trazodone (5-12 mg/kg) can be considered.⁹

• Dogs demonstrating aggression may still require injectable sedation in addition to oral premedication.