This double-masked, randomized, crossover, placebo-controlled clinical trial evaluated the use of pregabalin in 8 dogs that had neuropathic pain associated with Chiari-like malformations and syringomyelia. Each dog underwent a placebo and a pregabalin treatment phase. Using a numerical scale, owners reported improved daily pain scores when dogs were treated with pregabalin. Pregabalin also significantly improved quantitative sensory testing, including mechanical hyperalgesia, cold hyperalgesia at 32°F (0°C), and cold allodynia at 59°F (15°C). In addition to its efficacy, pregabalin was well tolerated and noncumulative and had few adverse effects other than mild sedation.