Gabapentin for Arthritis?

[Cheeko&Abby]

My rabbit Cheeko, who will be 11 in March is suffering from some pretty bad arthritis. The vet said it’s in his feet, legs, shoulders, pretty much everywhere. Up until this point he has been on meloxicam and tramadol, but since his kidneys are failing, the vet recently discontinued the meloxicam and put him on tramadol and gabapentin instead. She said the gabapentin might make him sleepy for the first week or so, but it should help after that. I researched gabapentin use in rabbits and found an article saying that it shouldn’t be used to treat arthritis pain since  people have reported that their rabbits have declined since being put on it, though there aren’t really any studies one way or the other. 

Has anyone here had any experience with gabapentin? He’s done well on the tramadol and meloxicam up until this point. 

Any input would be greatly appreciated! 

Jenni

[Bunny House]

I know long term use of meloxicam is very harmful on liver and the kidneys. My bun is on gabapentin for her nerve damage in her jaw, and it’s a miracle drug! Now I can’t say for sure on how it affects the arthritis but I know it really helps with the pain. She was on a whole bunch of different pain meds and this was the only one that worked.

[Cheeko&Abby]

Thanks so much, that’s really good to know that it can help. I read that gabapentin was for nerve pain and wondered how that related to arthritis. He was on meloxicam from May- November, but I think his kidneys weren’t great before that. Now he’s officially a hospice bunny, I’m just trying to keep him as pain free as I can until it’s his time. I thought the kidney failure would take him first, but it seems that the arthritis is progressing faster.

[Bunny House]

There is no harmful side effects for taking it so it wouldn’t hurt to try for a week and see if it does anything and if not, then switch to another med.
sending him some head rubs!

[DanaNM]

Hi Cheeko&Abby,

I don’t have any personal experience with gabapentin, but medirabbit (which is a source that I trust) has an article on some somewhat serious side-effects reported: http://www.medirabbit.com/Safe_medication/Neurolpetic/gabapent_effects.pdf

Gabapentin is an “off-label” drug in rabbits, and is addictive, according to that article. If you do decide to treat Cheeko with it, and he develops serious side effects, he should be slowly weaned off of it. Some of the side effects might also be similar to those of his kidney failure, so it might be hard to tell what is causing the problem. The article I linked describes this in more detail.

I know you have been through a ton with Cheeko, and are just trying to make him more comfortable. Weighing the side effects of all these treatments must be tough.

Not sure where you are or if this is feasible, but I have been hearing more and more good things about cdb oil for pets, especially for arthritis. Not promoting it by any means, but it might be worth looking into if it’s available in your area, especially if you are getting down to “last resort” type treatments.

((Cheeko)) <3

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[jerseygirl]

Thanks for linking to that page, DanaNM. This is what came to my mind about gabapentin also. Cheeko&Abby, perhaps you had already seen this, hence your questions about the drug?
If you hadn’t, it’s worth a read anyway as most of it is about treating arthritis in rabbits generally, even though the title is misleading. The part about gabapentin is in the yellow highlighted boxes.

Just a note, that is in regards to using gabapentin for arthritis , where you are looking at keeping a rabbit on something long term. For Bunny House’s situation, their vet may have prescribed it because 1) it was meant for short term pain management and 2) it is addressing nerve pain.
(Bunny House, do you give injections of gabapentin or is it available in an oral form?)

He’s done well on the tramadol and meloxicam up until this point.

Had your vet tried just the tramadol? Personally, I would have prefered they add in another NSAID with tramadol, rather then a second, addictive drug, with tramadol being a narcotic.

 NSAID Ketaprofen is mentioned in the linked page above. I do not know if it has long term side effects. Carprofen (Rimadyl) is another that is used for rabbits.

At 11, it is about giving quality of life (as you said) rather then prolonging it.  So I don’t really understand why the vet wanted to take him off something that was working. The renal system in aging pets is not going to be functioning particularly well, regardless of being on long term meds or not, in my view.. 

There have been studies on meloxicam for rabbits in the last 10-15 years that show they tolerate higher doses then cats and dogs, without negative impact to the kidneys. The duration of these studies where around 30 days though, not months or years. Perhaps someone has some info on longer term effects??
Sending good comfort {{{vibes}}} to your Cheeko. My lop, Rumball, lived to be 11 also – he passed late this September.

[Bam]

The others have already given you lots of good input, so I don’t think I have much to add.

The side effects of Gabapentin are very individual. It’s often used in dogs, however dogs metabolize gabapentin differently from most other species. My dog got gabapentin with an NSAID (Metacam is an NSAID – non-steroidal anti-inflammatory drug) for her osteoarthitic back. The side effects were pretty much what the Medirabbit article describes for rabbits – severe lethargy, muscle weakness, inability to move. I took her off the gabapentin, because side-effects like that prevent good quality of life. It’s of course not reasonable to medicate an animal so it just lies there in a state resembling torpor. On the other hand, one of my friends had an elderly dog that had gabapentin for a bad back – that dog became “as good as new”. She was happy, playful, agile. She was on gabapentin for several years.

Gabapentin is indicated for neuralgic pain, so it has no anti-inflammatory properties. It basically stops neurons firing. It is excreted solely via the kidneys, so p oor kidney function in the patient means the dose of gabapentin must be adjusted accordingly (kidney failure means decreased filtering-ability, which can lead to too high concentration of gabapentin in plasma). Your vet knows your bun has poor kidney function, so they are most likely taking this into consideration when calculating the dose.

Because you are aware of the possible side-effects, you won’t mistake them for symptoms of something else, which I assume was the problem in the Medirabbit article. People thought their elderly buns had poor balance and poor coordination because they’d got e cuniculi and started medication for that, plus kept giving the gabapentin. You are better informed and can wean your bun off the gabapentin if it’s not working out. 

[Bunny House]

Jerseygirl, it’s in an oral form. Caramel has no crazy side effects besides it can seem to be a little addicting so if I don’t give it to her within an hour, she will act sluggish and painful but when she’s on it, she’s like bam said “good as new” so that’s why we keep her on it. And because of her facial nerve issues, she will be on it for life. I know her vets at the vet school read studies and couldn’t find any longer term side effects but of course it doesn’t hurt to monitor blood and she will have CTs once a year to make sure her jaw abscess is still gone and not reforming so we can also check her organs at the same time

[Cheeko&Abby]

Thanks for the link Dana, that is the article I was referring to when I searched Gabapentin use for arthritis in rabbits. I’ve given it to him for 3 days now and he does seem more sluggish, but that’s what the vet said to expect for the first week. I think I’ll try it for 2 weeks and see how he’s doing, then slowly wean him off it if it’s not helping. I’m scared that he doesn’t really have good enough health to get worse and then better again. He’s living a good old man life, snuggling with Abby and eating a lot. I haven’t tried cbd oil, but even the vet asked if it’s something I’m trying. I’m not sure where to get it? I’m in the Phoenix area.

Jerseygirl, I completely agree with you about the meloxicam. His kidneys are already failing, so if it makes him more comfortable, why stop it? The vet even said he’s a hospice bunny, so I’m not sure why they’re trying to prevent additional kidney failure when it’s inevitable. I’m not trying to squeeze 5 more years out of him, just make him as comfortable as possible for the time he has left.
I’m so sorry to hear about Rumball 11 is a great age to get to!

Thank you for the information, bam. I hope the vet took the kidney failure into consideration when she prescribed it. I’m glad it worked for your friend’s dog, but I agree with what you said about your pup, the side effects don’t seem to be helping the quality of life. How long was your dog on it before you stopped?

[Bam]

My dog was only on it for a couple of weeks, the dose she was prescribed was very much too high for her, so we adjusted it from 300 mg twice a day to 100 mg once per day. I never gave it twice a day, because she was totally zombiefied on one capsule. The dose she was given initially was a standard dose for her weight (she’s a GSD), but she must be very sensitive to the substance. She took it together with Previcox (an NSAID, same type of med as Metacam). When the side effects did not subside, we took her off the gabapentin but kept the Previcox going. Now I only give her gabapentin (in a small dose) when she shows signs of extra discomfort. This has only happened 4-5 times this last year and a half. The gabapentin makes her fall asleep. I can’t know if it relieves pain or if it just makes her sleep, but good sleep can of course be beneficial for an individual that’s experiencing pain.

[Cheeko&Abby]

That’s a good point, maybe it’s good to have the gabapentin on hand just for that purpose. If I don’t see any improvement, I’ll slowly stop the gabapentin and just give him the meloxicam again.
I was talking to my sister about it earlier and she was gently trying to tell me it’s his time. He’s now on 4 different meds and the vet wants me to do sub q fluids as well to give him a few extra months. He’s already fighting me with the meds, so I can’t see him sitting still with a needle in him for fluids every day, it would make him so much more miserable.
I think I just need to love on him as much as I can and restart the meloxicam because it’s the only med he actually likes and choose a day sometime in the next month to give him all the treats he wants and say goodbye.

[Bam]

One of the forum leaders, LittlePuffyTail, gave her elderbun Bindi daily sub q fluids during his old age. I will alert her to this thread in case you want to ask her about giving sub Q fluids long term and how it affects the bun’s quality of life.

I heard from a former forum leader, Kokanee and Kahlua, she too has a dog that’s on gabapentin. Gabapentin is working out really great for her dog. She had an elderbun that was on Carprofen-injections for arthritic pain, and it worked very well. Carprofen is however the same typ of med as Metacam (NSAID) so it could have similar effects on the kidneys. 

(Scroll down to the fourth entry titled “Therapeutics”):

http://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/carprofen

[Cheeko&Abby]

Thank you so much for the information. It seems like he does best on the NSAIDs, but the vet was worried about his decreasing kidney function. I’ve also read that meloxicam doesn’t actually have a huge effect on rabbit’s kidneys, so if the vet agrees this is a hospice situation, I don’t see why they’d stop something that’s making him more comfortable… plus it’s the only med he enjoys taking.
I’ve been mixing the tramadol and gabapentin with critical care (which he loves) and he flat out refused it this morning. I’ve also mixed it with mashed up banana in the past, but again he didn’t want it this morning. Forcing meds down his throat twice a day isn’t any kind of life for him, it was different when he was on the meloxicam and took it willingly.
I feel like trying to squeeze more time out of him is unfair if it means he lives in fear of me squirting multiple syringes of bad tasting meds in his mouth multiple times a day

[LittlePuffyTail]

I’m sorry to hear about all that is going on with your bun. Bam alerted me to this thread and I can give you some info on sub Q fluids. My bunny, Bindi, who sadly passed away earlier this year at age 11, was getting sub Q every night for the past 3 years. For him, it was due to an issue with a tongue injury that left him unable to drink well on his own. At first, I thought it was going to be a nightmare and he would fight us and there was no way we could do it long term. The first week or so was rough, we put him on a blanket on the towel and I held him while my husband did the needle and syringe part. Really helps to have 2 people. I didn’t want to be the one to have to poke him so the vet showed my husband how to do it. Fairly simple when you get the hang of it. We always warmed the fluids (in the bag) to room temperature so it wasn’t too unpleasant. Bindi was really easy going and it just became part of our routine, just like any meds he was on. You would have to see if your bunny would tolerate it as well. 

I hope you and your vet are able to find a solution that works for your bunny.

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