Gabapentin

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Robyn and Penny

Robyn and Penny

Member Since 2013
So...I've been torturing poor Gayle over on FB and I figured I'd ask her. My darling smarty paws, Penny, has pain in her spine they are chalking up to arthritis although her x ray didn't show any definitive changes. Long story...she hadn't been laboring getting around or anything, but woke up out of a deep sleep one night rolling around on her back and almost like she was in a cat fight with an imaginary cat, so I took her to the Emergency Vet and her regular vet and both noted pain on palpation on her back where the thoracic meets the lumbar spine. Her BGs have been wonky since April, she's been OTJ since last Halloween, but the high and low numbers could def be due to pain.

Soooo...first they gave me Dasuquin, which is supposed to be SOOOOO palatable for cats, but after Day 2 Penny was on to me and won't eat her wet food if the Dasuquin is on it. Now, this cat is hardly finicky lol. So then her regular vet put her on gabapentin, and in an effort to save a buck b/c she needs to get a J.O.B. (yeah, right, like SHE would work lol) I got the capsules and give her half capsule (50mg) q12h. That went well for the first 2 doses but by tonight she would not finish a flavor that she normally DEVOURS. And it's Saturday night.

I do have buprenex but really don't want give her more when I just switched her from the bupe to the gabapentin.

So, my question was, since it can be mixed with food, I took 50mg of powder and mixed it with .02ml tuna water for tomorrow's AM and PM dose, but not sure if pre-mixing it would reduce the efficacy of the medication. I really don't wanna go the compounding pharmacy route for liquid compound or transdermal, but the stuff is pretty bitter so I may have to. Do you think premixing the syringes till I can get in touch with her vet and get a new RX is okay?

Also, what are your thoughts on the transdermal? It's available at Wedgewood Compounding pharmacy (don't know how expensive it is) and transdermal minimizes the possible weight gain side effect of gaba (she needs to lose weight, not gain it), but I still test her BGs once per day (usually her left ear so I would do her AM dose on the right ear if she lets me lol), but would residual gel affect her BGs or make it more difficult to test? Does anybody have any experience with any of this?
 
You might try wrapping in a bit of Pill Pocket or processed cheese to see if you can get in that way.

If it were a tablet, I'd coat with butter or oil to keep it from dissolving in the mouth, so it wouldn't taste as bad.

You could mix it with the oral syringe to hold it; you just want to be sure it was mixed evenly with the same dose per syringe. Some people will open time release capsules and separate the different granules to divide them evenly.

It may be easier to give if transdermal and worth it even if the cost is greater.
 
Very few drugs work transdermal. While any drug can be compounded as a transdermal most do not work. Can you put the meds in a gelcap and then administer the gelcap. That is what I use.
 
Why do they compound them transdermally if they don't work that way?

I can do an oral compounded liquid, but Penny's had some horrible diarrhea since starting it and not sure if that will subside as her body adjusts to the medication. Plus, I read that weight gain is a side effect of gabapentin. She's 18lb and needs to lose weight if we have a chance of her maintaining her remission to begin with. I also read the systemic side effects such as diarrhea and weight gain can be avoided with the transdermal. She's always had a problem with loose stools, even while on Buprenex and she has a very sensitive stomach so I thought this may work better.

My main concerns is ear testing since I still test her BG once per day. Will the gaba affect her BG reading since I'm testing her ear and she has meds on the other side of that ear?

I have the capsules that I was instructed to sprinkle a half capsule on her food twice daily. She caught on to that quickly, so my other question was can I pre-make syringes with the gaba powder mixed with tuna water to administer orally? Or will gaba lose its efficacy sitting in the tuna water for a couple of days. If I can pre-make them, I can stay with the capsules and prep like a week's worth of syringes at one time rather than paying a fortune for a compounded liquid.
 
I would talk to the vet about premixing for a couple of days. It seems to be sensitive at to what it is dissolved in.

Gabapentin is a gamma-aminobutyric acid analogue, which has been shown to be an effective antiepileptic. The solution stability of gabapentin in buffered systems was studied in order to facilitate the formulation of a liquid product. The degradation of the drug was followed as a function of pH, buffer concentration, ionic strength, and temperature. The results indicated that the rate of degradation was proportional to the buffer concentration and temperature. The pH-rate profile of gabapentin degradation showed that the rate of degradation was minimum at an approximate pH of 6.0. Further, the data suggested a slower solvent-catalyzed degradation rate for the zwitterionic species compared to the cationic or anionic species in the pH range of 4.5 to 7.0. There was no influence of ionic strength on the rate of degradation. Arrhenius plots of the data indicated that a shelf life of 2 years or more at room temperature may be obtained in an aqueous solution at a pH value of 6.0.

http://www.ncbi.nlm.nih.gov/pubmed/1608888

Gabapentin oral suspension
(Neurontin)
Refrigerate at 36º to 46º F (2º to 8ºC). Contact manufacturer.***
Off-label§ information indicates oral
solution stable for seven days at temps
up to 86oF (30oC).6
Pfizer
800-438-1935

From:
http://www.ashp.org/doclibrary/policy/p ... ndrugs.pdf

Here is some inf on transdermals
http://www.ncbi.nlm.nih.gov/pubmed/15515580
and page 3 of:
http://veterinarycalendar.dvm360.com/tr ... 9&pageID=3
 
Thanks! I def don't like the use of soy lecithin in the transdermals. That right there turns me right off the idea. I was just thinking that with a transdermal, Mom could help dose Penny like when I'm away for business next year. There's no way Mom can give her oral meds. I barely can and forget pilling Penny! lol

I did call a pharmacist today just on whether or not premixing the gaba powder in tuna water or Fancy Feast broth would make it less effective and he did some research but really couldn't answer my question. He couldn't find anything that said it would reduce efficacy. He and I both found that when gaba powder is mixed with applesauce (for elderly patients who can't swallow pills) it didn't reduce efficacy and when mixed with a protein such as in sugar free chocolate pudding, it actually increased it. But, this is cat food broth lol. The pharmacist said I could premix, refrigerate the syringes and see how she does so I just made up 2 days' worth. He also pointed out Penny's diarrhea could be from stopping the bupe, which causes constipation, but Penny never got constipated on it.

Bottom line...by the time I get syringes (which is impossible in NJ) with caps on them, go through the FF broths or canned tuna and the actual cost of the medication, I'm probably better off just getting the compounded liquid. My main goal is to keep Penny in remission. And if she keeps having pain, it's def a threat to her remission.

The other question I had is that Gayle mentioned her acro cats were on 25mg once per day. Acro cats are big. Penny is 18lbs (not Acro) and she was prescribed 40mg twice per day, yet everything I'm reading for pain control with gaba is that dosing is once per day. Do you think 40mg twice per day is a bit much? Do you have any personal experience with using gabapentin for arthritis with your cats?
 
Yeah, I know the oral solution has xylitol, which is why I'm playing with the idea of getting a compounding pharmacy to make an oral liquid.
 
I read that last night and that's where I got her starting dose should have been 25mg once per day rather than 50mg twice per day. I dk what my vet was thinking. It said it CAN be increased but everywhere i'm reading says 3mg/kg once per day as a starting dose. So, I'm gonna bring her down to 25mg twice per day, which is half her dose prescribed, and see how that goes. I think I'm gonna go with the oral compounded liquid b/c even though I'm mixing the powder with FF broth, it's very bitter and I don't want her starting to give me trouble at medication time lol. Shame it's not flavorless like buprenex. She just sits and takes her medicine when it's bupe lol
 
I don't know the med you are talking about, but Maggie was on 1/2 a Diltiazem for her heart, which is very bitter. Pilling was extremely hard to do and stressed her. We went the transdermal route and it seemed to work. Even if the dose wasn't 100%, she got most of it, as opposed to finding the pills all over the house. We would check her mouth after pilling, but the little sneak would then barf or spit it up somewhere totally undigested. We tested on one ear, put the med on the other.

The thing about transdermal medications is that you have to clean the ears at least once a week. You see, the "goo" builds up on the ear and eventually prevents the meds from working, but that isn't a problem if the "goo" is regularly cleaned off the ear.
 
Thanks Debby. If there's a question of the absorption of gabepentin (the med we are talking about) transdermally, plus ear testing, I think I should stick to the oral route. It's being used for pain and the pain was jacking up Penny's numbers, which was threatening her remission, so I don't wanna spend all that money for a transdermal and find it not working. I don't want her to suffer but she's only 6 and I'm not really happy she needs these meds to begin with...can't you tell? lol

One of the side effects of gaba is increased appetite and that's the last thing Penny needs. Her weight is what got her into this mess to begin with!
 
I tried gabapentin for a while for Neko, who has arthritis. She's also an acrocat, but just under 15 lbs. We started at 25mg twice a day and after a week when it didn't seem to do a thing we moved to 50mg twice a day. It made her more sleepy but didn't help the pain. The gapapentin was in pill form. They are quite tiny and very easy to give in pill pockets. I was giving buprenorphine at the same time (started it first). The vet said I could continue to do both at once. I stopped the gabapentin trial after two weeks when it didn't seem to do a thing. Bupe worked better for us. Acupuncture has also helped her arthritis pain. Other things you can add are fish oil to the diet (anti-inflammatory), Cosequin (powder is chicken/tuna flavor) and Hyaflex.
 
Thanks Wendy! She was feeling good on it yesterday but threw up overnight and was sick this morning. She's been working on a hairball b/c it happened a couple of days ago when she was still on buprenex. She started gaba Friday night and her BG was 84 yesterday, which tells me she wasn't in pain (her numbers had been up and down so when we figured out the pain, that explained it) but this morning she was sick and I gave her Vaseline, so I gave her bupe since that's absorbed through her mucosa rather than her stomach. So it hasn't been long enough to tell yet.

She's been moving around fine, so if it wasn't for the wonky numbers and the episode she had the night I took her to the ER, I'd never know she was in pain. She's only 6 and we are chalking it up to arthritis b/c they couldn't find anything in her x ray (it was a bad film thought) or her blood work and both the ER vet and her regular vet would touch this one area where her thoracic meets her lumbar spine and she would JUMP.

So what are you using to manage the pain?

I have Dasuquin but she caught on to that and don't like the flavor, so Hillary Maui over on FB suggested another type but I haven't ordered it yet. She won't eat chews so it has to be a crunchy treat. I really don't wanna give her liquid since I'm already forcing liquid medicine down her throat twice per day. Fish Oil is the 4th ingredient in her Young Again Zero Carb kibble she's been on since last year. I will look up the other stuff.
 
I'm using buprenorphine for pain. I get it compounded in chicken flavor. She loves her "chicken soup". :-D I give her a 1/4 tsp of babyfood squash twice a day to counteract the constipating effect of the bupe. From reading about other cats here with arthritis, you really have to try a number of things and see what works. What works for one cat may not for another.
 
Wendy, I just saw your reply. How much are you paying for the bupe? It would cost me over $80 per month to have Penny on it and she's back on insulin, Adequan, strips, lancets, forti flora so I can give her the shots (that's the only way I can stick a needle in her for Adequan and insulin is to have her face in a bowl full of food sprinkled with forti flora lol) I have a maxed out Care Credit at this point and she needs to get a job. I've been taking her off the gabapentin, her diarrhea is much better, she's been playful, active, happy. She also got her 10th shot (week 6) of Adequan today and lost 1lb 3 oz since all this started.
 
Prices in Canada are quite different from the US. A three month supply is costing me about $100. If Penny is playful and active with the Adequan, maybe she doesn't need the bupe just yet.
 
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