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  1. #1
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    Default Gabapentin dosage?

    I have been researching photoperiodic-induced headshaking.
    One of the coures of therapy seems to be the use of gabapentin (Neurontin) with some success. Does anyone have the general dosing information? In humans, I believe the titration up and dosing varies greatly. How does this translate to use in horses? Anyone have experience adminstering it for headshaking symptom relief?



  2. #2
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    Never used it for headshaking but when we had a full sized horse on it for other reasons I believe he was getting 2400 mg twice daily. When my laminitic pony is on it he gets 800 mg twice daily. I'm sure your vet will be more helpful than me though. Good luck!
    Quote Originally Posted by EquineImagined View Post
    My subconscious is a wretched insufferable beotch.



  3. #3
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    My experience has been if the dosage is too low, it doesn't do much, but we are using it for chronic pain, not headshaking, so there might be quite a difference there.
    My boy gets 20,000mg per day or 50, 400mg pills/day.



  4. #4
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    Wow Lieslot, that seems like a REALLY high dose! What type of chronic pain are you dealing with? We use if mostly in the winter on my Cushing's pony--he has trouble with cold induced laminitis and the 1600 mg a day seems to help. It would be nice to thing that we could increase the dose if needed without side effects. Is your horse on it all the time? I was also told to slowly taper the dose if taking him off of it, but my vet doesn't seem to have a problem with him staying on it.
    Quote Originally Posted by EquineImagined View Post
    My subconscious is a wretched insufferable beotch.



  5. #5
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    I haven't used it for headshaking - I generally use it for chronic pain, but I start at 2.5 mg/kg PO BID and work up to 10 mg/kg PO BID as needed.

    So for an "average" 1000 lb horse (450 kg) that would be 1125 mg to 4500 mg twice a day.



  6. #6
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    When I used it on Blush for wind-up pain, we used the 2.5 mg/kg dose and it worked well.

    Here is a paper that mentions dose: http://avmajournals.avma.org/doi/abs...rnalCode=javma

    The least expensive place to purchase at the time was Walgreen's, with one of their prescription cards.



  7. #7
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    I get mine at Costco, where they told me that the 400mg capsules were actually cheaper than the 800 mg tablets.
    Quote Originally Posted by EquineImagined View Post
    My subconscious is a wretched insufferable beotch.



  8. #8
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    Walgreen's pricing is better for the 100 mg capsules:

    100 mg: 300 for $13.33, 900 for $40

    But CostCo looks better for the rest.

    We used the 100 mg capsules, and they work fine for the 2.5 mg/kg dose. Good to know that CostCo is also an option, though. Everywhere else I looked wanted A LOT more money for it!



  9. #9
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    I actually get a ton of drugs from Costco--they have really good prices on ranitidine (300 mg) and doxycycline too! I don't even have to give the ladies at the counter my name anymore when I go to pickup.
    Quote Originally Posted by EquineImagined View Post
    My subconscious is a wretched insufferable beotch.



  10. #10
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    We used it for undefined nerve pain.
    It's not a massive dose necessarily, I know my practice goes by that dose for other horses. We go by 15mg/lb.
    It's a bit a hit & miss. The problem is, you go too low you have no effect, so one thinks it doesn't work, but it may well work, if the dose was higher.

    FWIW, it's also a great anti-anxiety med for horses. After years of separation anxiety, what separation he says , I don't need the others, why would I, lol. It has changed his personality for the better.



  11. #11
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    Default

    Thanks everyone for your responses. The use for the head shaking is for "undefined nerve pain" in essence. Fingers crossed this works . . .



  12. #12
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    Mar. 29, 2012
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    The problem with gabapentin dosage is that it takes sometimes weeks or months to build up to an ammount that is beneficial. It will take a long time because anyone would get very sick if they started with a full dosage. Check out this resource if you have more questions. http://gabapentindosage.com/



  13. #13
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    Quote Originally Posted by Lieslot View Post
    We used it for undefined nerve pain.
    It's not a massive dose necessarily, I know my practice goes by that dose for other horses. We go by 15mg/lb.
    It's a bit a hit & miss. The problem is, you go too low you have no effect, so one thinks it doesn't work, but it may well work, if the dose was higher.

    FWIW, it's also a great anti-anxiety med for horses. After years of separation anxiety, what separation he says , I don't need the others, why would I, lol. It has changed his personality for the better.
    It it is the same as humans I doubt it is anti-anxiety as much as an overall tranq. 20% or so of humans who take it have trouble with sleepyness, and some mental difficulties. I have not heard (or experienced) a drop in anxiety...I am just too tired to show my anxiety the same way!

    I wonder if in part this is why it could help some horses with headshaking....just to fricken tired to bother.

    Neurontin is hard on the liver and kidneys, so something to consider.



  14. #14
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    Interesting CHT. I'm not sure if it works in the same way it does in humans. I'd love to understand nervepain in humans better though, to see how it could relate to horses, especially since I really don't think the pain is equal on a daily basis, seems sometimes it's there other times it's not.
    With him there's no headshaking involved, it's more related to the sciatic/femoral nerve -we think-.

    I have not noticed any fatigue. If anything he finally has muscle he never had before (filled in the hollows underneath the hips, which he never did when he was still in work).
    Since on the meds he's always on the move. He's got a bit of a labyrint of paddocks as turnout and it's crazy the miles he must be doing on a daily basis. He never did that in the past. Up the little hill, down the little hill, round the house, round the ring. (tires my own knees going after him with my wheelbarrow ).
    I think the painrelief it gives him, has allowed him to use his body in a better way.
    He sure is very alert and even more playfull then he was before, which again I attribute to a feeling of comfort.
    He just appears to have lost his fears or inhibitions about things that used to be a big deal. You wouldn't get him thru a puddle of water either, where now he's not alarmed by it anymore. The washstall used to be a big no-no for years, now we are happy to go in there. It's almost like it altered his way of thinking, will be interesting to see if it stays like that when off it.

    It does him good the majority of the time, but he can have moments where it looks like things are majorly pinched sadly, at that time nothing will actually relieve the pain, luckily those moments are becoming less frequent and shorter in time (better touch wood now after saying this).

    Quote Originally Posted by CHT
    Neurontin is hard on the liver and kidneys, so something to consider.
    Yes, I wondered & worried about that. That's why I'm thinking a break after 6 months should be in place.
    Some suggest a taper down, others say not necessary. I know of a lady in the UK with a horse with pinched nerve at C7, similar dose of Gabapentin to my horse and he's rideable, they took him off it cold turkey and he got way worse, to the point of being dangerous, so he's back on it for 6 months and then they will taper down instead a sudden stop.

    Quote Originally Posted by WeDoThis
    The problem with gabapentin dosage is that it takes sometimes weeks or months to build up to an ammount that is beneficial.
    That has been my experience too, it took 4 weeks before I finally realized it actually DID work.



  15. #15
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    Quote Originally Posted by WeDoThis View Post
    The problem with gabapentin dosage is that it takes sometimes weeks or months to build up to an ammount that is beneficial. It will take a long time because anyone would get very sick if they started with a full dosage. Check out this resource if you have more questions. http://gabapentindosage.com/
    Pharmacokinetics of gabapentin in horses is not the same as it is in humans:
    http://www.ncbi.nlm.nih.gov/pubmed/20840393

    I will tell people giving it to continue for a month before stopping because it is cheap and generally has minimal side effects in the horse, but often, if it is *going* to work, I will see some effects after one or two doses. Now, it could be a slight improvement, and so I might up the dose to try and get a more complete improvement, but to me if it's going to work, it usually works quickly.



  16. #16
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    I will tell people giving it to continue for a month before stopping because it is cheap
    I never understood why people say it's cheap.
    At 20,000mg a day it's not all that cheap, I had to do some major online searching to get an acceptable price.
    At that dose the price at my vet's office was like $800 a month.



  17. #17
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    Quote Originally Posted by Lieslot View Post
    I never understood why people say it's cheap.
    At 20,000mg a day it's not all that cheap, I had to do some major online searching to get an acceptable price.
    At that dose the price at my vet's office was like $800 a month.
    That is a WHOPPINGLY large dose, though. HUGE. ENORMOUS. Most people would never even think to give a dose that large.

    We gave Blush 1400 mg twice a day, with excellent results. It was cheap.



  18. #18
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    I'm wondering if there aren't enough horses on the drug yet to determine the right amount. I was concerned about the dose too, but seems there's more vets going by that dose unalarmed. I also checked what dose they were using overseas and it was similar.

    Yet here only 2,5mg/kg was used. (hence my panic at first)
    http://www.ncbi.nlm.nih.gov/pubmed/17764439

    It's thought to have a low oral absorbability however, perhaps why some vets go with higher doses, dunno.
    Interestingly it mentions the increase thirst, albeit they only noticed it with iv administration. My gelding drinks more then before, but I never thought to attribute it to the Gabapentin.
    Here 20mg/kg was used to determine safety.
    CHT is actually right in her assumption, the iv route does show increased sedation, but seems not when given orally (which I hadn't noticed when given orally either)
    http://www.ncbi.nlm.nih.gov/pubmed/20840393
    Last edited by Lieslot; Mar. 30, 2012 at 07:16 AM.



  19. #19
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    2.5 mg/kg is standard around here, at least to start. I imagine some vets would increase if the felt the horse would respond better to a higher dose. We did not have to experiment as Blush responded beautifully to the lower dose.

    Just out of curiosity--have you tried backing your horse off, to see if a smaller dose has the same effect? Would certainly be easier on your wallet, and perhaps easier on his liver.



  20. #20
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    I do notice with me, my nerve pain is worse the more I use the area, so it does come and go. that doesn't mean the medications isn't helping, it just isn't helping enough, but I would be comatose if I took more.

    I felt results after day 3, but took 2 weeks to get to the "right" dose for me. When I tried cutting back I knew in 48 hours it was a mistake. Same with when I tried upping it.

    I get my liver and kidneys checked every 6 months; apparently not all are affected the same way, so maybe that would be better for your horse than taking them off it for a "break"?



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