Advertisement

Evaluation of prescribing practices for gabapentin as an analgesic among veterinary professionals

  • Rebecca Reader
    Correspondence
    Correspondence: Rebecca C Reader, Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA.
    Affiliations
    Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, MA, USA
    Search for articles by this author
  • Oladapo Olaitan
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, The Albert Sherman Center, Worcester, MA, USA
    Search for articles by this author
  • Emily McCobb
    Affiliations
    Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, MA, USA
    Search for articles by this author

      Abstract

      Objective

      To describe the prescribing practices for gabapentin as an analgesic within the veterinary community.

      Study design

      Anonymous online voluntary survey.

      Population

      A total of 718 veterinarians within the United States and Canada, including general practitioners and diplomates of the American Colleges of Veterinary Anesthesia and Analgesia, Emergency and Critical Care, Surgery and Internal Medicine.

      Methods

      An anonymous online survey was used to gather information about individual prescribing practices for gabapentin including frequency of use, reasons for prescribing and procedures for authorizing refill requests. Questions specific to gabapentin covered mechanisms of action, perceptions of efficacy and the potential for abuse in people. Dunn’s test for multiple comparisons and pairwise Mann–Whitney U test were used to evaluate relationships between veterinary specialty and survey responses.

      Results

      A total of 718 veterinarians responded to the survey, 528 (73.5%) answered all questions of the survey to completion. Frequency of prescribing was high with 365/529 (69.0%) of respondents prescribing gabapentin as an analgesic on a daily or weekly basis. Surgeons and general practitioners used gabapentin significantly more frequently than other groups, with surgeons more likely to prescribe gabapentin for postoperative pain. The most common reason [254/517 (49.1%)] survey respondents prescribed gabapentin as an analgesic was because administration of a non-steroidal anti-inflammatory medication was contraindicated for that animal. The majority of survey respondents [362/527 (68.7%)] considered the abuse potential of gabapentin to be low in people.

      Conclusions and clinical relevance

      Veterinary prescribing practices for gabapentin closely mirrored that of human physicians, with gabapentin being prescribed frequently and for uses largely unrelated to its labeled indication. The perception of the potential for abuse of gabapentin is low within the veterinary community.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Veterinary Anaesthesia and Analgesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aghighi S.A.
        • Tipold A.
        • Piechotta M.
        • et al.
        Assessment of the effects of adjunctive gabapentin on postoperative pain after intervertebral disc surgery in dogs.
        Vet Anaesth Analg. 2012; 39: 636-646
        • Connecticut Department of Consumer Protection, Drug Control Division
        Memorandum. New medications to be added to the Connecticut Prescription Monitoring and Reporting System (CPMRS).
        2020 (Last accessed 11 January, 2021)
        • Crociolli G.C.
        • Cassu R.N.
        • Barbero R.C.
        • et al.
        Gabapentin as an adjuvant for postoperative pain management in dogs undergoing mastectomy.
        J Vet Med Sci. 2015; 77: 1011-1015
        • Davila D.
        • Keeshen T.P.
        • Evans R.B.
        • Conzemius M.G.
        Comparison of the analgesic efficacy of perioperative firocoxib and tramadol administration in dogs undergoing tibial plateau leveling osteotomy.
        J Am Vet Med Assoc. 2013; 243: 225-231
        • Donati P.A.
        • Tarragona L.
        • Franco J.V.A.
        • et al.
        Efficacy of tramadol for postoperative pain management in dogs: systematic review and meta-analysis.
        Vet Anaesth Analg. 2021; 48: 283-296
        • Epstein M.
        • Rodan I.
        • Griffenhagen G.
        • et al.
        2015 AAHA/AAFP pain management guidelines for dogs and cats.
        J Am Anim Hosp Assoc. 2015; 51: 67-84
        • Evoy K.E.
        • Morrison M.D.
        • Saklad S.R.
        Abuse and misuse of pregabalin and gabapentin.
        Drugs. 2017; 77: 403-426
        • Goodman C.W.
        • Brett A.S.
        A clinical overview of off-label use of gabapentinoid drugs.
        JAMA Intern Med. 2019; 179: 695-701
        • Guedes A.G.P.
        • Meadows J.M.
        • Pypendop B.H.
        • et al.
        Assessment of the effects of gabapentin on activity levels and owner-perceived mobility impairment and quality of life in osteoarthritic cats.
        J Am Vet Med Assoc. 2018; 253: 579-585
        • Kharasch E.D.
        • Clark J.D.
        • Kheterpal S.
        Perioperative gabapentinoids: deflating the bubble.
        Anesthesiology. 2020; 133: 251-254
        • KuKanich B.
        Outpatient oral analgesics in dogs and cats beyond nonsteroidal anti-inflammatory drugs: an evidence-based approach.
        Vet Clin North Am Small Anim Pract. 2013; 43: 1109-1125
        • KuKanich B.
        • Cohen R.L.
        Pharmacokinetics of oral gabapentin in greyhound dogs.
        Vet J. 2009; 187: 133-135
        • Lamont L.A.
        Multimodal pain management in veterinary medicine: the physiologic basis of pharmacologic therapies.
        Vet Clin North Am Small Anim Pract. 2008; 38: 1173-1186
        • Millar J.
        • Sadasivan S.
        • Weatherup N.
        • Lutton S.
        Lyrica nights – recreational pregabalin abuse in an urban emergency department.
        Emerg Med J. 2013; 30: 874
        • Peckham A.M.
        • Fairman K.A.
        • Sclar D.A.
        All-cause and drug-related medical events associated with overuse of gabapentin and/or opioid medications: a retrospective cohort analysis of a commercially insured US population.
        Drug Saf. 2018; 41: 213-228
        • Siao K.T.
        • Pypendop B.H.
        • Ilkiw J.E.
        Pharmacokinetics of gabapentin in cats.
        Am J Vet Res. 2010; 71: 817-821
        • Sills G.J.
        The mechanism of action of gabapentin and pregabalin.
        Curr Opin Pharmacol. 2006; 6: 108-113
        • Smith R.V.
        • Havens J.R.
        • Walsh S.L.
        Gabapentin misuse, abuse and diversion: a systematic review.
        Addiction. 2016; 111: 1160-1174
        • Verret M.
        • Lauzier F.
        • Zarychanski R.
        • et al.
        Perioperative use of gabapentinoids for the management of postoperative acute pain: a systematic review and meta-analysis.
        Anesthesiology. 2020; 133: 265-279
        • Wagner A.E.
        • Mich P.M.
        • Uhrig S.R.
        • Hellyer P.W.
        Clinical evaluation of perioperative administration of gabapentin as an adjunct for postoperative analgesia in dogs undergoing amputation of a forelimb.
        J Am Vet Med Assoc. 2010; 236: 751-756