QUANTITATIVE SENSORY TESTING AFTER GABAPENTIN WITH OR

WITHOUT MELOXICAM IN DOGS WITH SUSPECTED NEUROPATHIC PAIN

RUEL HLM , WATANABE

1,2 R ,
1,2 EVANGELISTA MC ,
1,2 STEAGALL PV1,2

1Département
de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal
2Groupe de recherche en pharmacologie animale du Québec, Département de biomédecine vétérinaire, Université de Montréal

INTRODUCTION
Gabapentin and meloxicam have been suggested for the treatment of
neuropathic pain in dogs.1 However, their analgesic effects have not
been investigated.
Quantitative sensory testing (QST) has been studied and validated in
dogs with osteoarthritis2-6 and thoracolumbar disc herniation.7
Electrical nociceptive testing Mechanical nociceptive testing
The aim of this study was to evaluate the effects of gabapentin-
meloxicam (GM) or gabapentin alone (G) on QST in dogs with Figure 2. a) Transcutaneous electrical nerve stimulation using two cutaneous
naturally-occurring neuropathic pain. electrodes (frequency of 200Hz and increases of 2 mA every 2 sec); b)
Mechanical nociceptive stimulation using an algometer (Steel, Round, flat,
The hypothesis was that GM or G would reverse hyperalgesia or application surface 7 mm2). Positive responses to stimulation included limb
hypoesthesia (i.e. increase or decrease nociceptive thresholds, withdrawal, escape reaction, turning the head towards the stimulus,
respectively) depending on the disease when evaluated by QST. vocalization and attempt to bite.

MATERIALS & METHODS
Ethics committee protocol number: 16-Rech-1835.
Study design: Prospective, randomized, crossover, clinical trial.
Animals: Thirty-one client-owned dogs [6.7 (0.6-12.9) years; 26.9 ± 18
kg (22 males/9 females)] of different breeds with naturally-occurring
neuropathic pain were included after physical and neurological
examinations, and magnetic resonance imaging (MRI).
Treatment groups: Each dog was randomly allocated to receive
treatment 1 or 2 (Table 1). Each treatment had three periods
including gabapentin alone, or in combination with meloxicam and
placebo. The total duration of treatment was 21 days; duration of
each period was 7 days and included recommendations for patient
resting (Figure 1).
Quantitative sensory testing: Electrical nociceptive threshold (ENT)
and mechanical nociceptive threshold (MNT) testing (Figure 2a,b)
were performed on initial presentation (day 0) and after each
treatment period (days 7, 14 and 21) (Figure 1). Stimulation was
applied to the dorsal aspect of the metacarpus and the plantar aspect
of the metatarsus in a randomized order until a behavior response
was observed or a cut-off reached (150 mA for ENT and 20 N for
MNT) (Figure 2).
Statistical analysis: Data were analyzed using linear models with
treatment, gender, age and weight as covariates (p < 0.05).
Examinations Examinations Examinations
QST QST QST
MRI
1st period 2nd period 3rd period
RESULTS
The following diseases were diagnosed in the study: caudal cervical
spondylomyelopathy ± syringomyelia; lumbosacral syndrome;
intervertebral disc disease (IVDD); IVDD and discospondylitis; Chiari
malformation ± syringomyelia; vertebral congenital malformation;
polyneuromyopathy; nerve sheath tumor and bilateral neuritis.
Body weight was positively associated with ENT and MNT (p = 0.02
and p < 0.0001, respectively).
Mean ± SD ENT (mA) was significantly higher on initial presentation
(50.1 ± 26.8) than after G (38.4 ± 18.8) and GM (40.7 ± 14.3) but not
placebo (42.5 ± 18.3).
Mean ± SD MNT (N) was not significantly different after treatments
[10.1 ± 4.2 (initial presentation); 9.8 ± 3.9 (G); 10.0 ± 4.3 (GM); 9.9 ±
4.2 (placebo).
CONCLUSIONS
Gabapentin with or without meloxicam improved somatosensory
function in dogs with neuropathic pain by reducing electrical
hypoesthesia. These treatments did not change MNT.
Further cluster analysis of QST data should differentiate dogs with
neuropathic pain that suffer from hyperalgesia or hypoesthesia.
ACKNOWLEDGEMENTS
Examinations
QST This work was supported by MITACS Accelerate/Boehringer
Ingelheim and the American Kennel Club (Canine Health Foundation).
Guy Beauchamp PhD for the statistical analysis.

Day 0 Day 7 Day 14 Day 21

Figure 1. Timeline of the study. Dogs received either treatment 1 or 2 during
the study.

1st period 2nd period 3rd period

Treatment
1
Gabapentin (10 mg/kg q8h PO)
+ Placebo (q24h PO)
Placebo*
(1 tablet q24h PO
Gabapentin (10 mg/kg q8h PO)
+ Meloxicam (0.2 mg/kg PO
REFERENCES
+ 1 capsule q8h PO) followed by 0.1 mg/kg q24h PO)
Treatment Gabapentin (10 mg/kg q8h PO) Placebo* Gabapentin (10 mg/kg q8h PO) 1. Mathews et al. J Small Anim Pract. 2014 Jun;55(6):E10-68.
2 + Meloxicam (0.2 mg/kg PO (1 tablet q24h PO + Placebo (q24h PO) 2. Briley et al. Vet J. 2014 Feb;199(2):245-50.
followed by 0.1 mg/kg q24h PO) + 1 capsule q8h PO) 3. Freire et al. Vet J. 2016 Apr;210:95-7.
4. Knazovicky et al. Pain. 2016 Jun;157(6):1325-32.
Table 1. Treatment groups in dogs with naturally-occurring neuropathic pain 5. Rialland et al. Pain. 2014 Oct;155(10):2071-6.
6. Williams et al. Vet J. 2014 Jan;199(1):63-7.
after MRI.
7. Gorney et al. J Vet Intern Med. 2016 Mar-Apr;30(2):627-35.
* dextrose compounded in gelatin capsules