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Hyperesthesia And Long-term Gabapentin

Friend's Friend

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Hey friends!

Yet again I apologize for being the person who posts and runs, only to squiggle back a few months later with another question. I deeply appreciate everyone's kindness, patience and advice. <3

My situation this go-around is this: Friend's been diagnosed about two months ago with hyperesthesia (which explains a lot of his behaviors that I was confused about). My vet and I decided to adopt a conservative treatment and keep an eye on him (in part due to my limited finances); she said if he experiences attacks three days a week or more, we need to start thinking meds.

That time has come. It's honestly been a few weeks, but I kept hoping it was just a fluke, a bad week, a bad day. My vet's said previously that if we go the med route, it would likely be gabapentin. Friend's been on this before (to help with lingering UT issues and because my vet suspected hyperesthesia), and he was absolutely stoned.

So here are my dilemmas:
  • A stoned kitty is cute in the short-term, but he has at least a few years of life ahead of him, if not significantly more. I don't want him to spend the rest of it in a haze where he does nothing but sleep and stumble around blearily to his food bowl and litter box. (He sleeps a lot now, of course, but he also talks to me, follows me around, cuddles me, and does a million little things that make me smile. When he's on gabapentin, none of that happens. He's absolutely out of it.)
  • Cost! Friend's already on (the cheaper of several) UT foods, which is still significantly more expensive than anything he's been on (with the exception of the few months he spent on all-wet-food, before I found the UT dry food I could afford). So, long and short: the last time my vet prescribed gabapentin, she sent it to the local pet pharmacy, which compounded it into a liquid that lasted me seven days . . . for $50. I can't afford that every week for an indefinite period of time. :(
  • Friend also has a rather delicate mental state. I know some cats are just flighty, and perhaps I'm projecting here, but he has periods of behavior (how he reacts to me) which are reminiscent of PTSD. And I say this because it adds an extra layer of trying to catch him and restrain him to the point where I can either squirt liquid into his mouth or get a pill down his throat. Because I adopted him and he has a history of abuse, I don't know how to go about this in a long-term manner. (It's hard to see him so terrified of me--for "good reason"--when he already has periods where he's afraid of me anyway--for no reason. Does that make sense? I don't want to retraumatize him, especially when he's come so far from the frightened kitty I adopted. But, again, maybe as a human with such a history, I'm being overly sensitive.)
  • In addition to that, I'm visually impaired, which makes the task of seeing well enough to administer meds quickly all the more difficult. It takes me a while to even find his mouth, which isn't ideal when I need to get in and get out ASAP.
Friend's good when he's good, but when he's having an attack, he's obviously not well, and it's getting to the point where it's happening at least once a day. He's aggressive towards me, towards himself, in addition to all the other symptoms . . . ugh, my poor old man.

I've got a call in to my vet to talk about med options; I know that they make gabapentin capsules as well, and I'd presume that those are cheaper than a liquid compound. But . . . has anyone had their cat on gabapentin for a long time? Do they build up a tolerance to it (at least the sedation side-effect), or are they perpetually in Wonderland?

Any thoughts or experiences are welcome! I'm just at a loss trying to juggle what I can afford, helping Friend be well, and also ensuring that he actually has a good quality of life (i.e. not sedated all the time) to where he can still do at least most of the things that make Friend, Friend.

Thanks so much, all. I really appreciate it. <3
Dyl / Friend's Friend.
 
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FeebysOwner

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Hi. I am curious if there is any correlation between the increase in his attacks and when you changed his food? There might be a possibility that he has a mild allergy to the new food, which can sometimes look like some of the symptoms of hyperesthesia.

It is my understanding that once hyperesthesia has manifested itself in a cat, it isn't generally a progressive disease - in other words, there are other conditions that escalate the symptoms and when those conditions are treated, the symptoms normalize to what is standard for that particular cat. However, I am sure there are exceptions to this...

Has the vet tested him for other issues that sometimes mimic hyperesthesia (various allergies, spinal issues, arthritis, organ problems - as a few examples)?

Also, has the vet talked about using serotonin-enhancing supplements, or even something like Solliquin, to stabilize his mood - rather than Gabapentin? They would not act like a sedative. And, you could start with something like this first to see if it helps.

If the vet insists upon Gabapentin, you could ask to start off with the smallest dose possible - perhaps that would be enough to help him without drugging him out.
 
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Friend's Friend

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Hey friend,

Thanks for the response! We haven't run a battery of tests because I just can't afford them right now. If I had unlimited money, I would love to get him tested for other things, in the event that it isn't hyperesthesia but something else. (Not to question my vet's diagnosis, but more diagnostics might help rule out other possibilities.)

As for the disease progression, I've heard of other people whose cats have gone through periods where they have a greater or fewer number of attacks, for no apparent reason--not environment, change of food, nothing. The reason I switched Friend to dry UT food is because he wasn't eating anywhere near enough when he was on the wet food; he LOVES to eat and yet on wet food he lost 3 pounds in a month because he just wouldn't touch it. But, again, finances. I can't afford the super-duper prescription stuff, and my vet's said that he needs to be on a UT dry food if he can't abide by wet food . . . which paints us into a lovely corner.

Good to know about the seratonin-enhancers, though . . . we'll see what my vet says. She's really awesome in that she actually cares what I have to say / doesn't try to drape a blanket treatment over us, so hopefully we'll be able to have an honest conversation about this going forward. (As for the lowest-dose of Gabapentin, it's worth a shot! He's a 16-pound Maine Coon mix, so I don't know if a low dose would work, but may as well try if that's the road we end up going down.)

It's just so scary. :/ I love my squeaky old man so much and I just feel so helpless.

Anyway, friend, thank you again for chipping in some good thoughts!!

<3
Dyl.
 

FeebysOwner

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Sorry for another long response...

Feeby has signs of mild hyperesthesia, to me anyway. She will incessantly lick if I pet her back end, and sometimes try to bite me, as well as the typical rippling of the skin when petted/touched. She will also "squawk" in surprise if she isn't expecting me to touch her. And, yes, there are times this is worse than other times - but, I haven't necessarily been able to pin-point the triggers either. Hers is probably neurological and/or spinal in nature (she also twitches in her sleep, and has two nearly fused vertebrae in the upper spine), but once she started demonstrating these symptoms, thankfully they haven't gotten gradually worse.

When you look into any kind of treatment for Friend, ask about a transdermal form of treatment - meaning it is placed on the skin (a lot of times the ears) instead of pill/liquid form. Depending on the decided treatment, if a prescription med, it may cost more but would certainly be easier for you - and Friend - to administer.

I don't know what urinary care food you have Friend on, but I use both Royal Canin SO and Hill's C/D (both canned and dry) for Feeby. It is a tad bit cheaper by getting it through PetSmart, as opposed to the vet's office. And, they actually "issue the prescription" for it even though I don't use them for vet services. I have also heard you can buy Purina Pro urinary care foods without a prescription and that it is cheaper than either RC or Hill's - again I don't know by how much. I have also recently heard of Wysong Uretic dry cat food - which is cheaper than either RC or Hill's (chewy.com has a 5lb bag for $14). You could check ingredients on these against what you currently use and see if they are close enough to possibly make a gradual change to one of them.

And, lastly (I promise), you could try getting Friend a water fountain to promote drinking water. A lot of members on this site have had success with water fountains and getting their cats to drink more.
 
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Friend's Friend

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Hey friend!

Nah, long replies are great! :) Really, I appreciate it!

Yes, Friend's on the Purina Pro Plan stuff. ^_^ No prescription needed, it comes through Amazon, good stuff.

As for Friend's symptoms . . . at first my vet and I just thought it was a combo of urinary issues and then back issues. (He liked to jump down from his cat tree, which was about five-and-a-half feet up; we think he mussed up his back, because he was really sensitive to the vet examining him there). But then I tossed some other weird behavioral things that occur when he has an attack, and she said, "You know, if we look at his presentation, to me it sounds like hyperesthesia."

Which then led to "Call me if you notice this happening more than three days a week."

*shrugs and sighs*

Part of the issue is that I've never had a cat before who has emotional problems (so to speak) on top of what might well be neurological ones, so I didn't bring things up to my vet until I realized that they weren't Friend just being Friend--chronically anxious and neurotic: there was potentially something else going on. What's happened in this case as well is that our vet wasn't the only one who saw Friend during the time he had his urinary issues, which was also when I tentatively started to bring up his hyperesthesia symptoms, and unfortunately the clinic we used to go to got fussy about us switching back to our old vet. (The change had occurred because the clinic wanted to rush us in for Friend's urinary stuff. What a kerfluffle--too many cooks in the kitchen! The plus side is that we needed to drop in later that week for more stuff, and our regular vet saw us for free. Under the radar. Bless her heart.)

Anyway! Good to know about the transdermal options, maybe . . . rubbing something on his ears is definitely something I can do!

Re: a water fountain: Friend doesn't seem to like those, but he does have a bowl of water he always drinks from (and he's a good drinker--he's not one of those cats whom you never observe taking a sip), so I think / hope he's good on that front. (I just make a point to make sure it's topped off at least twice a day.)

Anyway!! Thanks again, friend. I really appreciate your help! :)

<3
Dyl.
 
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white shadow

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Hi again!

Just a few quick thoughts, as I'm on the run.

The degree of sedation from Gabapentin......will be dependent on the amount of the drug given. Translation: he doesn't necessarily have to be 'stoned' while getting Gabapentin. If the dosage is adjusted downwards, it's very likely that you will be able to find that 'just right' dosage that will control the hyperesthesia without overly sedating him.

[I have some experience with the long-term use of Gabapentin. One of mine with a terminal cancer received a pain management cocktail of drugs for the last months of his life. One of the other drugs was an opioid that generally causes sedation. That cat was no more 'sedated'/inactive/'stoned' than any of my others. One further point: While Gabapentin can/will cause sedation initially, that effect is seen to wane over time, as the cat's system adapts to it....see this (see "Side Effects"): Gabapentin (Neurontin) - Veterinary Partner - VIN.

I see that he will eat wet foods. The Gabapentin can be mixed into a very small quantity of some tasty food quite easily, so I don't see any need to have it 'compounded'. Simply open the capsule, mix the powder into the food. (A small amount, 1-2 teaspoonfuls, will ensure the drug is consumed. I use FF liver pate - because it's irresistible and 'inhaled' around here!) This is how it's given to many cats for sedation prior to Vet visits - I haven't yet read of any rejections for reasons of unpleasant taste.

It's best to start with the smallest dose that's likely to cause the desired effect, and increase in small increments if necessary.
.
 
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Friend's Friend

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Hey friend!

Thank you for the reply and the thoughts!

Yes, I was assuming that, like most drugs, the amount of sedation would be directly related to the dosage. Again, my concern is just that he's a big cat, so if it's dosed by weight--well, there we go. But maybe it isn't!

Oops, did I say he eats wet food? He doesn't! He hates it! I had to feed him all-wet-food for a while after he first had UT issues and he lost 3 pounds in a month. He detests the stuff. Still, I'm hoping that there would be some way we can get it into him that doesn't involve pills or a syringe full of liquid that he detests (no matter how good it's supposed to taste).

Anyway, deeply appreciated, friend! :) Thank you so much!

<3
Dyl.
 
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Friend's Friend

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Just to update everyone:

My vet ruled out Gabapentin because she's more concerned about the neurological aspect of it; the Gaba was primarily employed for short-term pain relief (lingering UT issues and what we thought was a jacked-up spine from a bad jump). (I know it's also used as an anti-seizure drug, but . . . anyway, that's what the good Dr. B. said).

So she's prescribed Clomicalm instead. I was a bit freaked out when I saw that it was intended only for dogs, per the label, but I guess it's not unheard of to use it in cats.

Not to hijack my own thread about a totally different drug, but . . . that's where things are now. I'm going to order it through the vet's office's online pharmacy thingy and give it a shot, I guess.

Thanks for the support, everyone!
<3
Dyl.
 

epona

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I am sorry to hear that your cat has this condition :(

I do not know anything about how these medications affect cats, but my husband takes a medication that is similar to gabapentin for his back issues (he has fractured vertebrae and spondylitis, complicated by spina bifida and is in a lot of pain constantly) - and he seems to be fairly "with it" on that medication.

I know it may be very different in the way it affects cats.

And posting up new info is good, it may help others. I will see whether that medication that you mentioned is licensed for use in humans, and whether it may help my husband.

Best wishes to you and your cat. xx
 

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Very strange, because Gabapentin is commonly used for hyperesthesia. Some interesting research (albeit a small study):

Cats received therapy with a combination of medications as follows: Gabapentin, 6 cats; meloxicam, 4 cats; antibiotics, 4 cats; phenobarbital, 2 cats; prednisolone, 2 cats; topiramate, 2 cats; ciclosporin, clomipramine, fluoxetine, amitriptyline and tramadol, 1 cat each. Improvement was seen in 6 cases; 2 with gabapentin alone, the rest with a combination of gabapentin / ciclosporin / amitriptyline (one cat), gabapentin / prednisolone / phenobarbital (one cat) or gabapentin / topiramate / meloxicam (one cat).

Based on these findings, gabapentin appeared to be the most frequently used an effective monotherapy for FHS, as well as an effective drug in conjunction with other therapies......
LINK: VetVine - Forum - Feline hyperesthesia syndrome

Also interesting is that Clomiclam (Clomipramine) doesn't appear anywhere in there....

You should be aware of the potential side effects: Clomipramine (Clomicalm, Anafranil) - Veterinary Partner - VIN - Translation: be on the alert for urination and constipation issues, dilated pupils (see post #15 in that thread FeebysOwner referenced)....
.
 
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Friend's Friend

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Hey friends!

FeebysOwner: Yep, that was one of the first threads I saw when I did a Google search to figure out why my vet would prescribe a med intended for dogs. :)

WhiteShadow: Thank you for the info! That is a small study indeed, although I don't know that the absence of Clomicalm necessarily means anything in-and-of-itself . . . This having been said, I do appreciate it very much . . . and yes, I've looked up side effects and will be in touch with my vet as needed. :) (In fact, I'll probably put a call in to double check about side effects before I give him anything.)

Epona: Thank you so much for the encouragement and support, friend! I really appreciate it. <3

Anywhoozles . . . we shall see. My vet did mention that we might have to try this and then switch back to gabapentin if this doesn't work, although it'll take a couple of months to determine that anyway. Seems like most things that require medication: it sometimes takes a little fiddling and a lot of patience. :)

<3
Dyl.
 

FeebysOwner

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Glad you recognize the "little fiddling and a lot of patience" concept!! Many on this site can certainly relate to that! Keep us posted about Friend, will you?
 
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Friend's Friend

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You betcha, friend! :) Also, I'm sorry if I came across as short in my response to you in the post above. I just realized it might come across as terse. :( (Same to you, WhiteShadow! <3)
 

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We have a 16 lb aggressive kitty who is due for his shots .Vet said to put one 100 mg capsule on his food tonight and then two caps over his food in the morning. He has never taken this medication before. Up to now,whenever a procedure is done at the vet,they have to anesthetize him. That is not healthy,so hence the gabapentin. Any side effects seen in anyone's kitty?
 
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Friend's Friend

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Hello, friend! ^_^

I personally didn't notice any adverse reaction to Gabapentin in my guy--and he's known for having bad reactions to meds. Basically he was just super stoned and happy on the Gaba, and I know it's widely prescribed. I'll be keeping my fingers crossed that it takes the edge off of vet trips for your guy!!

As for an update on Friend: the Clomicalm didn't end up going so well--he had some pretty serious issues with constipation and urinary retention (which isn't great when he has a history of urinary crystals), in addition to significant behavioral changes (which I kind of expected). When these didn't clear up after a few weeks, this past Monday I had an honest conversation with my vet about not wanting to go down the rabbit hole (or revolving door) of trying to find just the right medication that would work for Friend . . . so we're dropping back to a very conservative approach. He's happy as a clam in between the attacks, and so far he's never injured himself (despite attacking himself) . . . so we're just going to see how it goes for now without medication, although my vet recommended trying to distract him with catnip, and / or other herbal remedies in the meantime.

It still hurts my heart, a lot. But . . . just a day off of Clomicalm and he's already back to his normal self (although the GI issues haven't cleared up; I suspect that will take time). Selfishly, perhaps, this makes me very happy: I really missed my Friend-o. Now he's back to his chatty, "I'm going to hog your desk," nightly-cuddle old self. <3 Hopefully the future is kind and something simple like catnip as a distraction during attacks can help.

So that's the saga. Thank you all for your kindness and support, as always!
<3
Friend's friend, Dyl.
 

DukenGizmo

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Hi all. Not sure if anyone is checking up on this thread anymore, but just wanted to put it out there that I know how hard it is to see your kitty go through this.

My sweet Duke was recently diagnosed. He has upwards of 10 episodes a day. We are trying the gabapentin, but it’s so difficult seeing him a different cat. He’s so zoned out despite dosage decreases.

Anyway, if anyone wants to chat or needs some support, I am always here :) anyone willing to share more experiences on gabapentin with me would be greatly appreciated.

Best,

Rachel
 

Simonalm

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My kitty is on Pregabalin for his hyperesthesia and it has seemed to help. My vet has to call it in to our local pharmacy because he doesn’t have it and they compound it into a liquid. It was about $22 dollars but its suppose to last about 2 months. He also has had zero side effects from it, which I was really concerned about at first but thankfully he hasn’t. Pregabalin may be worth mentioning to your vet.

Good luck with your kitty. I know how sad/scary it can be watching them when they have an “attack”

With my cat I can usually tell when he’s about to have an attack and if I catch it in time I’m usually able to stop it from happening by distracting him. If I get out treats or the laser light right when his back starts to roll it seems to distract him enough that the full blown attack doesn’t happen.
 

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I use Canna Pet CBD on my cat with mild hyperesthesia. When he has a bad attack I mix 1/2 capsule in some canned food. He calms down quickly with no sedative effects. I use a whole capsule twice daily for my dog who has epilepsy (along with her Phenobarbital). There's also oil but the capsules are easier for me to dose
 
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Friend's Friend

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With my cat I can usually tell when he’s about to have an attack and if I catch it in time I’m usually able to stop it from happening by distracting him. If I get out treats or the laser light right when his back starts to roll it seems to distract him enough that the full blown attack doesn’t happen.
I've also found this to be true in Friend's case, thankfully. I bought a laser-pointer and distracting him with that when he starts the "routine" of an episode, it does seem to take his mind off of things and--as you said--a full-blown attack doesn't happen. I'm incredibly grateful for that.

Otherwise, his bladder and bowels are back to normal, and he's even being more affectionate than before. Knocking on wood this keeps things on the level for a while!

Dukengizmo: I'm so sorry to hear about your boy. :( It's absolutely heartbreaking to not only watch one's cat go through this but also to wade through medications. The logic vs. emotion of side effects is just so tricky to navigate . . . that's how it was for Friend and me . . . I knew he'd be different, but woof. Actually experiencing it was really, really tough.

I'm likewise happy to chat with anyone if you want an ear or a shoulder to lean on. <3

Dyl / Friend's friend.
 
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