Clinical findings in degenerative lumbosacral stenosis in ten dogs-A pilot study on the analgesic activity of tramadol and gabapentin

Degenerative lumbosacral stenosis is a relatively common multifactorial disease that affects mainly large breed or working dogs. It can cause neuropathic pain, and advanced imaging techniques are essential to achieve a final diagnosis. For improving the quality of life, when surgery is not possible, a conservative treatment is necessary. The management of pain requires early intervention and evaluation of response on an individual-patient basis. The aim of the study was to evaluate the use of tramadol for the treatment of lumbosacral pain in dogs affected by degenerative lumbosacral stenosis diagnosed by radiographs, computed tomography, and computed tomography myelography, considering gabapentin as an alternative treatment in case of unresponsiveness. Ten dogs were enrolled, and clinical findings and their severity scores were recorded; the short form of the Glasgow composite pain scale was used to assess pain scores before (8.6 +/- 1.5; 7-11/20) and during treatment (after 1, 2, and 4 weeks) with oral tramadol (3 mg/Kg every 8 hours) and prednisolone (0.5 mg/Kg/die) for 4 weeks. After the first week of therapy, only half of the dogs (5/10, T-group) showed a significant improvement of Glasgow composite pain scale score; in the remaining five dogs (G-group), tramadol was changed with oral gabapentin (10 mg/Kg every 8 hours for 3 weeks), with an improvement in pain score in one week. At the end of treatment, all the dogs showed low pain scores (T-group: 2.8 +/- 0.8; G-group: 1.6 +/- 0.9), below the intervention level (4/20). Given the supported evidence, oral tramadol should not be relied on as a sole or, perhaps, first-line analgesic in dogs, and gabapentin might be a valid alternative option in an outpatient setting. As controlled clinical trials are still lacking in animals, further studies should be carried out to confirm the analgesic activity of gabapentin in veterinary painful conditions and to rule out eventual adverse effects related to a prolonged administration. (C) 2019 Elsevier Inc. All rights reserved.