| The topic of pain relief is one of the biggest areas of modern conventional veterinary medicine. Dogs and cats can often suffer from progressive degenerative joint and spinal disorders that can cause great discomfort and interfere with the quality of life in both dogs and cats. The cornerstone of treatment of chronic pain in dogs and cats in recent years has centered around the use of nonsteroidal anti-inflammatory drugs such as Rimadyl, Deramaxx, and Previcox in dogs and Metacam and Ketoprofen in cats. Other drugs of the opioid class such as prescription Buprenex and Tramadol have also been used in recent years in aging pets with chronic pain. |  |
Nutritional therapies with glucosamine/chondroitin supplements such as Super Joint Enhancer or the Glyco-Flex products, as well as omega-3 fatty acids can also help as adjunctive therapies. Alternative therapies such as chiropractic, acupuncture, osteopathy, and physical therapy also offer animal guardians additional options. Recently, however, there has been increasing interest and use in both dogs and to a lesser extent in cats of the drug known as Amantadine, which blocks pain by binding to what are known as NMDA receptors. While it was first developed as an antiviral drug and to treat drug reactions that affect coordination, veterinarians have recently been increasingly using it in animals whose pain is not sufficiently controlled with nonsteroidal anti-inflammatory drugs and opioid derivatives such as Tramadol or Buprenex.
A recent study in dogs showed that the ability to perform every day activities was significantly improved by the addition of Amantadine to the nonsteroidal anti-inflammatory regimen that the dogs were already on. Experts suggest perhaps decreasing the dose in pets with reduced kidney function, but the only significant side effects appear to be agitation or diarrhea on rare cases. This is definitely a prescription medication that may come to play a key role in managing chronic pain in dogs and possibly cats in the future.
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18 Comments
You are very welcome. Please pass this information and resource of pet information on to your family and friends.
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Thanks. Please pass info on to family and friends.
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Thank you for the informative post. We sometimes forget that “pets are people too”.
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I have not yet used this drug and am in the process of learning about it. I will suggest that pet owners should more frequently be given the choice of using strong and very helpful narcotics when it comes to trauma or surgery related pain and severe geriatric arthritis. Demerol/meperidine and oxy- and hyrdrocodone are profund and very helpful when indicated. they make Tramadol look like kid’s play. Not every animal needs these, but some do. Too few DVMs recommend them because they do not want to carry them in their offices or they don’t even feel comfortable with Rx pads (which I very much disagree with) or because they want the profit from things they do have. Look around and ask. Your pet should have access to these drugs when appropriate.
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Dr. Michael Dym, VMD veterinarian Reply:
November 23rd, 2010 at 11:42 pm
Thank you Dr Cohen for points well taken. I agree that especially in pain deep soft tissue or orthopedic surgeries that these stronger narcotic pain meds offer stronger protection. As you say, not alot of vets want to deal with the heavier schedule 2 controlled substances in their practice, in terms of monitoring, record keeping and/or potential client exposure or misuse.
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Amantadine has quite literally been a life saver for my elderly beagle with two frail and hurting hind legs. He also has MCT and takes prednisone. His oncologist prescribed Amantadine over the summer after he hurt one leg while on vacation. The addition of 100 mg of Amantadine daily made the difference between walking and not walking; standing up or not, and we got past the summer injury. Last week, my dog slipped and hurt his “better” leg on a tile floor and I took him to my “regular” vet for help. That vet , who was not familiar with Amantadine, gave me Deramaxx. Three days later, my dog was at the emergency vet at 3 a.m. after more than 12 hours of vomiting and bloody diarrhea as the NSAID destroyed his stomach lining. It was completely heartbreaking to see him with such suffering and I was prepared to have him euthanized. After spending Thanksgiving in the hospital my buddy is back on pred and Amantadine. He is walking and standing up on his own, and feeling fine. It is wonderful to see him in his version of perky. Simply judging by the blank look from my general vet when I mentioned Amantadine, I suppose more vets need to learn about this pain killer. I am very very grateful for my oncologist who keeps up with the latest, and will call her first thing Monday to tell to her so.
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Dr. Michael Dym, VMD veterinarian Reply:
November 27th, 2010 at 6:59 pm
Thanks for sharing. Hopefully more vets and animal guardians will share this information on this blog so that more pets can benefit like yours.
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This is a great article but what I don’t understand is why 1800PetMeds isn’t selling the Amantadine (with prescription, of course)?
While on that topic, I would like to know why 1800PetMeds isn’t selling Methocarbamol (also with prescription)?
These are used to help my Border Collies intense and daily pain from advanced arthritis (to include a few fused vertebrate in her low back).
I would love an answer.
Thank you!
Jen
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Dr. Michael Dym, VMD veterinarian Reply:
December 26th, 2010 at 6:33 pm
I would check with 1800petmeds pharmacist about whether they plan to carry any of these prescription meds in the future. I have used both of these meds in practice with nice success on certain cases.
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Hi- my vet (neurologist) prescribed Amantadine for our 10 yo maltese. She had 2 hern disks removed about 2 weeks ago, but after a few days of promising recovery, she began showing symptoms of pain.
She has licked/scratched/bitten almost all the hair off her hind legs. The vet performed another MRI which shows she has an inflamed spinal cord.
The vet thinks that a second surgery won’t help. They prescribed her Prednisone, Tramadol, Nuerotin and just today added amantadine to her medication.
Are there any studies on the effects of amantadine and spinal cord pain in dogs?
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Dr. Michael Dym, VMD veterinarian Reply:
February 7th, 2011 at 1:39 pm
No studies that I know of of amantadine on dogs. Its use is emperical use borrowed from human medicine. Sounds like good bunch of meds. Also consider finding vet acupuncturist in your area http://www.AHVMA.org
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My instinct would be for you to discuss with the neurosurgeon tossing Tramadol and using meperidine, hydrocodone or oxycodone 1-2 x/day for 5-7 days then reducing the dose ad lib. Digs have a high tolerance if narcotic and mist veterinarians are too lax in prescribing them.
Dr. Cohen
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Dr. Michael Dym, VMD veterinarian Reply:
February 9th, 2011 at 1:09 pm
THanks for sharing Dr Cohen. Tramadol and meperidine are certainly excellent options for post surgical pain.
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Dr. Charles Cohen Reply:
February 9th, 2011 at 1:46 pm
Michael, where are you located? Could you give me a call sometime? I’m in Marina Del Rey, CA. Cell: (203) 824-4969.
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Dr. Michael Dym, VMD veterinarian Reply:
February 9th, 2011 at 2:06 pm
I practice in New Jersey. Thanks
Hmmm….
This is good!
I may even have to have my dog take this just in case he feels some pain.
Great article by the way!
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Hello,
My dog has hemangiosarcoma and is currently taking cytoxin, doxycycline, and carprofin. The amantadine has just been added. Should I discontinue the carprofin?
Sincerely,
Wendy
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Dr. Michael Dym, VMD veterinarian Reply:
March 21st, 2011 at 7:38 pm
You able to use both the carprofin and amantidine. However always be in touch with your vet about any med changes or questions as well.
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My 13-yr-old dog is currently on Rimadyl and Gabapentin for a ruptured ligament and DJD, with added Tramadol when in crisis. We are in the initial stages of treating the condition, and my vet has stated she would prefer amantidine to the gabapentin, and is researching the options for an optimum drug therapy.
Are there any significant difference between how amantidine and gabapentin work on the pain?
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Dr. Michael Dym, VMD veterinarian Reply:
March 26th, 2011 at 11:49 am
Both work differently on the pain. Amantidine would probably be my first choice given its track record on pain in animals in recent years.
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Very very nice, I think it is great when someone thinks of the pain relief for our very loved pets…They suffer just like we do. keep up the good work
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Dr. Michael Dym, VMD veterinarian Reply:
April 8th, 2011 at 11:57 pm
You are very welcome. Thank you for your kind comments.
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After our dog ‘Pepper’ got excited by some over-zealous chipmunks and jumped up and over the balcony – We rushed him to the Vet and he was prescribed Amantadine for his ruptured ligament…He’s a little down, but recovering nicely.
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Dr. Michael Dym, VMD veterinarian Reply:
June 26th, 2011 at 6:17 pm
Thanks for sharing your experience with amantadine.
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Amantadine was recently recommended for my 12 yr old lab. He’s had a very active and fun filled life and is paying for it now in his golden years! He is taking tramadol and rimadyl twice a day. Awhile back gabapentin was recommended to us and he had a really unpleasant reaction to it…like it woke up his nerves in his hips. He started chewing at one hip until it bled and had trouble walking. I actually tried him on it twice to make sure that was the issue. Now, amantadine is being recommended. I’m worried that the same thing will happen. It was really tough on him, but he does need more comfort.
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Dr. Charles A. Cohen Reply:
July 16th, 2011 at 11:55 am
Lisa,
What does your dog weigh and what strengths and amounts of Rx is he taking? One must distinguish between pain from arthritis and weakness to the hind quarters from nerve degeneration. If severe pain is present Usevof potent opiod narcotics can make a significant difference along with meaningful weight control, if necessary.
Dr. Cohen
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Lisa Reply:
July 16th, 2011 at 12:39 pm
Thanks for the quick response! He is 94lbs looks really good. He eats Nutro Senior and takes Fish Oil 1200mg and a Joint Supplement. He takes Rimadyl 100mg (1 dose AM, 1 dose PM) and Tramadol 50mg (2 tablets every 12 hrs). He definitely has weakness in his hind quarters and has suspected lumbosacral disease as well as suspected arthritis (since they hear creaking). His front ankles over the last 1.5yrs have slowly bent down as well. He has started swimming again once per week for a very short period. I don’t think he’s in severe pain. He seems happy and often wants to play (although we have to modify his play to no running, of course, he still tries initially). These are good days and his bad days are like he has a trick knee and he’s much weaker looking. In general he’s still very curious and does not seem to stop moving…so it’s hard to tell pain level on a daily basis. He is slow to get up and hobbles when he walks with some shoulder discomfort when manipulated. He will sit more than he used to and watch from afar until he thinks there is a reason to get up. The suggestions are the amantadine, prescription joint diet, laser therapy and physical therapy.
Thanks! any thoughts are greatly appreciated.
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Dr. Michael Dym, VMD veterinarian Reply:
July 17th, 2011 at 2:28 pm
I think the combination therapy you are doing is wonderful. Also consider consulting a veterinary acupuncturist as well which also may help.
Dr. Michael Dym, VMD veterinarian Reply:
July 17th, 2011 at 2:29 pm
Amantadine is usually quite safe to use in most dogs with little side effects.
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My dog was just prescribed Amantadine, Carprofen, and Tramadol for her severe hip dysplasia. Although she is now pretty good at getting up and getting down, she ACTUALLY seems to be in more pain. She has taken Carprofen before without issue and I had stopped the Tramadol after 3 doses and then restarted it after talking to the vet.
Now, at 1:41 AM, my dog seems to be fine one second and in complete agony in the next. My only thoughts are that the doctor said that amantadine could cause agitation and then said because my dog is already prone to agitation, it would be more likely.
So, I’m about 90% that is it Amantadine causing the yelping for apparently no reason. Therefore, i have 3 questions.
I just dosed her at 7:30 PM. The doctor said that she “might” become agitated, but if she did, it would go away after a while.
Questions #1: What is “a while”? This is really hard on me and the dog. Neither of us are sleeping right now.
Question #2: If I decide to withdraw the drug (after 3 days), will she go into some type of withdrawl?
Questions #3: If it is the Amantadine causing the agonizing yelping, how long before it is out of her system?
Thanks in advance for the advice. This is a really good thread and I’m sure it is helping a lot of people.
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Dr. Michael Dym, VMD veterinarian Reply:
November 23rd, 2011 at 11:34 pm
I dont think think the sudden yelping out in pain is due to amantidine, as its use in animals has been only recent, and there are not alot of case studies on this drug in dogs. We have borrowed its use from human medicine. In case it is causing issues, it should be at least 50% out of system within 24 hours and gone by 2-3days after dosing it.
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Thanks Dr. Dym,
We did DC the amantadine and the tramadol. We kept the Carprofen and the Dr. added gabapentin. She seems much better as she is not yelping for no reason except for maybe once or twice a day instead of 3 or 4 times an hour.
Again, I’m not sure if it was the drugs OR if it is just her getting better on her own.
Either way, I’m pretty happy with the outcome so far. I’d like to see her get even better, but I’ll take what I can get at this time.
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Dr. Michael Dym, VMD veterinarian Reply:
November 25th, 2011 at 7:48 pm
Sounds like you have a very progressive vet, as gabapentin only recently being used in veterinary medicine. A good medicine to decrease pain. Let us know how things progress. Have a great holiday.
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Update on my German Shepherd: She had a few good days, but then it got worse. Much worse. We met with the doctor again today and are trying to see if there is anything left in the tank to manage this for her.
The doctor DC’d the Carprofen and prescribed Vicodin. We kept the gabapentin and he added back in the tramadol. I do have one question though. We dealt with 2 vets today. One was very experienced and was the one who signed the prescription. The other one was very new and she said she had never used it before. However, she is the one who wrote the prescription and I think she wrote it up wrong. She wrote in a generic form (Hydrocodone/Acetaminophen) and it turns out, she actually wrote for Norco, which is twice as strong as Vicodin (10 mg of Hydrocodone vs 5 mg). I called her and she said that it was right and acted a little offended (but she already said she never wrote for it before). The pharmacist suggested that I give her half at first to see if it works.
I’m in kind of a pickle. Too much could be bad, but not enough would be just as bad. Do you know the dosing for Vicodin/Norco in dogs? Again, she is 80 pounds.
Any help you can give would be appreciated.
Thanks!
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Dr. Michael Dym, VMD veterinarian Reply:
December 1st, 2011 at 6:26 pm
I have no experience in my own practice of using Vicodin in dogs. I would go with pharmacist’s suggestion of using one half dose initially to see how she does. Only other options I can tell you would be to consider asking your vet for a referral to a vet also skilled in holistic medicines like acupuncture and herbology which may be helpful in this case for pain relief, given that you have not had much response to the various drugs thusfar tried. Good luck and let us know how things go.
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Sadly….today, I lost my best friend. Shakira couldn’t even walk today and although her mind was still all there, her body was done. I miss her so much. Here is her photo:
https://picasaweb.google.com/lh/photo/Ji5YHiTqaF44bhYfSyCVynzHFvbUYG6RVE8n1QLeEFQ?feat=directlink
PS – Take lots of pictures of your loved ones, including your pets. They are so very important during this hard time.
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Dr. Michael Dym, VMD veterinarian Reply:
December 1st, 2011 at 6:20 pm
Sorry to hear of your loss. You obviously loved Shakira very much. My heart and thoughts are with you. In deepest sympathy.
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Chris H Reply:
December 1st, 2011 at 11:57 pm
Thanks for all your kind words and for your contribution to the community here seeking knowledge.
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