BONUS: Mailbag - Is gabapentin toxic in pets?

Gabapentin is showing up more often in veterinary care —but that raises an important question:

Is gabapentin toxic in animals?

In this BONUS mailbag episode of Rumor vs Truth, we answer a listener question about gabapentin use in pets. Hosts Don Weinberger, PharmD and Steve Small, PharmD dig into what’s really behind concerns about toxicity—and bring in veterinary toxicology expert Dr. Tina Wismer to help clarify the risks.

Together, they discuss:

• Why gabapentin is used in dogs and cats
• Where these toxicity concerns come from
• The role of xylitol in certain liquid formulations—and why this matters
• Why dogs, but not cats, are affected by xylitol
• What pharmacists and clinical teams should watch for when dispensing
• What pet owners should do if exposure is suspected

No CE credit is available for this bonus episode.
CE credit is available for our full gabapentin episode.

******

🎧 Related Episode (CE Available)

• Rumor vs Truth: Gabapentin
  (The nerve of gabapentin, is it really as safe as we assumed?)
  🎧Listen: https://rumorvstruth.buzzsprout.com/episodes/19192704
  ▶️ Watch: https://youtu.be/0G9FU99me48 

******

TRC Healthcare Editor Hosts

• Steve Small, PharmD, BCPS, BCPPS, BCCCP, CNSC
• Don Weinberger, PharmD, PMSP

Guest

• Tina Wismer, DVM, MS, DABVT, DABT 
  • Senior Director, ASPCA Poison Control

******

Clinical Resources: 

• FAQ: Med Considerations for Cats and Dogs

🏷️ Our listeners can get 10% off a new or upgraded subscription with code rvt1026 at checkout. 

******

Email us: rumorvstruth@trchealthcare.com

The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Find the show on YouTube by searching for ‘TRC Healthcare’ or clicking here.

Learn more about our product offerings at trchealthcare.com.

Transcript

Introduction

Steve Small 0:12

Welcome to Rumor versus Truth. Now, this is a bonus mailbag episode where we'll answer one listener question outside of our regular full episodes.

Don Weinberger 0:21

We're sharing this as a short standalone bonus. So our main episode stay focused and on topic. As a reminder, no CE is available for this episode.

Steve Small 0:31

Great point. Now,

Listener Question

Steve Small 0:33

this question is about gabapentin that came in through our rumor versus truth at TRChealthcare.com email address. And they asked us, I see gabapentin is used for pets, but is it toxic?

Expert Insight

Steve Small 0:44

So I reached out to one of our specialty consultants, Dr. Tina Wismer. She is a veterinarian and senior director of poison control at the American Society for the Prevention of Cruelty to Animals, or ASPCA. So let's see what she had to say. Thank you for joining today, Dr. Wismer, to help us answer this question about gabapentin toxicity in pets. And maybe to start us off here, I'm sure some audience members are asking, why would a pet even be taking gabapentin or be exposed to it in the first place?

Tina Wismer 1:15

That's a great question. So first, I do have to say gabapentin is off-label in pets. Most of our drugs in veterinary medicine, we have very few. So we use a lot that are extra label. So we use gabapentin in dogs and cats for seizure control. We also can use it chronically for pain, or we can use higher acute doses for its sedative effects. So a stressful situation like going to the veterinarian or thunderstorms, we sometimes take advantage of the sedative effects.

Steve Small 1:52

Okay. So since it's used therapeutically intuitively, it means it's probably not toxic itself. So then where is this toxicity idea coming from with gabapentin that we're getting from some of our audience members?

Tina Wismer 2:04

So the issue is that uh many of the liquid formulations contain xylitol. And in dogs, xylitol can cause hypoglycemia and potentially liver failure at high enough doses.

Steve Small 2:18

Okay, yeah. So that's pretty serious and sounds like it can be deadly. Um so this isn't an issue in cats, though, correct?

Tina Wismer 2:24

Correct. Uh cats are not sensitive to xylitol.

Steve Small 2:27

Okay, so so it's just dogs. It's really good to specify. And then what should pharmacists be looking out for? Then do we then typically just use capsules of gabapentin or tablets uh for gabapentin in dogs, or can we use certain liquid formulations from your experience?

Tina Wismer 2:44

So capsules, of course, are easiest, right? Because it avoids the whole issue. Um, but like we tell our clients, um, we need to read the label. Um, at least one of the major uh formulations that's liquid actually says on the box contains xylitol not for veterinary use. So we just need to read, not all of them contain it, but at least one of the major players does.

Steve Small 3:08

Yeah, so pharmacy staff were in a perfect position to look out for that on labels. And you may even need to look closer with the package insert potentially to be sure. So excellent points there. And then let's say um, heaven forbid an actual poisoning does occur with xylitol. What should pet parents do in that case?

Tina Wismer 3:27

So the good news is the amount of xylitol, um, if this was given therapeutically to a dog, is really not enough to cause problems. The issue is dogs will ingest the entire container of medication because it's tasty, right? It's sweet. Um, and then they can get themselves into problems.

Steve Small 3:47

Yeah. So definitely keep those medications away from pets, just like we do with children, right? And then should uh uh pet parents be contacting, you know, typical poison control for advice if something occurs, or what what's what's the best steps there to take?

Tina Wismer 4:02

I would recommend that they call their veterinarian first. If their veterinarian is not familiar with it, then they certainly can give us a call. Um, but what's the most important thing is going to be determining the weight of your pet and um how much xylitol you've ingested into what the risk is.

Steve Small 4:19

Great. So reach out to your veterinarian if there's ever a concern. Perfect. Love that advice. And thank you so much for helping us answer this question uh from our audience members. And I'm sure we'll have some more pet-friendly questions in the future. So uh we'll stay in touch.

Tina Wismer 4:32

Thank you for inviting me.

Summary

Don Weinberger 4:37

Okay, yeah, that Steve was a great interview. And it's why I see some compound formulations with gabapentin with sorbitol instead for dogs, because that's sorbitol is is safer to use in that population, dog population. Uh so yeah, that's good to know that xylitol definitely is toxic and watch out for it. Uh and see like this question is all bark and no bite. Uh, there is a toxicity with some gabapentin formulations, but like I said, it seems like the xylitol an active ingredient and not the active drug itself.

Steve Small 5:09

Yeah, and I'm glad we could clarify that for folks. And we have a great veterinary resource called Med Considerations for Cats and Dogs. It gives lots of helpful veterinary tips, including warnings about xylitol toxicity in dogs. So go check it out.

Don Weinberger 5:22

Yeah. So thanks for listening to this bonus mailbag. Keep sending questions through the link in the show notes or email.

Steve Small 5:27

Yeah, we look forward to hearing them. And we'll be back with our next full episode on Ivermectin coming soon on June 16th. So we'll see you then.