Pain meds - memantine

[Revival75]

Does anyone have any experience with memantine?

We have recently consulted a behaviourist vet who has suggested some of the issues my dog is having is due to chronic pain. They have identified an unusual walk hence suspecting the pain with possibilities of it originating from her neck or front legs.

she has had a trial of gabapentin, they are now saying they don’t think this is working so suggested we try metamine. I am a little reluctant given the side effects they have suggested (agitation, depression) and we don’t know she actually is in pain. She is 4 years old and very active.

does anyone have experience with this? I guess I just need convinced I am doing the right thing.

That seems an odd choice for a pain trial. Is there some underlying health issue that means they can’t use something more basic and “ broad spectrum” like meloxicam or paracetamol ?
that’s a very niche pain medication

I agree with @3smallpupsthat that seems a very odd choice. Same with gabapentin as it’s not a standard painkiller either.

I would want Metacam for a pain trial.

Thanks for your reply. I’m unclear why this has been recommended other than the fact that she is a bit of a nightmare taking meds and it would be one small tablet per day🤷‍♀️.

inwould be happier with something more mainstream too I think but get the impression that my questioning their recommendations isn’t well received. At the ne of the day she’s my dog and I need to be comfortable that I am doing the right thing

Thanks. I may push for that. I’m not sure if it is because there was a suspicion of nerve pain

Metacam can just be mixed with their food or given orally - my cat has been on it for years and he comes and sits nicely when it’s medication time 😂

AFAIK it’s unusual to trial gabapentin without doing a standard painkiller first.

What does your regular vet say?
I'd be asking about scans to try to find the reason for the pain.
I don't know much about memantine other than it takes months to work.

My vets prescribe a three week course of Gabapentin for pain trials, so I don't think it's an unusual choice.
My dog is currently on Gabapentin, Metacam and Paracetamol, as prescribed by a specialist in pain management.

I've not heard of memantine, sorry. I hope you can find something to help your dog though.

I think it's unusual as gabapentin targets nerve pain, not joint/muscle pain - I always thought it was normal to start with Metacam and then go up the "scale" when/if that doesn't work.

@beaglescurleduplikebagels I have no idea. The vet said she'd just been on a course for pain management and that's what was recommended. That was in 2022, so things might have changed.

Maybe it just varies depending on the vet and what they prefer. Ours has always started with metacam and then added in gabapentin if needed.

Thanks all.
yeah I do find it odd that none of the more standard painkillers have been suggested or trialled like metacalm.

the other suggestions have been acupuncture and cannabis oil but there is doubt my girl would be ok with being handled as she’s deeply suspicious of vets 😤

Have they done x rays, to rule out skeletal issues, hip dysplasia etc? It does sound odd that they jumped to gabapentin. Our vet has suggested gabapentin but that’s only if the standard (metacalm, paracetamol, traleive) aren’t working. Gabapentin is a drug that takes time to work and certainly in humans doesn’t help everyone. If your dog is in pain I would have thought they would have given something more immediate acting? Never heard of the other drug they have suggested.

No she hasn’t been x rayed or anything.

we were referred to the behaviourist for some anxiety related issues. They gave suggested that this may be linked to chronic pain due to her odd gait, way of walking etc. I am not sure why we wouldn’t have started on mainstream drugs as a pain trial I would be happier going down this route given there is quite a bit of guess work going on here.

Our collie had something similar in that we worked out he wasn’t walking quite right but the vet did xraya of neck, back and hip to work out the issue and he has a hip injury but he’s on meloxicam and started physio for his hip which has lead to issues with his neck too compensating. By working out the cause of the pain we can deal with the pain and underlying cause. He’s nearly 3 so a similar age so we are not dealing with old age arthritis.

Surely if the vet suspects chronic pain, they should be investigating what is causing it.

I saw a pain specialist with one of my dogs, as he had behavioural issues that I believed were caused by pain. The pain specialist identified a problem with his gait and referred us to an orthopaedic specialist for investigations.

Yeah I know what you mean.

they have said that chronic pain can be different and that they (ortho, neurology) probably wouldn’t do anything (ie surgery) for a dog that is running about like mine does and at her age anyway (so they would just treat with pain meds) so no point subjecting her to scans, tests etc 🤷‍♀️ but kind of makes treating her with something unheard of more difficult to justify.

That’s such an odd stance for your vet to take. I mean your dog is only 4! Are they planning to keep her on pain meds for life?
I say all this as our 8 year old dog has hip problems which when he was X-rayed was identified. He is now under a referral for the orthopaedic surgeon. I find it strange your vet doesn’t want to at least investigate when the root cause is. I wouldn’t be happy with that if it was my dog. It’s impossible to monitor and assess short and long term if they don’t know what the cause is surely?

@Revival75 I agree with pp. When you said 'at her age', I thought she was elderly.
4 is no age at all. It could be something treatable, causing the pain. Or something that would benefit from physiotherapy or acupuncture.

I took on a 9 year old foster dog, who had mobility issues and chronic pain. She had full x-rays so we could see what we were dealing with. She's now on a cocktail of pain meds that target specific areas. And she's had physiotherapy and laser treatment. She's 11 years old now, and doing better than she was when she was surrendered to the rescue.

If I was you, I'd be pushing for investigations to find what is causing the pain issues.

Thanks for all the advice.

yes, I’m confused as she wasn’t ever referred for pain, but I do kind of agree she walks funny (paces and bunny hops etc).

I guess I am trying not to subject her to more vet exams (if not necessary) as she’s sooooo stressed by them (she’s had quite a few bad experiences with unrelated incidents (more accidental, minor things but needing sedated etc) but maybe that is the right way to go.

it’s all so confused & just want to do the right thing by her. Get the impression that the behaviourists we have been referred to maybe don’t always agree with the ‘specialist’ as they have said often they can’t find anything with chronic pain 🤷‍♀️. Don’t feel we are getting to the bottom of anything despite paying £££££

There’s a bit of missing the point here
the point of a pain trial with behaviour issues is to see if pain relief makes any difference to the behaviour issues .
if a pain killer for say a month seems to show a benefit , then you go looking for the cause
if not then you assume behaviour issues are not pain related .
no one is planning on keeping an undiaydog on pain meds for life , it’s just a short trial
that’s why though , you would usually use a standard pain killer that you know will reliably provide pain relief . Not the occasion to mess about with weird neuropathic pain meds !
honestly I’d go back to your first opinion vet , explain the situation and ask for a month of metacam . If they have the referral report they would probably prescribe it without another visit .
Good luck anyway .