The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia

Background: Chiari-like malformation (CM) and syringomyelia (SM) are commonly observed disorders in the Pomeranians. Both disorders can lead to pain and diminish quality of life to varying extents. In veterinary medicine, affected dogs are often treated with gabapentin or pregabalin, which contrasts...

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Main Authors: Ramona ter Maat, Kathelijn van Heusden, Larissa Hoogervorst-Spek, Marta Płonek, Paul J. J. Mandigers
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Animals
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Online Access:https://www.mdpi.com/2076-2615/15/7/992
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author Ramona ter Maat
Kathelijn van Heusden
Larissa Hoogervorst-Spek
Marta Płonek
Paul J. J. Mandigers
author_facet Ramona ter Maat
Kathelijn van Heusden
Larissa Hoogervorst-Spek
Marta Płonek
Paul J. J. Mandigers
author_sort Ramona ter Maat
collection DOAJ
description Background: Chiari-like malformation (CM) and syringomyelia (SM) are commonly observed disorders in the Pomeranians. Both disorders can lead to pain and diminish quality of life to varying extents. In veterinary medicine, affected dogs are often treated with gabapentin or pregabalin, which contrasts with human medicine, where the tricyclic antidepressants amitriptyline and nortriptyline are the first-choice treatments. Methods: affected dogs were treated with either amitriptyline or gabapentin. If a pre-syrinx was present, furosemide was also added. Owners were asked to score the clinical signs they observed (ORCS). Results: 90 Pomeranians were included, of which 62 received amitriptyline and 28 received gabapentin. Adding furosemide did not have an influence on the outcome. A logistic regression analysis with the number of ORCS, duration of ORCS, treatment (amitriptyline or gabapentin), and outcome (responder or non-responder) as the dependent variable revealed that the number of ORCS had an Odds of 1123 (<i>p</i> = 0.03). Duration of the ORCS (Odds 1.027; <i>p</i> = 0.45) and treatment group had a low influence (Odds 1.258; <i>p</i> = 0.65). Conclusions: In this study, amitriptyline demonstrated a moderate, though not statistically significant, more favorable effect on CM/SM pain compared to gabapentin. Adding furosemide to either of these two treatments did not influence the outcome. The outcome for dogs affected by CM/SM is not influenced by MRI grading; however, the number of ORCS and a longer duration negatively impact the outcome. A dose of 1 to 2 mg/kg body weight of amitriptyline administered twice daily proved to be more effective in several dogs.
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spelling doaj-art-1981def5305d44a68d10bf4dcb7ecc082025-08-20T02:09:10ZengMDPI AGAnimals2076-26152025-03-0115799210.3390/ani15070992The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or SyringomyeliaRamona ter Maat0Kathelijn van Heusden1Larissa Hoogervorst-Spek2Marta Płonek3Paul J. J. Mandigers4Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The NetherlandsDepartment of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The NetherlandsNeurology Service, Evidensia Referral Hospital Arnhem, Meander 10, 6825 MB Arnhem, The NetherlandsNeurology Service, Evidensia Referral Hospital Arnhem, Meander 10, 6825 MB Arnhem, The NetherlandsDepartment of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The NetherlandsBackground: Chiari-like malformation (CM) and syringomyelia (SM) are commonly observed disorders in the Pomeranians. Both disorders can lead to pain and diminish quality of life to varying extents. In veterinary medicine, affected dogs are often treated with gabapentin or pregabalin, which contrasts with human medicine, where the tricyclic antidepressants amitriptyline and nortriptyline are the first-choice treatments. Methods: affected dogs were treated with either amitriptyline or gabapentin. If a pre-syrinx was present, furosemide was also added. Owners were asked to score the clinical signs they observed (ORCS). Results: 90 Pomeranians were included, of which 62 received amitriptyline and 28 received gabapentin. Adding furosemide did not have an influence on the outcome. A logistic regression analysis with the number of ORCS, duration of ORCS, treatment (amitriptyline or gabapentin), and outcome (responder or non-responder) as the dependent variable revealed that the number of ORCS had an Odds of 1123 (<i>p</i> = 0.03). Duration of the ORCS (Odds 1.027; <i>p</i> = 0.45) and treatment group had a low influence (Odds 1.258; <i>p</i> = 0.65). Conclusions: In this study, amitriptyline demonstrated a moderate, though not statistically significant, more favorable effect on CM/SM pain compared to gabapentin. Adding furosemide to either of these two treatments did not influence the outcome. The outcome for dogs affected by CM/SM is not influenced by MRI grading; however, the number of ORCS and a longer duration negatively impact the outcome. A dose of 1 to 2 mg/kg body weight of amitriptyline administered twice daily proved to be more effective in several dogs.https://www.mdpi.com/2076-2615/15/7/992CBD oilNSAIDopioidsfurosemideneuropathic pain
spellingShingle Ramona ter Maat
Kathelijn van Heusden
Larissa Hoogervorst-Spek
Marta Płonek
Paul J. J. Mandigers
The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia
Animals
CBD oil
NSAID
opioids
furosemide
neuropathic pain
title The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia
title_full The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia
title_fullStr The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia
title_full_unstemmed The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia
title_short The Effectiveness of Amitriptyline and Gabapentin in Treating Pomeranians with Chiari-like Malformation and/or Syringomyelia
title_sort effectiveness of amitriptyline and gabapentin in treating pomeranians with chiari like malformation and or syringomyelia
topic CBD oil
NSAID
opioids
furosemide
neuropathic pain
url https://www.mdpi.com/2076-2615/15/7/992
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