We have been using gabapentin with Jimmy since September, along with buprenex he receives for pain, to relieve anxiety and pain-litter box use, post surgery, flare up of a UTI, etc. But we have run into an unexpected complicatioin.
He had a massive UTI in November where he was urinating huge amounts of urine colored dark red with blood because the bladder was severely irritated. The emergency vet did not give him fluids-a typical protocol is to give sub q fluids to help ease the bladder irritation which helps remove irritants and bacteria. They did give him Onsior, a pain reliever. It slightly improved his condition. The next day, he saw the regular vet who gave him fluids. This helped the Onsior kick in and improve his condition. We also increased the gabapentin amount from a daily .50ml twice a day to 1ml three times a day to relieve pain and irritation. The vet gave him Veraflox antibiotic for 14 days.
Eventually, he recovered. We titrated down the gabapentin to .60ml to three times a day and he seemed to respond very well.
Except late January 2026, he became combative. He received higher amounts of gabapentin than normal for vet visits because he became too angry and could not be properly managed. We gave him 3.0ml two hours before we left for the vet office. While calm enough to be put in his carrier, at the vet office he became angry and reactive and lost patience to be handled after 20 minutes. So, we increased the amount to 4ml at three hours before the visit and still he was reactive.
When I researched what is the cause, it turns out that while rare, gabapentin can cause aggression in cats after a long time use. And four months apparently is long enough. His cardiologist suggested trazadone but that is contraindicated with Prozac that he takes. This means that I must titrate down the gabapentin to twice a day and then see how he responds, hoping it eases his aggression at home, and maybe leaving the larger amounts administered for vet visits able to work well as they once did.
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