Amantadine as a Therapeutic Option for Neuropathic Pain in Dogs

Understanding the Study

Objective

To evaluate whether amantadine improves neuropathic pain associated with degenerative lumbosacral stenosis (DLSS) in dogs. The study used objective force-plate gait analysis. It also assessed whether adding amantadine improves outcomes in dogs previously unresponsive to meloxicam alone.

Study Design

• This was a prospective randomized clinical trial.

• The study involved 20 client-owned dogs with confirmed DLSS.

• All dogs had previously failed to respond adequately to meloxicam therapy.

  
  

Treatment Groups

Group A (n=10)

• Meloxicam:

- 0.2 mg/kg loading dose

- Then 0.1 mg/kg SID for 7 days

• Amantadine:

- 3 mg/kg SID for 21 days

Group B (n=10)

• Amantadine alone:

- 3 mg/kg BID for 21 days

Outcome Measures

Objective force-plate analysis was conducted at:

• Baseline (T0)

• Day 7 (T1)

• Day 21 (T2)

  
  

The following were measured:

• Peak Vertical Force (PVF)

• Vertical Impulse (VI)

• Stance Time (ST)

  
  

Key Results

1. Significant Improvement with Amantadine

Both treatment groups showed statistically significant increases in:

• Peak Vertical Force (PVF)

• Vertical Impulse (VI)

  
  

These improvements were noted after 21 days, indicating enhanced limb loading and reduced pain-associated gait abnormalities.

Group A (Meloxicam + Amantadine)

• VI improved significantly:

- T0 → T1 (p=0.012)

- T0 → T2 (p=0.008)

• PVF improved significantly:

- T0 → T1

- T0 → T2

- T1 → T2

Group B (Amantadine Alone)

• VI improved significantly:

- T0 → T2 (p=0.0012)

- T1 → T2 (p=0.0034)

• PVF improved significantly at all time points.

  
  

2. Amantadine Alone Appeared Effective

Dogs receiving amantadine without NSAIDs showed similar objective improvements to those receiving combination therapy. This supports a direct analgesic benefit of amantadine for neuropathic pain associated with DLSS.

3. No Significant Change in Stance Time

Stance time did not change significantly. This is likely because the enrolled dogs had mild-to-moderate disease. Improvements were reflected primarily in force generation rather than gait timing.

Clinical Interpretation

The authors suggest that amantadine's NMDA receptor antagonism may reduce central sensitization and chronic neuropathic pain. This allows dogs to load affected limbs more normally. Importantly, this study specifically enrolled dogs considered refractory to meloxicam alone. This makes the findings clinically relevant for difficult chronic pain cases.

Limitations

• The sample size was small (20 dogs).

• There was no meloxicam-only control group.

• Follow-up was limited to 21 days.

• While force-plate outcomes improved, long-term clinical durability remains unknown.

  
  

Clinical Take-Home Message

This 2025 randomized trial provides objective evidence that amantadine can improve gait kinetics and likely reduce neuropathic pain in dogs with degenerative lumbosacral stenosis. This includes dogs previously unresponsive to NSAID therapy. Both amantadine alone and amantadine combined with meloxicam produced significant improvements in limb function over 21 days. The authors conclude that amantadine is a useful addition to multimodal management of canine DLSS-associated neuropathic pain.

Practical Dosing from the Study

• Amantadine 3 mg/kg PO BID (monotherapy), or

• Amantadine 3 mg/kg PO SID with meloxicam.

  
  

Notably, the study cites a previous veterinary case report by Madden, Gurney, and Bright (2014) describing the successful use of amantadine for chronic neuropathic pain in a dog.

New Reported Potential Adverse Effect

The second update pertains to a case report in which a dog treated with amantadine developed hypoglycaemia. This condition resolved after discontinuation of treatment. You can read that report here – it’s certainly worth knowing this is a potential adverse effect.

Our original post on amantadine

Conclusion

In summary, amantadine shows promise as a therapeutic option for managing neuropathic pain in dogs with DLSS. Its effectiveness, even in cases unresponsive to other treatments, highlights its potential role in veterinary pain management.

References

Caterino C, Della Valle G, Aragosa F, Cavalli S, Lamagna F, Fatone G. Amantadine as a therapeutic option for neuropathic pain in dogs with degenerative lumbosacral stenosis. BMC Vet Res. 2025 Jul 16;21(1):469. doi: 10.1186/s12917-025-04911-9.

Shahira A, Medina-Serra R, Adam F, Zoff A. Suspected amantadine-induced hypoglycaemia in a dog treated for chronic lumbosacral pain. Vet Anaesth Analg. 2026 Jul 28;53(5):101290. doi: 10.1016/j.vaa.2026.101290.

Telemedicine

Did you know we offer a telemedicine service for chronic pain advice? If you have a DLSS case that you are struggling to control, you can request advice here.