Pregabalin chewable tablets relieve nerve-related pain by reducing the release of neurotransmitters involved in pain signal transmission within the spinal cord.

The U.S. Food and Drug Administration (FDA) has approved pregabalin chewable tablets ( Liavium-CA1 ; TriviumVet ) for the treatment of pain and clinical symptoms associated with canine cerebellar tonsillar herniation (CM) and syringomyelia.
This approval was granted to TriviumVet, a company headquartered in Ireland . The FDA 's approval pathway is a conditional approval pathway, which is used for drugs intended to treat serious or life-threatening diseases, fill unmet animal health needs, and require complex or particularly difficult studies to demonstrate their effectiveness.
Cerebellar tonsillar herniation (CM) is a genetic disorder in dogs where the skull is too small, causing the cerebellum to protrude beyond the base of the skull. This restricts the flow of cerebrospinal fluid and leads to syringomyelia, a condition characterized by painful cavities filled with fluid within the spinal cord. This condition causes nerve fibers to dilate and become compressed. The most common symptom is paresthesia, typically affecting the back of the head and neck, and may develop into pain.
Pregabalin is the active ingredient in Liavium-CA1 and is designed to relieve neuropathic pain by reducing the release of neurotransmitters involved in pain signaling in the spinal cord. According to the FDA , this medication must be taken orally twice daily with food and is a prescription drug because, according to FDA regulations, veterinary supervision is required to diagnose syringomyelia and CM , determine the appropriate dosage, and monitor for adverse reactions. The veterinarian may also recommend the concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Dogs weighing less than 3kg cannot be accurately administered Liavium-CA1 .
In a statement, the FDA wrote, "Conditional approval means that the FDA has determined that Liavium-CA1 is safe and has a reasonable expectation of efficacy for its intended use. The agency stated that TriviumVet has up to five years to collect more efficacy data to support full FDA approval."
Previous treatment options for CM and syringomyelia included neurological medications such as gabapentin, as well as diuretics, antacids, and corticosteroids designed to reduce cerebrospinal fluid production. Acupuncture was also used as an adjunct therapy.
Clinical symptoms
The clinical signs of syringomyelia and CM are diverse and usually progressive. Affected dogs may become withdrawn and bark when jumping, running, defecating, or being picked up. Intermittent pain, especially at night, is common. Due to increased intracranial pressure, some dogs may experience difficulty walking or constipation. Tenderness around the shoulders, ears, back of the neck, or sternum is also frequently reported.
Another typical symptom is phantom limb scratching, where the dog appears to scratch while walking, even without obvious external stimuli. Some dogs may rub their faces persistently. Touch, exercise, excitement, or wearing a collar can all trigger symptoms such as scratching or pain.
Dog breeds prone to CM include Cavalier King Charles Spaniel, Brussels Griffon, Maltese, Yorkshire Terrier, Chihuahua, and Pit Bull.

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