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Polka might have SM, vet tomorrow

M

mlhirsch

Well-known member
A bit of background - Polka is 14 years old and a trooper!! Has had an enlarged heart, all her life, with a slight murmur. Bad liver values, so she has been on denamarin for over a year. Had a dental a few months ago, and had a very bad infection. We just returned from vacation and she is digging like crazy, scratching her neck, scratching ears (pulled out hair), rubbing her head in the floor, weakness in back legs is worse, shedding like crazy. She has woken me up at 4AM two mornings in a row digging and rubbing her head. I try to hold her and calm her down, it works for a bit, then it starts all over. I called my vet and she is sending me in to see an internal medicine specialist. I wanted to see the neurologist, but they are all at a conference this week. I called OSU and MedVet to see how quickly i can get in to a neuro. They assure me that they will call and consult if needed. I am looking for some advice on what to ask. She is old and I just want to keep her comfortable for as long as i can. I thought we were going to lose her over a year ago, but she still keeps on kicking. It is just within the last few days I see a horrible down turn. I am very worried.
 
It could be SM but possibly something else too. OSU knows the condition pretty well. I'd probably be wondering if I could trial some of the medications rather than put an elderly dog through an MRI. If you go to my site www.smcavalier.com you can download Dr Clare Rusbridge's treatment diagram. Maybe your vet will have you try some initial steps on the diagram as these are common pain relievers? Frusemide can help and is common for heart conditions. Prednisalone might be of immediate help to relieve discomfort.
 
Karlin said:
I'd probably be wondering if I could trial some of the medications rather than put an elderly dog through an MRI.
Click to expand...

I agree, a diagnostic MRI can take a long time under general anesthetic. My boy's took 3 hours.

Polka sounds a wonderful girl and a fighter too. Hang in there :hug: I hope you can get to a neuro soon.
 
This must be so distressing for you. Has your vet checked her ears for a foreign object, such as a grass seed? This has come on so sudden - I would make sure they look for something like that if they haven't already.

Also in some cavaliers PSOM (primary secretory otitis media) can be quite painful - this could be diagnosed with a CT scan, if you don't want to go the MRI route. OSU has a PSOM study (scroll down to Dermatology on this link): http://www.vet.ohio-state.edu/2743.htm

Since she has liver issues, they may not want to prescribe gabapentin, metacam, rimadyl for suspected SM, since it could stress her organs. Maybe ask if Tramadol would be a safer pain medication for her?
 
Thanks for helping. I am very concerned about what meds she is given b/c of her liver and heart, and goodness knows what ever else. Those are some very good ideas. Thanks Karlin, i did print the info from your site to take with me. I just keep hoping that it is something minor, but at her age, i unfortunately don't think so. With her, i just feel so lucky we get one more day. We shall see, i am headed to the vet in about a 1/2 hr. I'll post when I know what is going on.
 
so I just returned from the vet. They are thinking it is a slipped disc because of the way she is responding to the neuro tests. So we are treating for the slipped disk and SM in case that is it also. They will reevaluate in 4-6 weeks. So lets hope she starts to feel better. the only downside is I have to keep her in a crate or very quiet the entire time for limited exercise.
 
On an elderly dog with no previous signs, I'd guess it might be a disk. My Lucy who is 10 in a couple of weeks had back pain and difficulty walking etc and it was her back. She had an excellent MRI scan later on for research that confirmed it would have been her spine.
 
So sorry to hear about Polka, I hope it is something that can be sorted.

Thinking of you
 
I know it has only been two days, but i haven't seen any change in Polka so I am very concerned. she is on Tramadol for pain, Furosemide and Prilosec. I have a question for those who doggies have SM. What is their behavior like during the night. Polka is pretty much fine all day. then around 2AM or 4AM she starts digging and rubbing her head in the bed the floor where ever she is. She can't get comfortable. I have no idea what to do. I have called the vet again to see if i am to notice any changes from the meds this quickly. I am thinking i should, but I haven't. So I am very concerned. This is my 5th night with very disrupted sleep. I just want her to feel better. Our other cavalier, Colleen, just sleeps right throught it!
 
I'd try gabapentin and/or prednisalone. Tramadol may really not be helping the pain adequately if it is a disk problem. Nor if it is SM -- it s a pretty low level pain killer.

Also normally for SM you wouldn't have a dog on both prilosec and frusemide though maybe that's OK to do --these are both for the same thing though.

Normally drugs are trialed for 2 weeks so no, you wouldn't necessarily see any immediate response. But if she is doing this due to pain I'd ask for a stronger pain medication. Preds. would help both disk pain and SM pain. Really if they think it is a disk pain I'd be looking for pain meds to address that in the first instance to see if you can get it to settle.

SM dogs often are more uncomfortable at night but it could also be when any kind of spinal pain is more noticeable too.
 
Prednisone works wonders for Oliver who has bulging discs and goes through pain cycles during which he does not want to move. He just lays in the crate (even though none of my dogs is still in a crate, I keep one out) and I have to physically pick him up to take him outside to potty. The only thing I have found that helps when he is that bad is prednisone - and the difference is pretty quick and amazing.

I do have a dog with SM, but her symptoms are mostly related to imbalance issues rather than pain and she is on prednisone for that. It has been a wonder drug for my dogs.
 
Ok so I just talked to the vet again. So they are going to add gabapentin and she is on Tramadol for pain, Furosemide and Prilosec. Which they don't want me to stop. That just seems like so many drugs for her. I asked about the difference between the furosemide and the Prilosec. I guess one stops the fluid from producing and the other helps it exit from the body. I am very confused. I am headed to my regular vet tomorrow with her to see if I can sort this out before giving the gabapentin. I just feel like i want to do the right thing, but it isn't sitting well with me to give her all of these meds. I am going to have my regular vet call in to this Dr. to see what is going on. I am just so worried, i don't want to do the wrong thing.
 
update: i have an appointment next wednesday with internal medicine and a consult with the neurologist. I just want to make sure i have everything covered with Polka and i think i am off on the right track. Right now she is sleeping peacefully by my desk at work. I wish she would sleep this peacefully through the night.
 
Ive no advice for you but i just want to say im sorry you& Polka are going thro this.You couldnt be doing more for her & she's a lucky girl to have a mum who cares so much. i hope things improve soon & good luck with your appointment next weds:hug:
 
Good on you for sorting this out so quickly for Polka. Would be interested in hearing how she gets on with the Gabapentin.
 
Thanks for the well wishes! This is very difficult for any dog owner to go through.

Polka was a bit unsteady last night after her 1st dose in the afternoon. I am thinking it is becuase of a combination of the meds. She still went on her evening walks and ate a great dinner. She is really a trooper!! She only had one episode last night and calmed down quickly. she was up like a champ this morning and ready for her walks. I am hoping I will see her improve as the week goes on, before her neurologist appointment.
If it wasn't for this site I would not be aware of SM. She is 14, I have had her for 13 of those years. My parents had a Cavalier, and no problems at all. so i am very glad I have the support. Kudos to Karlin for making this available!!! I will say that all along I believe that Polka was showing very mild signs of SM. It was just lately that they greatly escalated.
 
Polka Update
Yesterday she had a consult with a neurologist. They believe it is one of two things:
1) slipped disc or 2) Chari Malformation
Right now, because she is 14 we are not doing an MRI we are trying to make her more comfortable and in less pain. She is now taking: Gabapentin, Prilosec, nonsteriodal anti-inflammatory, and tramadol (for pain at night). We are keeping her activity very low. If this doesn't help her, then we will need to regroup. They are hoping that if it is a slipped disc she can fix it on her own. And if it is CM, then medications should help. I have noticed she is rubbing her head much less and she is no longer waking me up during the night. So I think we are on the right track at least for now. I have elevated her food too and what a huge improvement, she now eats everything!!!
 
Hope things continue to improve with Polka. It is hard with an older dog when it could be so many things and they are not able to have all the more diagnostic tests done. Hang in there!
 
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