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Devilica
12th February 2010, 12:05 PM
Sorry for the long post, just needing to share with people that understand.

A little background.
My beatiful tri, Tilly will be 3 in May. I can't imagine her getting to 5 :( She showed symptoms within a month of us getting her but of course we didn't know what they were. I figured she was just in too much of a hurry to sit and scratch so carried on walking. The odd yelps were treated with many things and then xrayed with no results. the day after the pedigree dogs exposed program I had an appointment booked with the vet to discuss MRI.. but as soon as I saw that program I knew.

Her MRI showed several large syrinxes and our neurologist said that according to the scan she should go straight for surgery. Luckily her physical symptoms werent too severe and on examining her he didn't feel surgery was quite so urgent, so I had time to research and make informed choices.

Tilly is getting weaker in her front legs and her scratching was getting worse. I have found that she copes best with her scratching if I shave her coat quite short. Unfortunately we missed her grooming appointment due to the snow so she had got quite long but is now sorted. We are lucky that we only have yelping if I pick her up wrong or she jumps up/down awkwardly. Her skin is getting so sensitive I can barely stroke her without setting off a scratching fit. Not only her neck, chest, head, ears and front legs but also now her stomach, hip and thighs can start her off. She "twitches" all the time. Small kicks and twinges that constantly remind you that she is in pain.

I did try tramadol (25mg twice daily) on top of the gabapentin (100mg 3 times a day) and frusemide (10mg 3 times a day) but she didn't like it at all. She is normally fantastic at taking her meds but the tramadol was constantly spat out and it left her slightly dopey. Metacam was also tried but made no significant difference.

Myself and the vet feel that corticosteriods are not the way to go as she is already a dog that is prone to weight issues and needs very careful monitoring on food amounts.

It would definately be time for surgery if that route was one I thought would benefit her in the long term. But I have taken the decision that the odds of improving her life are just not high enough to put her through a drastic procedure that she won't understand. For now I believe her quality of life is fair. She still loves her food, loves her walks, is getting more and more clingy and cuddly and luckily I am home all day to provide that support. We are into Palliative care. It may be a long way off or it may be months or even weeks away, but I want to be strong enough for her to not drag out her suffering. For now she has more good days than bad ones... Long may it last :)

Tilly will have as much fun and love as we can squeeze in.

http://i42.photobucket.com/albums/e309/PastelDragons/DSC00247.jpg

Karlin
12th February 2010, 12:19 PM
I am so sorry; you are facing such difficult decisions and such a hard situation. This is the nightmare situation for any cavalier owner. :(

If you haven't done so, and want a well informed perspective,I'd suggest talking to Clare Rusbridge just to make sure you are happy with this decision. It is a completely personal choice and a hard one. But you may find that prospects are not as grim as you feel they are right now.

I also would definitely review that level of medication with a neurologist, not a vet -- not least as she is not getting enough relief from it by your description. That is a very low dosage of gabapentin for example and I would think you could eliminate most or all these symptoms with a meds adjustment (my Leo is not nearly as symptomatic and is on 150mg gabapentin 3x for example -- 100mg 3x is really only a starter level of medication; many dogs go up to 200mg 3x). There are numerous other painkillers plus higher dosage of gabapentin or moving to Lyrica; there are several other options in CSF inhibitors besides frusemide that may very well work much better, etc. Vets do not really have the expertise to make these decisions. A neurologist familiar with treating this condition will start working through mixes to get the right blend.

If you aren;t working with Clare I would sure highly recommend it. If you are, I am very sure she would want to review Tilly's current regime, and would be recommending adjusting medications if a dog is this symptomatic *Karen & Ruby can advise -- she went through exactly this and went back in to Clare :) ). There are several medication choices that should be able to manage this if you are opting for plliative care.

Best of luck with getting a good balance -- please let us know if you get some additional relief for Tilly. :flwr:

Sabby
12th February 2010, 12:24 PM
I can’t advise you about all the different medicines and only you can make the decision on the operation. I personally wouldn’t put my dog through it, but it breaks my heart to read your post. Just to say I hope that you still have a long time with Tilly yet and that my thoughts are with you and Tilly.:hug::hug:

Rubysmum
12th February 2010, 12:26 PM
sorry to hear this. i have a 5 month old pup and took a chance on the breed as theyre so good with children but as i find out more about the health problems i cant stop worrying she will develop a problem -if she scratches im imagining the worst . no help am i but i really sympathise , i dont know what i would do without ruby now -good luck and enjoy tilly as much as you can -you will know if she is still enjoying life more than not!

Charlifarley
12th February 2010, 01:21 PM
This is what is ahead of most of us with SM dogs. What to do when the meds don't seem to work any more. As Karlin writes, she may well do better on stronger/different medication. It's so hard to know what to do, when each dog experiences things differently and needs different medication. I hope you manage to get Tilly sorted out and that she starts to feel better soon.

*Pauline*
12th February 2010, 01:35 PM
I agree that a review of her drugs may be the answer. I have just introduced a daily dose of Rimadyl on top of Gabapentin. It isn't a major strong drug but it's makes him noticeably more playful. I just wanted to post so you know I'm thinking of you and hope you find something to make Tilly more comfortable. It's hard living with this I know. It sounds like you are giving her a lot of love and I'm sure she appreciates all you do. Hang in there, you are not going through this alone :hug:

Love my Cavaliers
12th February 2010, 03:43 PM
I am so sorry you are going through this with Tilly. SM is heartbreaking. I can only say that steroids (Prednisone - 5 mg/day) have been a miracle drug for Riley. On good days, her symptoms are almost eliminated, and the majority of her days are good. Her weight is the same as before she started steroids. She doesn't seem hungrier or thirstier after having been on them daily for 8 months. I know it's up to me to monitor her food intake and it's hard to resist those huge beautiful pleading eyes. But, I do resist giving her too many treats since I know it's best for her. It also took us almost a year to figure out the right meds for her and the right dosage. She did not respond at all to the typical SM drugs. But once we started steroids, we(the neurologist and I) knew that they were the answer for her. This is not to suggest that steroids are the best way to go for Tilly, but just to keep an open mind and know that drug therapy with SM is often a trial and error process. We actually tried one medication that even half the normal dosage left Riley unable to sit, stand or walk. Needless to say, she only got one dose of that one!! My thoughts and prayers are with you and Tilly as you figure this out. These SM dogs are so amazing, that even when their symptoms seem so horrible, they are still loving us. Best of luck to you.

Karen and Ruby
12th February 2010, 04:05 PM
Hi there

I have to whole heartedly agree with Karlin. You definatly need to re think her meds. Nothing lasts forever and they need tinkering every now again to keep our babys comfortable.
Ruby was not as bad as you have described with Tilly but she was certianly headed that way fast- we went back and slowly merged her on to a new drug regime and she has been a completely different dog since then (I also think bouncy Charlie entering our home had a bit to do with it too)!!

i really hope you can get some releif for little Tilly- im sure she has some fuel left in the engine still xxx

Let us know how you get on and if you have any questions do feel free to ask xx

jacies
12th February 2010, 04:25 PM
I am really sorry to hear of your problems with Tilly and agree with everything everone has said. Chaos was also getting like Tilly and I also thought she would not have much longer but since her meds have been changed she is a different dog. She had SM from a young age but was only diagnosed at the age of 4 and is now 6 years old.
I think it might be worth trying the Tramadol again as this has really helped Chaos and when I put it in cream cheese she does not know she is getting it. Apart from the Tramadol she is also on Gabapentin and Omeprazole. She also is on steroids, initially was having 1 x 5mg every day but that has now been reduced to one every other day and is still doing well on that. I am soon going to try to cut that down to half a tablet every other day. She has put on some weight and is always hungry but I have not increased her food at all except for adding some vegetables and I think the weight gain and other potential side effects are worth it for her to be pain free for as long as possible. All in all she is so much happier and you can see by her eyes that she is not in the pain that she was. I really hope you are able to sort out her meds to make her feel better.

Cathy T
12th February 2010, 04:47 PM
I do hope you are able to adjust her meds to make her more comfortable. Reading about her just breaks my heart. And on such a young pup, just so heartbreaking. What an awful position for you to be in, how to figure out what's best for Tilly.

meljoy
12th February 2010, 05:01 PM
Im hoping and praying that you can keep Tilly happy and comfortable for a long time to come yet.
At least she knows you love her and that in it'self must help her;)

izziewizz
12th February 2010, 06:10 PM
oh bless her she look's lovely it must be so hard for you
i'm at the begining of my journey. with my charlie & mybe my poppy.
only been on med's 2 week's on monday still limping having his scan
on tuesday. then i will know for sure what's going on.i know there mybe
a lot more to come. but like your self we have to love and look after them
and make there life's happy


take care give her a
big :hug:

Devilica
13th February 2010, 12:14 PM
Thank you everyone.. I don't often get down about things and generally try to remain positive and do what I can... but sometimes it just all gets too much. I will phone the vet again on monday (between my cavs I practically live in there) and will get a referral again. I was originally referred to Mike Targett at Bristol... and I am not sure I could make it to wimbledon to see Clare nor up to chestergates to see Geoff :( There are times I really wish I had someone healthy around to drive me to places or a more predictable illness!

I presume it would be easier to medicate if they had at least seen Tilly?

Claire L
13th February 2010, 12:28 PM
I'm so so sorry you are going through this nightmare:hug:. Tilly is a beautiful girl and it just breaks my heart to read her story:cry*ing:. It must be so hard on you, worrying all the time and wondering what to do and who to turn to .

I hope and pray that Tilly can get her meds sorted . I only wish I was in the UK; I would gladly drive you to wherever you needed to go . Maybe some UK folk could work together to help you take Tilly to see Clare :xfngr: