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kimy27
28th April 2010, 06:38 PM
I took Bailey back to the vet because I felt like the metacam and furosemide were not fully controlling her SM symptoms. I was looking for her to try the gabapentin but the vet said that was "the bug guns" and has decided we should try tramadol instead.

The tramadol comes in 50mg capsules which is fine except that Bailey is to have half a capsule twice a day.

Is anyone else's dog on this medication and if so how do I go about splittin the capsules?

Thanks :)

Love my Cavaliers
28th April 2010, 06:42 PM
When Riley and Oliver have been on Tramadol, the vet gave me 50 mg tablets which are easy to split. I even had to quarter them for Riley since she is so petite. Could you check with your vet to see if they carry the tablets?

jacies
28th April 2010, 07:36 PM
Chaos is on Tramadol and I get 50 mg capsules which have to be split to give her 25 mg twice a day. I get empty capsules from ebay, they are quite cheap and then open the Tramadol capsule, pour the contents onto a piece of paper that I have folded in half and divide the powder into half with a knife. I scrape one half onto another piece of paper and it is then quite easy to funnel the two halves into the empty capsules. I could not find a supplier of the right kind of Tramadol in tablets because they were time release and I was told that they could not gaurantee the doses would be equal.
Hope this helps. I have to say that Chaos is also on Gabapentin, Omeprazole and Prednisolone as well.

Nicki
28th April 2010, 08:00 PM
Sorry to hear that Bailey needs more help now.

Tramadol can be very effective, but it is a drug that dogs can quickly get used to, so my neurologist said that it was not good to use it all the time.

milandmais
29th April 2010, 12:10 AM
Oh god, I'm on tramadol for my broken back,did'nt have a clue that dogs can take it too.

EddyAnne
29th April 2010, 06:37 AM
I remember something that Tramadol releases Serotonin. Some may remember topics about Serotonin and MVD. So if you Cavalier has MVD then maybe Tramadol may NOT be advisable even if its intention was to help regarding SM symptoms. Maybe something to look into to find out the facts rather than rely on someting I remembered, I'm getting older and my memory may not be as good as it was.
.

kimy27
29th April 2010, 09:50 AM
Thanks for the replys. Our first attempt this morning was a disastar. As advised by the vet I managed to open the capsule and split the powder between the two parts. Unfortunately my first attempt at rolling half the capsule into some cold meat resulted in the powder spilling everywhere :sl*p:

On my secon attemt I managed to get the other half rolled up in the cold meat but couldn't get Bailey to swallow it! The powder just foamed up in her mouth and she spat it out :sl*p:

I will need to go back down to the vets and see if they have any empty capsules.

kimy27
29th April 2010, 01:08 PM
Called the vets and they said I can empty the powder onto some food and give it to her like that. So that makes it much easier lol.

Nicki
29th April 2010, 07:59 PM
You are right EddyAnne, Tramadol does indeed release seratonin
- I've been doing a bit of a search about it and found this


One of the two studies involves blocking the Cavalier's excessive production of seratonin. Research thus far has suggested that: (a) seratonin (5HT) activates growth activity in canine mitral valves; (b) dogs with MVD have more seratonin receptors in their valve cells than other dogs; (c) mitral valve cells have the capacity to make their own seratonin; and (d) Cavaliers also have a higher level of seratonin in their bloodstream.
Researchers are exploring the possibility that if seratonin levels can be reduced, by blocking the receptors in the mitral valves, then the progression of the deterioration of the valves and their leaflets can be slowed.

from Rod Russell's site:

http://www.cavalierhealth.org/mitral_valve_disease.htm


So definitely something you would want to be wary of with MVD...

kimy27
29th April 2010, 09:03 PM
Okay now i'm confused because I'm pretty sure I heard the vet saying that Bailey would probably NEED tramadol when she is older FOR her heart. She wasn't my usual vet though and I was surprised when she said tramadol would be the next step as this wasn't in the notes we got from Baileys neurologist. Her instructions were to go from furosemide to metacam to gabapentin.

Now she is on furosemide, metacam AND tramadol which seem a bit much to me. Maybe I should ask my usual vet for her opinion. The thing is though, the vet that gave Bailey the tramadol is a lot older and more experienced that my usual vet so I don't want to be stepping on any toes.

Nicki
29th April 2010, 10:31 PM
Tramadol is not a medication I would think of in connection with MVD - I can't even think of a similar sounding one that you might be confusing it with...


Frusemide is often given in conjunction with other drugs - have you seen Clare Rusbridge's treatment protocol http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

Maybe you could print it off to take in to your vet?


I think I would also want to get the neurologist involved with a treatment protocol...the vet should really be following their instructions or going back to them for help.

kimy27
29th April 2010, 10:51 PM
I see in that treatment protocol gabapentin is the next step up from metacam with tramadol coming after that :confused:. It was silly of me to see another vet... I'll call my regular vet tomorrow and see what she thinks.

Cathy Moon
30th April 2010, 12:49 AM
I see in that treatment protocol gabapentin is the next step up from metacam with tramadol coming after that :confused:. It was silly of me to see another vet... I'll call my regular vet tomorrow and see what she thinks.

When our Charlie was still alive, he was treated by neurologists, and he was given Gabapentin as his main pain drug, with Metacam used only as needed on bad days. As his SM condition progressed, he was then given Tramadol in addition to Gabapentin and Amantadine, when those failed to ease his pain (we also tried acupuncture). This was at a very late stage in his disease. It seemed to me that our vet would only use Tramadol as a last resort.

Now our Geordie has SM. First the neurologist prescribed Gabapentin as the main drug, with Metacam as needed. The vets and the neurologist do not want to give him Tramadol. Perhaps it is because of his MVD, but they didn't say. Now Geordie takes Lyrica.

EddyAnne
30th April 2010, 04:09 AM
I would be interested in hearing what veterinarians and even specialists may say about Cavaliers with MVD taking Tramadol, and keep in mind that they may not have heard about the research that found Cavaliers with MVD had excessive production of Seratonin. A google search appears to indicate some technical stuff about Tramadol and Serotonin. Tramadol may be being used for some Cavaliers with SM but if they also have MVD then maybe Tramadol might not be advisable, but maybe it is advisable if the Cavalier does not have MVD. I would be interested in what the veterinarians and even specialists may say.
.

Karlin
30th April 2010, 11:44 PM
Most neurologists would suggest trying the initial basics that you have tried, but these don't generally seem to work for many of the people I have heard from or who have posted on forums with SM dogs. I wouldn't consider gabapentin 'the big guns' but pretty much the normal main drug that does really seem to help most dogs with this condition. As the neurologist noted, something like tramadol is sometimes added when gabapentin alone doesn't seem to help, or metacam etc on top of the gabapentin.

As Nicki notes the vets should really follow the specialist's advice. Maybe bring in Clare Rusbridge's treatment diagram? Also you can just be firm and say you would like to follow the neurologist's recommendations and now do a two week trial of gabapentin at the starting dose. I'd never be afraid to be firm on what you would like to do next in acre for your dog, not least when you wish to follow your own specialist's specific recommendations. :thmbsup:

There's often a lot of trial and error to get medications just right. And then further adjustments as you go along.

Thanks too for previous posts on Tramadol and seratonin levels.

kimy27
1st May 2010, 09:34 AM
I spoke to my regular vet yesterday and she said the other vet probably gave Bailey the tramadol because they don't actually have gabapentin and would have to order it in. I explained to her about Claire Rusbridge and the treatment protocol and how gabapentin is the medicine that most SM dogs take. She wasn't aware of any of that but took a note of Claire's name and said she would look her up.

It just surprises me how little vets seem to know about SM but I am glad that I have a vet who is willing to listen to me and do a bit of research.

I have agreed to keep giving Bailey the tramadol over the weekend and if I don't see any improvement to give my vet a call and she will order the gabapentin. I also intend to print off the treatment diagram to give to her. Hopefully once she has read up a bit on Claire Rusbridge she will see why gabapentin is probably the best next step to take.

harleyfarley
2nd May 2010, 01:45 PM
kim

I dont know if you know but gabapentin is a human drug and not ususally for animals thats why vets dont stock it as a rule, get her to write you a precription and take it to your chemists, I know lots of people that do that, and you only pay the prescription charge, i was sceptical at first but my chemist did it without no problems. di

Karlin
2nd May 2010, 02:29 PM
Yes normally they do not order it in -- they write you a prescription. Yu can get it much cheaper by going to a good online UK pharmacy generally or shopping around and ask for generic gabapentin rather than Neurontin. If they have an issue in giving you a prescription, I'd go to a different vets as giving you the prescription would be the norm.

I would strongly suggest giving your vets Clare's website address as this will give them plenty of information on SM and they can download relevant documents themselves.

http://www.veterinary-neurologist.co.uk/

Also you can send them to:

www.smcavalier.com
www.cavalierhealth.org

kimy27
2nd May 2010, 11:20 PM
Thanks. I didn't know they could write me a prescription and my vet certainly didn't say thats what she would do. She said they would order it in. I will say to her about the prescription and hopefully it won't be a problem.