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CavyMom
30th May 2010, 06:19 AM
Hi, I was an active member on this forum a year or two ago, and got busy with other things on my life and didn't get on much. I'm now back to seek the expertice and advise and am praying some of you may be able to help me find a way to help my beloved Amber.

Some back ground - In February of 09 I took Amber to a UKC dog show in Utah, she did beautifully but upon returning home (at the time in Las Vegas, a good 8 hour drive) I first noticed Amber just wasn't right. She was hiding in her crate when I got up the next morning and I became very concerned, Amber always slept on the bed, I'd never known her to hide like that! When I tried to get her to come out and gently tugged her collar she just screamed, when I coaxed her out she was holding her neck funny, and seemed painful everywhere. I took her to the vet that said it was just a pinched nerve, put her on steroids, and she did improve for a while, but has never been the same since. Usually a few days on Rimadyl, and Tramadol as well for really bad episodes has her back to normal in 2-3 days.

Amber has always been a fly chaser (usually imaginary, ESPECIALLY if she's outside - She'll spend HOURS chasing nothing at all if I don't make her come back inside!), air licker, and air scratcher. All I've read now can be big red flags for SM.

Now fast forward 16 months, my poor Amber is once again having a very bad episode, usually these have been triggered by something (to active the day before, a trip, a change in our routine, etc), but this time nothing at all has changed, and I can't touch my dog anywhere above her shoulders or she just screams, and it's just killing me! I can't stand seeing my dog in pain like this, I love her to much!!! This dog is my heart dog, she has been my loyal and loving companion since the entered my home, I've got her on the Rimadyl and Tramadol as I have in the past, but it doesn't seem to be helping her much, and all the vets here seem to want to do is treat the pain, but I'm not convinced this is just a pinched nerve, especially after a year and a half and it hasn't gone away!

What are others opinions, does this sound like SM? Is there anything I can do for my dog? Is there a way I can find a vet that would know the symptoms and could help me determine if that's what is causing Amber's pain and discomfort? I have a kind of tight budget right now, I can't afford thousands of dollars for an MRI, but I will spend what ever it takes to get to the bottom of Amber's problems and get her some relief! I am so afraid if I can't find a way to help her soon I'll be left with no choice but to put her down, I can't just let her suffer, but that is the LAST thing I even want to consider, I love this dog more then anything else and want to help her, but if there is nothing that can be done to relieve her pain I will not just keep her alive in pain and suffering like she is! I took her to the vet today, and he just told me to continue with the Rimadyl and Tramadol. I've gone to several vets over the last 16 months, and none of them have offered me anything better to help her, I don't want a quick fix, I don't want a pain killer, I want an answer to the CAUSE of her pain so I can seek out treatment options to improve her quality of life!

Nicki
30th May 2010, 02:16 PM
Yes of course we remember you - I'm so sorry you are going through this. Very sadly it does sound like SM, and Amber may need different medications if this combination is not working.


Have a look at http://sm.cavaliertalk.com/ and http://www.veterinary-neurologist.co.uk/, there is information you can print off to take to your vet, also a treatment diagram.

I think the best thing is to get a referral to a neurologist, even if it's just for a clinical exam - at least then you should get a more definite diagnosis.

Keep us posted - it's so hard when you have this strong attachment, but you are right, you have to put Amber first, no matter how hard that is - it's not fair to keep them going for us.

I hope that with more informed veterinary care, that Amber can be made more comfortable.

Holly
30th May 2010, 03:35 PM
I'm sorry you are going through this, as well. I was 99.9% certain that my girl was displaying signs of SM and an MRI wasn't in the budget for me as they are $2,000+ here. I took videos of her behaviors and got her an appt with a neurologist. She agreed that it is most likely SM and we started her on meds (Gabapentin, Previcox, and Prilosec). This has helped her a great deal. Try to get her in with a neurologist as Nicki said. I would also try to get her on Gabapentin. (By the way, my girl also fly-catches imaginary and real flies compulsively!)

Here is a list of board certified neurologists in the US (some of them do offer reduced rate MRIs):

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

CavyMom
30th May 2010, 03:40 PM
Thanks Nicki and Holly, I kind of had a feeling that's what would be said. I'll print that stuff off and take it to my vet tomorrow, I'm in northern Utah now, I don't know if there is a neurologist in this area, but I'll sure ask my vet about it and find out! If it's a drive, maybe he can get us started and get her doing better, the way she is right now I think a long drive would just be to torchurious! But maybe if I can get her on different meds and get her feeling somewhat better in a month or so a trip to see a neorologist may be possible if there's not one close by that I just don't know about!

CavyMom
30th May 2010, 04:54 PM
I'm sorry you are going through this, as well. I was 99.9% certain that my girl was displaying signs of SM and an MRI wasn't in the budget for me as they are $2,000+ here. I took videos of her behaviors and got her an appt with a neurologist. She agreed that it is most likely SM and we started her on meds (Gabapentin, Previcox, and Prilosec). This has helped her a great deal. Try to get her in with a neurologist as Nicki said. I would also try to get her on Gabapentin. (By the way, my girl also fly-catches imaginary and real flies compulsively!)

Here is a list of board certified neurologists in the US (some of them do offer reduced rate MRIs):

http://www.cavalierhealth.org/neurologists.htm
Thank you for the link Holly, I need to do alot more research on this disease again obviously, one thing that caught me off guard was the Prilosec, isn't that a medicine usually used for heartburn, or am I thinking of the wrong medicine?

I looked at that list of Neurologists, unfortunatly it's just like I feared - The closest one is about 2 hours away from me :( I really don't think Amber is up for a 2 hour car ride at this point in time! But I'm going to take some of the information you two have just given me into my vet tomorrow and see if I can get her on Gabapentin, Prilosec, and Previcox, and hopefully that'll bring her some relief so in the next month or so I'll dare take her for a car ride and can get her in with the neurologist!

Holly
30th May 2010, 05:06 PM
If I understand correctly, in SM dogs, drugs such as Prilosec or Tagamet reduce the flow of the crebral spinal fluid. I was told by neuro to do 10 mg a day (1/2 of a Prilosec) but her stomach got a bit upset with it, so we reduced to 5 mg a day (1/4 of a Prilosec). I buy the generic which is Omeprazole and it's relatively inexpensive.

You can purchase Gabapentin at Costco-- that is the most cost effective price I have seen. Previcox comes from the vet, but I buy the larger pills (227 mg) and divide it into 8 pieces. She gets appx 29 mg a day, but I was told this can also be a bit higher dose if needed.

Of course, definitely check with your vet on all of this but this is the regime that has worked for us:

Am
Gabapentin (100 mg) and Previcox (29 mg)

Afternoon:
Gabapentin (100 mg) and Prilosec (5 mg)

Bedtime:

Gabapentin(100 mg)

Karlin
30th May 2010, 05:47 PM
Hi and so sorry you are posting with these worries.

I would really advise getting her to the neurologist absolutely without delay -- 2 hours should be manageable if you talk to your vet and can get her back on steroids and tramadol for example. Or can get her started on gabapentin. I think you are talking about a very, very urgent situation -- I cannot stress enough that you are describing quite severe symptoms where every day of delay may mean you have no options left for her very soon. The Cavalierhealth.org list of neurologists is good and notes those with experience. I'd at least call the neurologist's office, describe what is happening, and see what they think. I am sure they will try to fit you in immediately. Perhaps they will advise your vet on some immediate medication to ease her pain and make the drive more comfortable, if your vet is uncomfortable prescribing something like gabapentin. It would be wise to get advice directly from the neurologist by phone. Please let us know how the visit goes. :flwr:

PS I would agree with getting her on prilosec or tagamet til you can see a neurologist, both available in the US over the counter -- talk to your vet about this and use Clare Rusbridge's document on dosage. This might help right away as well and are well tolerated by dogs.

CavyMom
30th May 2010, 05:50 PM
Thanks Holly! I know I can get Prilosec without a prescription, can I get the Gabapentin without one, or do I need my vet to get me one before I go to Costco?

Nicki
30th May 2010, 09:42 PM
You will need a prescription for Gabapentin.

CavyMom
30th May 2010, 09:54 PM
Thank you everyone for the great advise! I'll call that neurologist tomorrow and see if they're even open (since it's a holiday), if they aren't, I'll call Tuesday and discuss Amber with them. In the mean time, I'll go get some prilosec and get her at least started on that, and get her into my regular vet tomorrow to see if I can get her put on the other meds until I can get her to the neurologist. Thanks again for everything!

CavyMom
1st June 2010, 06:42 AM
Thank you again everyone for the great advice! I did get Amber back in with my regular vet today, I took in a bunch of information on SM to him, as well as treatment guidelines, medication guidelines, etc that was provided. He gave me a 2 week supply of the 2 medications, and had me go to Walmart to pick up the Prevacid. We'l see how she does with that, if I notice a big improvement, we'll continue with it, or maybe up the dosage. In the mean time, I did leave a message at the neurologist, they didn't seem to be open today, so hopefully they'll call me back tomorrow, if not I'll call them back. My vet said he'd read up on the information I gave him, and review his exam and history notes on Amber, but he said based on what I'd told him and the research I'd done on my own, he agreed it's likely that she has SM, and where she hasn't been responding well to the treatments we've followed so far, it'd be a good idea to start treating her like she does have SM and do what we can to provide her relief. I love my vet - He'll listen to what I'm telling him!!!!!!! Sadly, I wish I'd moved back to Utah when Amber started having problems, the last 16 months or so have been hard, going from vet to vet, not one of them listening to my concerns when the problem seemed to slowly get worse with each relapse! Now that I'm back under his care, I'm sure I can make sure she gets proper treatment and medical care, but I also think this is out of his relm of expertice, so I will continue to persue the neurologist and hopefully get her an appt with them soon!

Just in the 12 hours or so since I started her on meds, I'm already noticing a slight difference, she's not as restless, and for the first time in about a month, she actually took a nap with me without constantly shifting and moving around! Small step in the right direction, her whole expression looks much more relaxed then it has the past week or so. Hopefully that's a sign the meds are starting to do their job and bringing my poor baby some relief!

Zoe bowie
1st June 2010, 07:55 AM
Oh I'm so glad you are seeing Amber a little more relaxed, hopefully these medications will work for her. Keep us updated & hopefully the neurologists will get back to you soon. Sending you & Amber hugs :hug:

Karlin
1st June 2010, 12:34 PM
That's wonderful that you re seeing her get some relief :flwr:. Don;t be too hard on the vets; this is a specialist condition and most would have virtually no training in the area -- and as SM can only really be diagnosed by an MRI, something that is pretty much only done by specialists and which most vets o not know how to interpret, they'd be unlikely to know too much. Also, cavaliers remain a fairly uncommon breed in the US especially I should think in a state like Nevada (and anywhere away from the two coasts) so vets aren;t likely to even know the breed is predisposed to SM. Even vets over here where cavaliers are the most popular small breed still either know nothing or little about it and tend to miss a correct diagnosis (Clare Rusbridge surveyed clients and found it took well over a year on average after the point they started taking their dogs in for a problem, that it was correctly diagnosed as SM, so it can be a long and frustrating journey).

It is wonderful to find a supportive, interested vet. :)

Fingers crossed you can soon speak to the neurologist and then can get advice on what to do next.

Holly
1st June 2010, 03:21 PM
That's great news and sounds like a step in the right direction. This is such a sad disease and it's hard to watch when they are having a bad time. My sweet girl had a bad night last night (which is infrequent and I am not sure what sets it off. She was panting a lot, restless, and digging at my bed- all of which I have learned are signs of pain. She got all of her meds on schedule yesterday.) I gave her some Tramadol and she settled down and went to sleep and seems fine this moening. My vet gave me Tramadol too keep on-hand for bad times and it helps when I have to use it (not very often). You might ask about something like that when you see the neuro.

Good luck. Thinking of you and Amber!

Holly
1st June 2010, 03:24 PM
PS-- One more thing I found out... (my neighbor is a pharmacist at Sam's Club). He said they will price-match the cost of the Gabapentin and Tramdol with anyplace I find that is cheaper. If I'm not mistaken, I believe 90, 100 mg Gabapentin are $14.00 at Costco. Not sure if you have any of these whole-sale places near you, but that's a much better price than CVS or other pharmacies, where it's $35.00 for the same amount.

CavyMom
1st June 2010, 04:30 PM
Thanks again everyone for the support! You wouldn't think it, but cavaliers are actually a very popular breed here - I need to update my profile, I'm actually in Northern Utah now, but even in Vegas, there where cavs everywhere! Here almost every dog show I attend I see majors in cavaliers, and you can see them all over the place! Amber was born in England, and I'm told that certain english lines, including Amber's line, tend to be more prone to this condition, not sure if that's true or not!

Problem with Cavaliers in this area is since they are pretty popular, there are a TON of back yard breeders :( The vets here are pretty familiar with the heart problems that especially back yard bred cavaliers are very prone to, but the SM is definatly not something I can usually find a vet that's even heard of it. A lot of the vets I've used are so dead set it's a pinched nerve or something else they aren't open to any other suggestions. My little IG, Aiyana, was nearly killed by a vet that wouldn't listen when I told him that she wasn't responding well to his treatments, finally I left and went to a vet that listened to my concerns and picked up on the real problem right away! Good vets anywhere I think are hard to come by!

Anyway, I do have a Costco near me, so once I've at least spoken with the specialist and we know if Amber is responding to the drugs she's on right now I will definatly persue the Costco idea to make the meds a bit cheaper. I bet even the Prilosec I can get cheaper at Costco!

Amber also had a pretty rough, restless night, pretty much her normal the last little bit :( I have tramadol I keep on hand as well for her, which helped some, but right now it doesn't seem to really be enough to control the pain she's in :( I'm hoping a few more days on the new meds and they'll be a huge difference in her!!! This is the hardest part of owning a dog for me - I just hate seeing one of my babies sick or in pain! I'm hoping over the next couple weeks she'll start feeling better and go back to the happy - go - lucky girl I've always known and loved!

Love my Cavaliers
2nd June 2010, 08:13 PM
Although what is going on with Amber certainly sounds like SM, her symptoms were also similar to Oliver's when he had ruptured cervical discs. He wouldn't move out of his crate, hated to have anyone touch his head, neck, etc. He whimpered in pain all the time, wouldn't run, jump, or play and was just miserable, even while sleeping - and that was even when he was on prednisone and tramadol. He did not do fly-catching though. I took him to an ortho who referred him to a neuro who did an MRI, found the discs and then he had ventral slot decompression surgery with spectacular results. So, unfortunately with whatever you're looking at with Amber, a trip to the neurologist is in order. Getting on the right meds is critical. Riley, my SM dog, has only been helped by prednisone. I hope Amber starts feeling better soon.