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View Full Version : Ella's Decisions, Lyrica and Advice



anniemac
5th November 2010, 02:56 AM
Sorry for the long post.

Thank you all so much for all of your kind thoughts about Ella. I know you can not tell me what to do but I really need your opinions. I was first faced with the decision about Ella's eye. I will not go into much detail, but I went from a specialist to her vet. The specialist would not do the surgery without the marble which was costly. The specialist worked with her neurologist and at first we talked about Ella's prognosis with SM. Long story short, I talked to her vet because it would be less but he would not do it at first because of the risk (so he thought) and her SM. He talked to her neurologist and he told my vet that it would not cause any harm.

I debated and it was tough because she is already in pain and I felt bad for putting her through more when I know her days are valuable. Her vet said she is already in pain and it might make her feel better so I felt good dropping her off. We then talked and he said that if it is not bothering her, then he would recommend me focusing on her SM.

Ella is so strange and this condition is so hard and tricky. I talk about Ella and her severity but unless you are around her for a period of time you would not notice. I said just 2 days ago that it is so weird that she doesn't scratch, yet she will sometimes not walk and will get tired easily. She has difficulty walking up stairs. I just know, I can tell in her eyes and also her MRI in September was proof that it has gotten worse.

I was gone for a week and my friend who is real familiar with her kept her. A person we work with lives downstairs from him. I got many phone calls because that guy who has seen Ella several times but for brief periods was scared and thought something was wrong. I asked if there was a change in weather (which there was) later. My friend said that he was one of the people thinking I was making this up and that he told him that Ella is sick. You can not see it sometimes, but we know. It seems like recently she is not walking sometimes and is worse.

Then she will go chase a squirel. She will hide in a crate or was laying on the floor. She had been better since being on prednisone, but I know that can not be good long term. Her neurologist said I could try Lyrica. I went to pick it up and it was very expensive. With the surgery and everything, I was going to wait.

So here are my questions.

1) Can I try Lyrica for a brief period and go back to Gabapentin? I want to see if it makes a difference and I am going to be faced with the other choices.

2) Ella's MRI was not good with the progression and how she had surgery and was on medication, yet it got worse. Her neurologist said if it was his dog, he would try another surgery. The only other choice would be making her as comfortable as possible and facing the inevitable. (which that may be longer hopefully)

3) I have heard that the alphasonic really helped some people. It is very costly and would equal the same as the surgery but far less risky.

4) I have only gotten a few details but Dr. Dewey told my neurologist that surgery would be extremely intense and she will be unable to walk for a month or two and the risk is so much higher. I don't know if I want to put Ella through that.

As you can see I am all over the place and as Margaret Carter said it sounds like I have been on a rollercoaster.

Nikki, you said that Rupert had a trauma with a dog and made it worse. Would removing her eye help or is it something that is already done and might be why her SM seems worse. I have heard that in humans some people will develop SM from a trauma or injury.

I just want to make sure I am doing what's best for her. I am trying to plan for her future and don't know if ultrasound therapy to help the scar tissue would be better than putting her on Lyrica. I would do both but limited resourses.

Thank you so much.

Tania
5th November 2010, 09:06 PM
I am not an expert but if it was me, I would most definately keep Ella on Lyrica. Lyrica works in a slightly different way to Gabapentin and is the first drug to be approved in the treatment of Fibromyalgia. It works on specific type of nerve calcium chanels and has a more potent activity than Gabapentin. If you withdraw either drug suddenly this could cause fits, this has to be done gradually and really under the advice of your vet. I personally would not risk withdrawing something like Lyrica in favour of ultrasound therapy. There is not any reason to explore other therapies as an addition. I have recently been reading about the various treatments and how they work so maybe others will want to clarify or correct the above information. We are all still learning.

Molly and Dougall are definately affected by the weather, reading a lot of posts I know people here have similar experiences. You may also know recently, I had problems with Dougall, he went through a really bad patch, I have no idea why or what triggered it. It seems now, it never happened and he is quite comfortable.

Molly like Ella, never scrateched or shown any of the obvious symptoms, we thought she had joint pain and she could never walk very far and tired easily.

These poor dogs seem to suffer pain episodes, all we can do is watch and try and do our best for them.

Hugs to you both :hug:

anniemac
5th November 2010, 09:18 PM
Thanks Tania!

I have not started her on Lyrica. I was going to get it filled and obviously I had a lot on my mind these past two days. With her eye surgery on the back burner, I am going to put her on Lyrica. Her neurologist prescribed it for her so are you thinking it would be more of a problem to stop. I was just going to switch :sl*p: He did not say anything about gradually starting on that. Maybe its because Lyrica is stronger and to change is more of the problem.

So surgery is off, switching to Lyrica, and she is scheduled for an appointment for ultrasound therapy. I can at least talk to the Doctor and see. Just doing something is making me feel better. She is one of the dogs that reacts well to acupuncture (unlike Dougall). Let's hope Ms. December will be her for a long time :xfngr:

Tania
5th November 2010, 09:24 PM
When we were prescribed Lyrica, we were told to gradually introduce it over a period of a week whilst gradually withdrawing Gabapentin.

anniemac
5th November 2010, 09:31 PM
He prescribed it yesterday. He called it in and I have to picked it up. Well I went to pick it up and was shocked with cost so that's why I asked this. It might have instructions on it, but if it doesn't, then it might be better to call him Monday and get with him about all the drug recommendations.

Nicki
5th November 2010, 09:35 PM
1) Can I try Lyrica for a brief period and go back to Gabapentin? I want to see if it makes a difference and I am going to be faced with the other choices.

2) Ella's MRI was not good with the progression and how she had surgery and was on medication, yet it got worse. Her neurologist said if it was his dog, he would try another surgery. The only other choice would be making her as comfortable as possible and facing the inevitable. (which that may be longer hopefully)

3) I have heard that the alphasonic really helped some people. It is very costly and would equal the same as the surgery but far less risky.

4) I have only gotten a few details but Dr. Dewey told my neurologist that surgery would be extremely intense and she will be unable to walk for a month or two and the risk is so much higher. I don't know if I want to put Ella through that.


Nikki, you said that Rupert had a trauma with a dog and made it worse. Would removing her eye help or is it something that is already done and might be why her SM seems worse. I have heard that in humans some people will develop SM from a trauma or injury.




I think it would be the traumatic event itself - Rupert did not have any physical injuries, just the stress and trauma itself.

I was aware of dogs in the past who developed SM as the result of an injury.


question 1 - changing meds. Should only be done with supervision - vet or neurologist. You would be able to switch over to Lyrica, try it for a month or so to see how it went - and then switch back.


2 and 4 - this is a very difficult decision and one only you can make in consultation with [ideally] your neurologist. I personally would not want to put a dog through two surgeries - but do realise that that would then leave you in a palliative care situation, which is very sad. I don't know the success rates for 2nd surgeries - I don't think there is anything published. it might be worth contacting Sandy Smith, author of "For the love of Ollie" - I know one of her Cavaliers underwent a 2nd surgery. http://www.fortheloveofollie.com/index.php

3 - I have not used alphasonic - there is some information about it on Rod Russell's site http://cavalierhealth.org/syringomyelia.htm#--_post-surgery
Acupuncture might be something else to consider - it has been effective for some dogs.


I know that Ella is on a cocktail of drugs - but it really is a matter of experimenting to see what helps.

I did find a supplement that worked for Teddy for a long time - http://www.sashasblend.com.au/cb_pages/sashas_blend.php


Sorry just posted this and seen there has been a whole conversation in the meantime!! Can you get a prescription from the vet and get it filled somewhere else? Might be cheaper.

Nicki
5th November 2010, 09:48 PM
When we were prescribed Lyrica, we were told to gradually introduce it over a period of a week whilst gradually withdrawing Gabapentin.

You are right Tania, that's what we were told too. Although they are fairly similar, I think it would be safer to do this.

If there are not any instructions Anne, then maybe try to speak to your vet - or wait until Monday to speak to someone.

Jane P
6th November 2010, 07:55 AM
You are right Tania, that's what we were told too. Although they are fairly similar, I think it would be safer to do this.

If there are not any instructions Anne, then maybe try to speak to your vet - or wait until Monday to speak to someone.


I was told by Clare Rusbridge to do a straight switch from Gabapentin to the Lyrica which I did with no problems. (I have checked back on my emails to make sure this is correct.) She also said you can try giving half Gabapentin and half Lyrica to keep costs down but she was not sure how effective this would be.

Cathy Moon
6th November 2010, 05:34 PM
Our neurologist had us do a straight switch to Lyrica, and we didn't experience any problems with Geordie when doing this.

A half dose of Lyrica (25mg capsule) is so close in cost to a full dose (50mg capsule) that there wouldn't really be any savings.

Blondiemonster
6th November 2010, 07:14 PM
Hi Ella and Anne

I have been gone from the forum for a little bit, and catching up on some posts.
So sorry to hear Ella isn't doing well. It's not fair you have been going through this again after having to face the surgery and all that. ..
I totally understand about people not being able to tell. Its such a tricky thing and such a tricky disease. I am not sure what I would do if i were in your shoes (second surgery or not). I think I would probably be heartbroken either way..
It's so hard you have to make that decision for her and just which she could talk and tell you what she wants!!!
A little update on us here...
I understand it's hard to tell something is wrong for people who dont know your dog. Blondie seems like a "normal dog" as well. But when you know her then you know that on bad days she sleeps a lot, and can't run onto the stairs so well. It's very dependent on the weather. I have a feeling that since fall has come it's gotten a little worse. Not sure about other SM dogs on here..
She is still not scratching (if she does, it's at her ears) but she does yelp when picking her up or putting her down more then I would like too!. And once in a while she'll have a short yelp at night when sleeping (which her neuro says is due to a change of pressure in the fluid in brain). Which is defenitely a new symptom since her last neuro visit. Then there's weeks where she is happy and active and seems like a normal dog again. However, I can't say that I've seen an improvement in symtoms after the PSOM got resolved (she was completely normal then) but gradually, little by little I see some signs rearing up there ugly head. I am going to go see Dr West again for a follow up clinical exam in a couple of months, (unless she gets a lot worse,then Ill go sooner) and see if he feels medication is necessary. I will update him on the symptoms. Last time he didn't think she should be put on gabapentin yet, based on her pain refelxes during clinical exam. So all she is taken is omeprazole.When the time comes he him and I think it's time to put her on meds, then I am still not sure what ill do. Will I put her on meds for a while? Or opt for the surgery. I know Clare recommends surgery when meds aren't working anymore (not in all cases, but generally), but Blondie has a really really bad MRI and I just believe that once symptoms worsen, Gabapentin and pain killers are a dangerous route. Surgery will eventually be inevitable, and I don't want to wait until it doesnt help anymore. She is turning 4 in April, and I would love to have her around for as long as possible... I know with surgery, most people win at least a couple of years, if not more. Well, that is worth it to me... I can't even bear the thought off not being able to beat down this horrible disease... Big kisses and strength to you and Ella

Tania
8th November 2010, 10:33 PM
The main point I was trying to make was not to withdraw either drug suddenly as this could have an adverse affect, rambling on as I did, the message got lost.

We were told to initally replace the last dose of Gabapentin with Lyrica for a few days, then the replace the first and after maybe 4/5 days withdraw the middle dose completely.

kind regards

Nicki
9th November 2010, 11:01 AM
That sounds very sensible Tania - the advice leaflet says not to stop suddenly too.

Sandrac
9th November 2010, 12:00 PM
We were told to initally replace the last dose of Gabapentin with Lyrica for a few days, then the replace the first and after maybe 4/5 days withdraw the middle dose completely.

I'm changing Minnie over to Lyrica shortly and Clare Rusbridge has told me to do it as Tania has stated but over a period of 3 days, but to cut the middle dose of Gabpentin sooner if there is too much of a sedative effect.

Hope that the Lyrica helps Ella.:hug:

Jane P
10th November 2010, 08:01 AM
It's odd that we have all been given different advice. As lyrica is basically just a stronger form of gabapentin I thought it wouldn't cause withdrawal problems? This just goes to show that the most sensible thing is to always follow exactly what the vet treating your dog says at that particular time.:)

anniemac
15th November 2010, 11:23 PM
Thanks for all the replies! Happy to report that Ella seems to be doing better on lyrica! You know its good to know there are other alternatives especially when She seems to have tried a lot. Never give up hope. As Tania wrote about a doctor saying prognosis can never be determined.

Not that her neurologist gave one, but I never thought 3 months after 2nd MRI, medications still could help.

Take each day and tail wag at a time


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Reptigirl
16th November 2010, 01:13 AM
Happy to hear she is doing better on Lyrica!

Sandrac
16th November 2010, 10:43 AM
Thats great news.:)

lovecavaliers
16th November 2010, 12:50 PM
Great to hear Anne! I hope Ella has continued comfort and tail wags:lotsaluv:

Nicki
16th November 2010, 01:41 PM
Fantastic news, so pleased for you both.

Indeed, treasure each day and tail wag :lotsaluv:

Karlin
16th November 2010, 07:31 PM
Great news -- long may it continue to help. :)

anniemac
17th November 2010, 01:32 AM
The prescription says take 2 50mg 2 times a day. At first I just read it as one 50 mg and she seems good on that amount and not 100. I don't know if they wrote it wrong but hey 50 mg 2 times a day is working. Just in case, does that seem about right? Why would he write a prescription for 2 50 mg tablets instead of one 100 mg? I will continue with what is working. She seems to have more energy and is playing with her boyfriend who a month ago wouldn't :)

She will not leave him alone but a month ago she would want to be in a seperate room watching squirells. Well maybe she still would be if she could see squirells out the window :)

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