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3cavies
30th March 2011, 03:15 PM
Recheck at the vet yesterday didn't go to well for Maggie. The medication has had no effect at all. If anything, she seems worse. We have an appt. with the Neurologist at Auburn University on Tuesday do discuss surgery:(

Kate H
30th March 2011, 04:35 PM
Hi Stacy

Sorry things don't seem to be going well with Maggie, but many people with SM dogs find that their medication needs adjusting over the first few weeks and months, so the neurologist may be able to suggest a different combination/dosage. For example, Gabapentin is metabolised (sent through the system) at different rates by different dogs; the average is about 8 hours, but averages mean that there are dogs who need the same dose but much more often and others that need it only twice a day. It's a bit of trial and error. So your neurologist may be able to make Maggie more comfortable by adjusting her medication while you weigh up the pros and cons of surgery.

Let us know what he says,

Kate, Oliver and Aled

Love my Cavaliers
30th March 2011, 04:59 PM
I'm so sorry Maggie hasn't responded to her medication. Riley didn't respond to any medication (Gabapentin or Prednisone) either which is why I decided to go the surgical route with her. For Riley, it was the right decision. Three years post op, she is a like a miracle dog. I didn't think she'd still be alive, but she is alive and doing beautifully.

Good luck at your neuro appointment. Maybe they'll decide to try a different cocktail of meds or different dosages before they recommend surgery, or like Kate said, to at least make her more comfortable. Let us know how Tuesday goes.

Pat
31st March 2011, 01:45 AM
To review - Maggie has been on gabapentin and prilosec for about a month now, right? What dosages? And she was on prednisone but for ten days only. Did she seem improved during those ten days? Would you consider another trial with adding prednisone or an NSAID assuming that her symptoms have increased? Is it worthwhile to try a switch to Lyrica to see if that makes a difference? Those are things that you could discuss at your neurologist appointment.

You indicated before that Maggie's only symptom was some scratching but she evidenced no pain. Do you think that has changed and she is now exhibiting pain?

The AL neurologist seemed to favor no surgery but meds only, while the MS neurologist was pro-surgery. Do you think that the AL neuro will change his mind and now decide that surgery is the best option? If that is the case, I'd really think seriously about having the MS neuro do the FMD. He has pretty extensive experience, and his swine tissue duroplasty seems to be superior in many respects as far as helping to prevent scar tissue formation. Do you have info on the track record and surgical techniques for the AL neurologist? I can't even find him listed on the ACVIM list of neurologists, so I'd want to do some major research on him to understand the pros and cons of using him for surgery. The pros and cons of the MS neurologist are pretty well documented, and I can share my personal notes and his speaker notes from the CE session of his that I attended.

Sorry for the 20 questions game - you don't have to answer them all; I'm just trying to give you some food for thought as you consider all of the aspects and options. I like to make an outline on paper to help me think through all of the ramifications when I have a big decision to make!

Pat

gyoselyn
31st March 2011, 10:23 PM
Stacy,
I'm so sorry that the medication is not going so well for Maggie. I totally agree with Pat's suggestion. Dr. Shores did surgery on Corey when he was still in AL and when he left we decided not to go to AL for the follow up check up because I couldn't find the neuro name that's replacing him on the ACVIM list of neurologists. So far Corey is doing great, a lot better than before the surgery. Hope this help and keep us posted.

3cavies
31st March 2011, 10:26 PM
Thank you all for your comments and such great information. It gives me alot to think about. I have a list of questions started for the Neurologist. I do hate the thought of surgery but am leaning toward it due to reading that since it is a progressive disorder results are usually better when it is done earlier. I don't want to wait until it worsens and possibly limits the results. Hopefully we'll have a clearer picture of her condition and what steps we need to take next after our visit. If anyone has found that not to be the case or has different information, please share. I want all the information possible, even thought I'm already pretty overwhelmed. So much is out there, I just want to make the best decision I can for her. Pat, she is still not in pain, but her scratching has increased and she only walks a short distance without scratching. Before it was only caused when she was on lead or you touched the side of her neck. Now she does it without anything provoking it.

Blondiemonster
2nd April 2011, 11:28 PM
Aw. Sorry to read meds have been ineffective. Personally i would also pursue surgery if meds didnt help and u see progression. Though the thought of the actual surgery is unbearable to me...

Sandrac
3rd April 2011, 07:08 PM
Sorry to hear that Maggie is not responding to the medication mix she is on. We had to play around with Minnie's medication quite a bit until we got the right mix.

She did not do well on gabapentin but when change to Lyrica(pregabalin) 50 x 2 a day it made an immense difference.

I certainly think it is worth while speaking to your Neuro about the medication options available.

It is such a big operation that personally I would not want to consider that as an option until all other routes have been tried.:l*v:

3cavies
6th April 2011, 10:06 PM
Just got back from Auburn with Maggie. Dr. Sorjonen changed meds to Gabapentin (100mg. once a day), Prednisone (5mg. twice a day), Omeprazole (10mg. twice a day), and Sucralfate (1g. twice a day). We go back in 2 weeks. If we don't begin to see an improvement by then, we will most likely move toward surgery.:xfngr:

mommytoClaire
7th April 2011, 03:35 AM
Praying you see improvement with the new regime.

Hugs to you both,

Cindy and Claire

Ddavis
7th April 2011, 10:41 AM
I hope this new lot of medication does the trick for Maggie.

Pat
7th April 2011, 02:18 PM
Gabapentin once a day? Is that right or a typo?

Pat

3cavies
7th April 2011, 03:17 PM
No Pat, that's correct. Her symptoms are still very mild compared to some. She shows no obvious signs of pain just the scratching. He did increase the Gabapentin from 25mg. to 100mg. Do you see that as a problem? This is my first experience with this, so any help is appreciated. Thanks.

Pat
7th April 2011, 04:56 PM
No Pat, that's correct. Her symptoms are still very mild compared to some. She shows no obvious signs of pain just the scratching. He did increase the Gabapentin from 25mg. to 100mg. Do you see that as a problem? This is my first experience with this, so any help is appreciated. Thanks.

Stacy, I'm an SM novice as I've not lived with an SM Cavalier, and I hope that Karlin and others will chime in.........but my understanding is that Gabapentin is effective for about 8 hours, and it is usually given twice or even three times per day for effective symptom relief. 25 mg once a day is kind of laughable, and I think that once a day dosage in general is just not going to give a good demonstration of whether or not the drug is going to be effective. I know that Maggie's symptoms are mild, BUT you are actually considering surgery because you have seen no improvement and perhaps even worse scratching. From my novice perspective, the neurologist has prescribed a high dose of pred (and has hopefully told you about side effects including throwing a dog into Cushings) and has moved from a "nonexistent" dose of Gabapentin to a low dose of Gabapentin.

Did he say why he added sucralfate? Also, PLEASE tell me that he instructed you to give sucralfate either two hours before or two hours after any food or medication. It coats the stomach and greatly interferes with the absorption of medications. And it should be given away from food also in order for it to work effectively.

Pat

P.S. My personal belief is that Gabapentin (and Lyrica) are much "safer" drugs than steroids or NSAIDs, so I know that if I personally had a dog with SM, I'd want to give a higher dose of Gab or Lyr in order to try to avoid pred and NSAIDS. But that's just me, I know too many horror stories from steroids and NSAIDs (and even some from diuretics), esp. because of my years in the canine kidney diet group and the CHF group and reading thousands of stories. And, on that subject, I'd also be monitoring much more aggressively than the recommended blood chem screenings if my dogs were taking pred, NSAIDs or diuretics on a long term basis.

Kathleen
7th April 2011, 05:53 PM
I agree about the Gabapentin. My Jade has fairly severe symptoms and what works best for her is Gabapentin 100mg 3x a day and she has to have Pred ( only 2.5 mg per day). The pred is a miracle drug for her and when we tried to wean her off it, her pain was much worse. I have the option of increasing the Gabapentin, but so far she is having a lot of good days. Jade is also on Puresis 10 mg twice a day. She can't take Omeprazole as it gives her bad diarrhoea. Hope this helps....

Love my Cavaliers
7th April 2011, 07:19 PM
It's so hard when you get so much conflicting information, but the dosing of gabapentin is really most effective when given every 8 hours. I actually was on it myself for migraine prevention and took 300 mg every 8 hours. I've also been on Sucralfate and what Pat says about timing it around food is the same information I was given.

You probably will notice a difference though with the huge dose of prednisone. Riley was on that dosage for a while and she was like a puppy. She had so much energy and her symptoms almost disappeared. Her neurologist only kept her on that dosage though for about a month and then decreased it to her current dosage of 5 mg a day which she has been on for about 2 and a half years. She also is on Denamarin to protect her liver and Pepcid to protect against stomach upset. She has her blood checked every 4 months. Like Jade, Riley needs the prednisone. It is a miracle drug for her also and I will take any and all side effects at this point, which luckily have been minor.

Good luck through this confusing time. Remember, you know your dog best. But you also have to have faith and trust in your neurologist. We're here to help and give our opinions, but mostly we are here to give you our support. There's no one magic prescription for every dog. Wishing you and Maggie the best.......

Kate H
7th April 2011, 07:38 PM
My understanding is that gabapentin is a pain preventive rather than a pain killer, so it needs to be in the body 24 hours a day. Dogs metabolise it at different rates, but the average is 8.5 hours. One dose almost certainly won't last 24 hours. 100g twice a day didn't really control Oliver's mild headaches; he does much better now he's gone up to 3 times a day. Perhaps your vet will up the gabapentin dosage when Maggie is eased off the prednisone? 'Among the skills required by vets is the ability to juggle' :badgrin:

Kate, Oliver and Aled

3cavies
21st April 2011, 10:31 PM
Just an update: The increased medication has again had no effect. Surgery is scheduled for Tuesday morning :( I didnt want to risk waiting and it progressing to a point that she was in pain. I hope and pray this is the right thing to do for Maggie.

Furrfoot
22nd April 2011, 05:17 AM
I will say a prayer for you both- I hope it goes well.

sins
22nd April 2011, 10:38 AM
We'll be thinking of her on Tuesday Stacy.
She's a young fit and otherwise healthy cavalier and perhaps going down the surgical route now,may give her the best chance of a normal life.
I guess there's no right or wrong decision regarding surgery...it depends on the patient and the surgical facility/resources available to you.
Just to echo what Pat has said about NSAIDs.
Daisy didn't cope well with Rimadyl...she's been vomiting twice daily over the last ten days and we've now stopped it.
Looks like Gabapentin from now on.
Sins

3cavies
22nd April 2011, 01:41 PM
Thank you all so much for your kind words and support. And Sins, my best to you and Daisy. I hope she feels better soon. :)

Love my Cavaliers
22nd April 2011, 04:07 PM
Oh, I'm so sorry that the medication had no effect on Maggie. In some ways it makes your decision to have surgery a little easier though. At least that's how I felt with Riley. Pre-operatively, no dosage of gabapentin or prednisone or anything else made any difference in her symptoms. After her surgery, she is well controlled on 5 mg a day of prednisone. It will be three years in June since her surgery - amazing. Please PM me if you just want to talk or you have any questions or concerns.

Tuesday will be the longest day for you, but you can spend the day on CavalierTalk and we'll chat with you and help you get through it until you hear from Maggie's neurosurgeon that she made it through surgery o.k. Just remember to keep breathing.

lovecavaliers
22nd April 2011, 11:52 PM
I will be thinking of you both on Tuesday sending tons of positive vibes your way. Your such a good mommy.

hugs to you both

Blondiemonster
23rd April 2011, 02:38 AM
It is really hard to have to go through the stress of a surgery like that... Please let us know the details of what happens Tuesday and after.. I wish u lots of courage and keep my fingers crossed for a smooth surgery. WE are here when u want to talk...
Big hug for maggie.:lotsaluv::lotsaluv:

anniemac
23rd April 2011, 03:35 AM
I'm so sorry and I will be thinking of you

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anniemac
23rd April 2011, 03:42 AM
Tuesday will be a long day but hang in there. Like others said there is no right or wrong, you are doing what you think is best. Stay strong. One person sent a picture of how they decorated the kennel for recovery. I thought it was a good idea. Hugs and paws crossed.

Sins I'm sorry to hear about daisy...

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3cavies
23rd April 2011, 04:47 AM
Thank you all so much !

penquite
23rd April 2011, 08:36 AM
Just to echo what Pat has said about NSAIDs.
Daisy didn't cope well with Rimadyl...she's been vomiting twice daily over the last ten days and we've now stopped it.
Looks like Gabapentin from now on.
Sins


Hi Sins
This rang a bell with me. My first boy who had SM did not do well on Rimadyl either. He was given Metacam and it did not cause any problems for him. Just a thought.

Holly
25th April 2011, 07:57 PM
Wow, I can't imagine giving my SM girl her Gabapentin only one time per day. I can tell as soon as it begins to wear off and it's time for her next dose. If I am even a little off schedule, she starts up with the scratching and bunny-hopping. As long as I keep her on a regular schedule, 3/day, (sometimes 4, depending on timing) she is kept very comfortable. Once a day seems like it would only exacerbate her symptoms because she would get relief, and then it would wear off after 8 hours and she would have to go a long time until her next dose.

And, I should have added.. good luck to you tomorrow!

Love my Cavaliers
25th April 2011, 08:40 PM
Good luck tomorrow Stacy.

sins
25th April 2011, 09:29 PM
Very best of luck tomorrow Stacy.I know it'll be an anxious time for you but we'll be thinking of you both and hoping for a successful result.
Sins

Charlifarley
25th April 2011, 09:41 PM
Best of luck tomorrow from us as well. We'll be thinking of you both and keeping fingers and paws crossed for a successful outcome

mommytoClaire
26th April 2011, 03:15 AM
Saying a prayer for you and your sweet Maggie.

Let us know how things go.

Cindy and Claire

anniemac
26th April 2011, 03:31 AM
Thinking of You and Maggie tomorrow

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3cavies
27th April 2011, 03:28 AM
Thank you all so much. The surgery lasted a little over 3 1/2 hours and they said Maggie did very well. She should be home by the weekend. The support of the wonderful people on this forum has been such a comfort and inspiration to me. I appreciate it more than you all know. Will post updates as we get them.
Thanks again,

lovecavaliers
27th April 2011, 03:33 AM
So glad to hear that Maggie is doing well. I can't imagine how tough of a day it was for both of you. I bet your counting the days till this weekend when you get to see your little girl again. We are all here for you, keep posting updates when you get the chance.
:lotsaluv:

jessie22
27th April 2011, 04:07 AM
I'm also so glad to hear she did well! I know it must be very hard to wait to see her again. She'll be oh-so-happy to see her loving mommy this weekend! Stay strong!
I'll be praying for Maggie to have a great recovery and for you to feel at peace until you are with her again. :)
--Jessie

Love my Cavaliers
27th April 2011, 04:16 AM
Oh, I'm so glad she's through surgery. I've been checking peridodically through the day to see if you had posted any updates. Glad to see she did well. Now you can sleep well. How are Jackson and Roxie doing? Are they missing her?

anniemac
27th April 2011, 04:36 AM
So glad to hear that. I'm sure its been a long day. Try to get some rest

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sins
27th April 2011, 11:04 AM
So pleased to hear she's come through it safely.:)
I'm sure she'll do even better once she gets home to familiar surroundings and can recuperate without stress.
Sins

gyoselyn
27th April 2011, 04:45 PM
So glad that the surgery went well! You're such a good mom to stay with her through all this and now you can breath :o. I'll be praying for her speedy recovery. Keep us posted when you get a chance.

mommytoClaire
28th April 2011, 04:17 AM
So glad to hear the news, let us know how she continues to do.

Ddavis
28th April 2011, 09:52 AM
Fantastic news that she came through the surgery so well. Can't wait till you get her home and you keep us updated on her speedy recovery to hopefully a painfree life.

3cavies
28th April 2011, 08:38 PM
Just an update: Maggie is still doing very well and is handling being weaned off the pain meds well. She has made several friends there and the vet students pet her and love on her every chance they get. She gets to come home tomorrow morning. :)

mommytoClaire
29th April 2011, 05:11 AM
Best news of the day!

Furrfoot
29th April 2011, 06:14 AM
Yay! We could use some good news around here, and that'll work! ;)

3cavies
29th April 2011, 06:57 PM
Maggie's finally back home after the surgery in Auburn. She is doing so well ! She's curled up beside me as I'm writing this. We have to keep her relatively still for a couple of weeks, which has already proven difficult as she wants to play with Jackson & Roxie. The Auburn University Small Animal Hospital was just awesome. Dr. Sorjonen and the staff there were so wonderful and we are very optimistic that Maggie will have a great outcome from the surgery. Thank you so much to everyone for your well wishes and kind words. It means alot.

Nicki
29th April 2011, 09:06 PM
Fantastic news that Maggie is home :jmp::jmp:

Remember to keep her quiet, I know it's very difficult - do you have an x-pen or similiar where you can contain her?

Love my Cavaliers
29th April 2011, 09:18 PM
Oh, yay!! Keep lots of crates around the house so that she can be where the action is and see Jackson and Roxie, but still be kept quiet. Riley's neurologist also said only 5 minute leash walks for elimination 4 times a day. And remember, even if she's curled up on your lap and seems to be content, if Jackson and Roxie take off after sometihing, she's likely to want to join in the fun once she starts feeling better.

So, glad she's home though. It feels so much much better to have them home where you can see how they're doing and you can take care of them. She must love it too. Lots of hugs and kisses!!

Karlin
30th April 2011, 12:51 PM
Great news, and fingers rossed now as she recovers. :flwr: Lots here have been through this and can offer help and advice.

susandavis1
30th April 2011, 12:55 PM
Relieved to hear that Maggie is doing well :wggle:

Blondiemonster
8th May 2011, 03:36 AM
How is maggie doing?

3cavies
8th May 2011, 06:00 AM
We go back for a recheck next week but Maggie's doing really well.

anniemac
8th May 2011, 06:02 AM
We go back for a recheck next week but Maggie's doing really well.

So glad to hear

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lovecavaliers
20th May 2011, 11:54 PM
How did Maggie's follow up visit go?