Which medication?

Hi ,I've recently joined this forum after my beautiful, 6 year old blenheim boy Rossi had been diagnosed,
with sm, by mri after 2 really bad pain episodes.We hadn't even heard of sm and hadn't recognised the symptoms of face rubbing and unexplainable yelping and lameness that he had displayed over the years. Rossi was my wedding present from my husband in may 2005, we are both 53 and been married before. It was love at first sight when I saw Rossi and I've adored him ever since. We feel so bad that we didn't realise what was wrong with Rossi because of our ignorance but as soon as he was diagnosed at ChesterGates referral hospital I vowed that I would do everything in my power to make his life as good and as comfortable as possible. Rossi was on Metacam and gabapentin but the neurologist told us to take Rossi off the metacam as it can affect the liver, longterm. Within days of this he had a couple of severe pain attacks so the vet and the neurologist said to put him back on it for a while. He has now been taken off it again and I can see the difference in him already, after a few days. He is so uncomfortable and doesn't know where to put himself. He runs about on his walks but afterwards he is very slow and hangs his head and is still rubbing and scratching. The gabapentin alone just doesn't seem to be enough on its own. We are not supposed to see the neurologist now until December.I don't know what to do. Should I ring and try to see him before then as I can't bear to see Rossi so uncomfortable. Does anyone else out there take their dog to ChesterGates and if so what meds are they on? Could anyone tell me what meds seem to work well for their dogs. I just don't know what to do.

I'm so sorry about Rossi and so sorry that his pain is not controlled. What is his dosage of gabapentin and how often does he get it? My SM dog only gets prednisone, gabapentin didn't work for her but it does for many, many dogs on this forum so there are other people who will be able to advise you better once they know how much medication he is getting. I would say it's worth a call to his neurologist to tell him how much pain he is in. No dog should be in pain from SM, there are just too many meds that are able to control their pain. If one doesn't work you try another, or you try a different dosage. I wish you luck.

cavluvver said:

Hi ,I've recently joined this forum after my beautiful, 6 year old blenheim boy Rossi had been diagnosed,
with sm, by mri after 2 really bad pain episodes.We hadn't even heard of sm and hadn't recognised the symptoms of face rubbing and unexplainable yelping and lameness that he had displayed over the years. Rossi was my wedding present from my husband in may 2005, we are both 53 and been married before. It was love at first sight when I saw Rossi and I've adored him ever since. We feel so bad that we didn't realise what was wrong with Rossi because of our ignorance but as soon as he was diagnosed at ChesterGates referral hospital I vowed that I would do everything in my power to make his life as good and as comfortable as possible. Rossi was on Metacam and gabapentin but the neurologist told us to take Rossi off the metacam as it can affect the liver, longterm. Within days of this he had a couple of severe pain attacks so the vet and the neurologist said to put him back on it for a while. He has now been taken off it again and I can see the difference in him already, after a few days. He is so uncomfortable and doesn't know where to put himself. He runs about on his walks but afterwards he is very slow and hangs his head and is still rubbing and scratching. The gabapentin alone just doesn't seem to be enough on its own. We are not supposed to see the neurologist now until December.I don't know what to do. Should I ring and try to see him before then as I can't bear to see Rossi so uncomfortable. Does anyone else out there take their dog to ChesterGates and if so what meds are they on? Could anyone tell me what meds seem to work well for their dogs. I just don't know what to do.

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I am so sorry your poor boy has got SM. There is a lot of us that are trying to keep our affected dogs comfortable and give them some quality of life.

There are some members here that have taken their cavaliers to Chestergate.

If it was me I would put him back on metacam while you get another appointment with the Neurologist to explore what other drugs may help him.
I feel no dog should be left uncomfortable when there is something that will give them relief. Better to chance a shorter life that is painfree than allow a longer life of discomfort and misery.

I think most of us have had to find by trial and error what will keep our SM dogs free of pain, and we have to keep adjusting and try larger doses & new medications

What dosage of gabapentin is Rossi getting? Some of the dogs have as much as 300mg three times a day. There is also a newer stronger drug called pregablin ( Lyrica )

I'll PM my telephone number, give me a ring if you want a bit more information.

Ross's medication

Thanks Bev and Margaret for your kind replies. It is so good to talk to people who know what I am going through. My life just seems to revolve around Rossi at the moment as I love him so much and I can't bear to see him in any pain, or any other animal for that matter. It's as if I am seeing him for the first time again but now knowing that a lot of the little things he does, that we thought were just querky parts of his character, are actually reactions to pain. It's as if we have a different dog. I constantly watch him to see if he is okay and I am driving my husband mad. He says that I need to chill out but I can't. When he has a good day it's like the world has been lifted from my shoulders and I feel deleriously happy, bordering on hysterical, such is the relief. This is why I know I will feel better when we get his meds right. Rossi is having 100 mg of gabapentin three times a day. But it doesn't really seem to do a lot. Although he has not had any more severe pain episodes he is doing a lot of rubbing and scratching and, as I have said, he is so restless and hides under tables and chairs etc. He used to fall asleep on my knee a lot or lie next to me on the sofa, on his back, and snore away while I tried to watch tv. But now he only stays for a minute and then he is off, trying to find somewher more comfortable or cool. I miss him. But I know that we just have to do everything we can to make his life as good as we can. I will take your advice and contact ChesterGates to see what can be done. Thank God for pet insurance, it's been such a help to us. I feel so sorry for anyone, and their dogs, who hasn't got it. Well thanks again and thanks margaret for leaving me your private message. speak to you soon, love Jackie :luv:

Most people with SM dogs find that it can take several weeks or months to get the balance of medication right. My Oliver was MRId at Chester Gates and we saw the neurologist several times after the diagnosis 2 years ago. We haven't been back since then, but our neurologist never seems to mind me or my vet ringing up to discuss any changes in medication, or possible new symptoms. So I would ring your neurologist and have a talk about adjusting Rossi's medication; he or she may want to see him, but may be able to suggest an adjustment over the phone such as an increase in the gabapentin dose, or using an alternative, or may want to have a chat with your vet. The people at Chester Gates (and this seems to be true of most if not all neurologists!) don't just see a dog for an official appointment and then ignore them; they continue to be concerned about how they cope. Obviously there are limits to what can be done over the phone, but it can be a useful first point of advice.

And all of us kick ourselves for not noticing symptoms of pain - even vets miss them, partly because there are so many different pointers (some dogs scratch, some never do, some have a lot of pain, some have hardly any - and most symptoms of SM can also be symptoms of other things). Hindsight's a great thing!

Kate, Oliver and Aled

Most people with SM dogs find that it can take several weeks or months to get the balance of medication right. My Oliver was MRId at Chester Gates and we saw the neurologist several times after the diagnosis 2 years ago. We haven't been back since then, but our neurologist never seems to mind me or my vet ringing up to discuss any changes in medication, or possible new symptoms. So I would ring your neurologist and have a talk about adjusting Rossi's medication; he or she may want to see him, but may be able to suggest an adjustment over the phone such as an increase in the gabapentin dose, or using an alternative, or may want to have a chat with your vet. The people at Chester Gates (and this seems to be true of most if not all neurologists!) don't just see a dog for an official appointment and then ignore them; they continue to be concerned about how they cope. Obviously there are limits to what can be done over the phone, but it can be a useful first point of advice.

And all of us kick ourselves for not noticing symptoms of pain - even vets miss them, partly because there are so many different pointers (some dogs scratch, some never do, some have a lot of pain, some have hardly any - and most symptoms of SM can also be symptoms of other things). Hindsight's a great thing!

Kate, Oliver and Aled

Rossi's meds

Hi Kate. Thanks for your support and I will be ringing ChesterGates to ask advice.

Hi there - so sorry that you are dealing with this disease, you are unfortunately not alone here!


i know that Metacam has a bad press for causing organ failure but I use it quite alot with |Ruby alongside her Pregabalin.
She has tests every 3 months to check her liver function/enzymes and urine tests and blood tests and so far so good. She has been on/off it for 2 years now and the longest stint was 2 months when she has severe back pain.

She has it on her bad days and it really helps her cope- like Margaret said Id much rather Ruby have a quality life where she can enjoy herslef than worry about drugs causing problems in the future.

Hi there - I haven't been on the forum for a while, I am so sorry to hear about Rossi.

It is a bit of a juggle with meds. Bonnie was diagnosed with SM when she was only 9 months and she was started on prednisolone and that controlled her symptoms till about 5 months ago, so her neurologist has also added gabapentin into her meds, at the moment she only needs 100mg twice a day, but we have the option of increasing it to 3 times a day, bear in mind that it usually only lasts for eight hours. I also have tramadol on stand-by for any of those bad days, luckily we haven't had any for a while. So I would defininately put him back onto metacam until you spoke to her neurologist about changing meds.

I agree with Karen and Margaret that I would much rather give Bonnie quality of life rather than worry too much about the long term effects of the meds.

All the best with Rossi

Paula, Bonnie and Molly

I am sorry to hear about Rossi. I would certainly want to see a neurologist earlier than Dec 3rd if he is living with this level of discomfort, even if it means trying to get in to a different neurologist at a different centre. Or I would ask Chestergates if you can adjust his meds up or add in other things -- if they have diagnosed him, they should be able to do this by phone as there are definite steps one takes in medicating. For a dog with the range of symptoms you describe, 100mg 3x sounds a very low dose of gabapentin. My most-affected dog would have far less noticeable symptoms but needs 200mg 3x and in addition, like many dogs with SM, takes a CSF inhibitor -- a drug that has the effect of lowering the pressure of the cerebro-spinal fluid which is likely to be what causes the formation of syrinxes. Typically Chestergates prescribes a CSF inhibitor like frusemide first, so I would ask them about trying frusimide or cimetidine or omeprazole. My fellow would also get metacam if he looks more scratchy (eg often when weather is changeable) and has tramadol for any emergencies -- eg real signs of pain. Some dogs are on tramadol daily.

There are also other drugs besides metacam. Did they see test results which showed a risk of damage from using it, or was this just a general point made? I occasionally use it. There are however many other options in painkillers, too.

There is much info on this condition on Dr Clare Rusbridge's website here, under syringomyelia:

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

One option might be to take in the treatment diagram to your vet and see if s/he will consider trying supplementing what Rossi gets with frusimide etc (though this makes dogs need to pee more so just be aware that Rossi may have some accidents initially -- most dogs need to get out about 30 mins after taking it:

http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

Rossi's meds

Thanks everyone for your kind advice. I am going to ring ChesterGates to have a chat about this as I have also talked to Tania who runs Cavalier Matters website and her dogs are on Zetac and gabapentin. I just know that Rossi needs something else. In answer to your question Karlin, there were no signs that Rossi shouldn't take metacam but, in his opinion, the neurologist didn't like the use of it longterm and Rossi had been on it for about six weeks.

My SM girl was on Previcox in conjunction with Gabapentin and Prilosec. The Previcox is very similar to Metacam (I was told) but is easier on their systems for long-term use. She was on it for about a year and a half. We took her off the Previcox, as the Gabapentin and Prilosec really seem to help.

Good luck!