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Pixie28
7th September 2011, 11:56 AM
Hi,

I'm new here. I have a very small Cavalier who weighs only 4.8kg (she was the runt of the litter) She has been diagnosed with SM and put on 50 mg Gabapentin as well as Metacam.

I have been ringing round the pet chemists online to see if I can get it cheaper, as it is £135 a month from the vet! h*lp

Everywhere that I have phoned, say there is no such thing as 50mg and the lowest dose is 100mg. I know there is a 50mg as she is on it. I can't seem to find anywhere who does it.

Does anyone know anything about this or has anybody had their dog on this dose?

Thank you in advance

Kate :)

Nicki
7th September 2011, 12:36 PM
Welcome to the forum and sorry to hear about your wee one - you will find lots of help, advice and support on here as sadly many of us have either had or still have dogs with SM.

I'm presuming you are in the UK? according to the British National Formulary Gabapentin is only available in the following sizes 100 mg, net price 100-cap pack = £3.57; 300 mg, 100-cap pack = £8.83; 400 mg, 100-cap pack = £5.53 [the prices quoted are net of VAT and are usually correct, they show the huge markup there is on drugs, but remember that veterinary practices rely on income from drugs to support the practice, otherwise fees for consultations etc would have to rise considerably. They also have a legal responsibility for the dog for medication they prescribe.]

I suspect that the price you are paying is due to it being specially compounded to obtain this dose. You can compound it yourself, you can obtain empty capsules from a pharmacy or even on E-bay now! You can tip the contents of a 100mg capsule onto a piece of folded paper, and then carefully tip half into a new capsule and half into an old one, and reseal. It's a bit fiddly but doesn't take too long to do. [At one point one of my Cavaliers was on an epilepsy drug and there was a manufacturing problem, so we could only obtain very high dose capsules - I had to split each capsule into 6 doses :yikes] Of course you will need to get the 100mg capsules or a prescription from your vet for which they may charge, ask them to put repeats on it too, and you can obtain the drug from pharmacies - I think Boots the chemist is one of the cheapest right now. Your vet may not be too happy about you splitting capsules, as it's impossible to be totally accurate, but if you are very careful it balances out over the course of a day or so.

I think Gabapentin is available in a liquid form in other countries, but not the UK - it is not recommended as it is very irritating to the gut lining, another reason why this drug should only be given in sealed capsules.

BTW anyone can register to access the BNF :) http://bnf.org/bnf/bnf/current/129255.htm#_129255

Have you seen a neurologist? Really they are the best people to see as they have experience with SM and are able to do a full consultation. Also have a look at http://sm.cavaliertalk.com/ and http://www.veterinary-neurologist.co.uk/ [from where you can download a treatment alogirthm - under Syringomyelia, downloadable PDFs] It is usually recommended for your dog to be given one of the CSF reducing drugs, Clare Rusbrdige recommends Zitac [cimetidine as being the gentlest for long term treatment]

Hope this helps

BrooklynMom
7th September 2011, 12:42 PM
Have you tried calling the human pharmacies? Not the animal ones? I get Brooklyn's at a people's pharmacy. But she is on 100 mg...I have no idea about 50mg, sorry! I would just say try the people chemists and see how you go, they can sometimes break it down smaller for you if they are a compound chemist (if it does not exist).

There will be some good advice from other board members for you too I am sure :)

On a side note, what a tiny little cav :) I would love to see pics if you get around to it.

Pixie28
7th September 2011, 01:18 PM
Hi, thanks for your reply. I have rung round loads of vet pharmacies but not tried human chemists. Is it exactly the same drug?
I rang the neurologist to ask and apparently where she went, they make it up themselves.
I shall keep trying. I found 100mg for £14 and I am paying £135!!!

Here are a couple of pics of little poppy! I also have a ruby and a jrtXcav

http://tapatalk.com/mu/56a52813-52dc-56f5.jpg


http://tapatalk.com/mu/56a52813-5209-9856.jpg

Nicki
7th September 2011, 01:21 PM
She's very sweet :grin:


Yes it's exactly the same drug, it's a human drug that is not licensed for use in veterinary medicine like many other human drugs [they probably won't ever be licensed as there is not a large enough market for it to be profitable for the drug companies to do this] , however it has been used for some time now.

You are more likely to be able to obtain it from general pharmacies.

Can I ask who quoted you £14 that is a good price!

Pixie28
7th September 2011, 01:43 PM
It was HyperDrug who said £14 or thereabouts. It was for the 100mg's.

Very good price!

Pixie28
7th September 2011, 01:46 PM
Oh that's strange. I had a post with the photos on but it has disappeared!!

Nicki
7th September 2011, 01:54 PM
Thanks for that - I think some people have had problems with them saying that they have it and not delivering :(

Just found your photos post and approved it so you should be ok now!!

BrooklynMom
7th September 2011, 02:25 PM
Oh she is adorable!!!!

Yes, the drug is the same in a human pharmacy. My Cav gets hers from a human pharmacy :) And it will likely be cheaper and they will help you with how to make or get a 50mg tablet. If a regular human pharmacy can't help, call a compound pharmacy (still a people pharm)...they make blends and unique drug sizes. I have used compound pharmacies for my own weird medicine strengths :)

Good luck and welcome to the boards!!! Poppy is so adorable.

Karlin
7th September 2011, 03:11 PM
There definitely isn't a 50 mg form manufactured, but as others said, you can either split a capsule (which is what I did back when one of my dogs was on that low a dose) or use a compounding pharmacy. I had never even heard of compounding pharmacies until I had Cavaliers with SM! I suppose one thing to keep in mind is that often that low a dose isn't adequate, or becomes inadequate over time, so I wouldn't buy massive amounts if it is costly to compound at that dose. I don't know of very many dogs that have remained on the dose that low, although it is the initial trial dose for dogs. Often it needs to be increased pretty quickly if it's not managing scratching and other symptoms, or more typically, the drug loses its effectiveness over time (at which point a related drug in the same family, Lyrica–the generic name is pregabalin– can be very effective and actually tends to work better as it is the more advanced version of the same kind of drug and can be given at a much lower dose).

I am really shocked at the amount your vet is charging though–I suppose they are ordering in themselves from a compounding pharmacy and then will charge so that they make some profit off of doing this on your behalf, which is fair enough, but those are extortionate prices. My vets don't even offer this particular drug, because it is the human drug–they just write me a prescription and I take it into my local pharmacy.

Pixie28
7th September 2011, 06:51 PM
Thank you for all your help. I just called in to my local Lloyd's chemist and they said that they are not allowed to give medicines for animals!

I rung the neurologist and he was really rude, asking why on earth I want to get it elsewhere and what is my problem.:mad: This is a different neurologist to the one I saw with Poppy, but at the same clinic.

I am going to ask on the next appointment in two weeks if I can have 100mg's and try and split them.
I think it is the only way!

Thanks :)

BrooklynMom
7th September 2011, 11:39 PM
Out of curiosity, where do you live?

A pharmacy might not think about "drugs for pets", but since this is actually a human drug, all you need is a prescription technically. Maybe try a few more places, explain that you need the human form.

Tough one! Because you shouldn't have to pay that much. It might also be worth a frank discussion with your neuro about costs and how it is too much for you to pay. Maybe you can mention that you have some friends who you know that pay a lot less for the 100mg tablets. You could also ask if you could buy from the pharmacy he gets the meds from directly to save costs. Most neuros/vets will listen if you just talk openly and kindly because it is all about keeping our cavs pain free and if it costs too much to do so, well, that doesn't work for anyone. Especially now that you know we all pay so much less, just tell him you can't afford this dose at this price and ask what he can do to help.
Also ask if he ever links up with human pharmacies or if he could for your sake.

How does your pup go on the 100mg? Is there still scratching/symptoms?

Margaret C
8th September 2011, 12:33 AM
Thank you for all your help. I just called in to my local Lloyd's chemist and they said that they are not allowed to give medicines for animals!

I rung the neurologist and he was really rude, asking why on earth I want to get it elsewhere and what is my problem.:mad: This is a different neurologist to the one I saw with Poppy, but at the same clinic.

I am going to ask on the next appointment in two weeks if I can have 100mg's and try and split them.
I think it is the only way!

Thanks :)

I would think it would be obvious what your problem would be, or is your little dog insured and so he cannot see why you object to being ripped off?

My SM cavalier Tommy was on gabapentin until the beginning of this year and I find the price you have been quoted unbelievable.

If you are in the UK you should ask your vet for a private prescription for 100 mg capsules & then split them. A vet cannot refuse to give a private prescription but they can charge you for it ( My vet charges £7 )

Tommy is now on Lyrica ( pregablin ) 75mg twice a day, and as the tablets cost approximately £1.50 whatever the strength, my vet prescribes 150mg capsules which I get from Tesco & cut in half.

Tommy is not insured so it is a considerable saving.

You can buy 100mg tablets gabapentin on-line from Chemist Direct at 25p per tablet, but their delivery times can be unreliable.

Hyperdrug ( Canine Chemist ) were reasonably priced at about £14, and very helpful, but you need to contact them by phone, and Tesco is also usually very good but the price can fluctuate sometimes.

You are welcome to PM me if you want more information.

Pixie28
8th September 2011, 01:03 AM
Thank you for all your input.
Have you had any problems with Tesco or any other pharmacies when you give them the prescription? I was asking the pharmacist and as soon as I mentioned it was for a dog, she said, "well now you've told me that, I can't do it for you"
How do I go about getting the tablets from a human pharmacy when it is for a dog?

Also, I did have insurance and it has all gone. It was per condition and all the money went on the MRI etc. :( I am having to pay for the medication.

Oh and I am in Norwich. I took poppy to Newmarket to have her MRI.

K x

Pixie28
8th September 2011, 01:06 AM
And I forgot, in answer to your question, she seems alot brighter since taking the tablets but you can tell she needs them as when 8 hours come, they start to wear off and the scratching starts again. Another thing I found strange is that this other neurologist i spoke to said to cut it down to x2 50mgs a day instead of 3 to save money. I thought they had to be 8 hours apart? X

BrooklynMom
8th September 2011, 01:31 AM
Okay...thanks for that additional info. I am in Australia, so I cannot help you on how to deal with the pharmacies over there, but there are a lot of people on here in your area that may be able to give you advice on that and what they did to get their perscriptions. My pharmacist just took the prescription, but I am sure it will be a bit different there considering it is a different country. Call some other places though, maybe try Tesco? And some other pharmacies. Maybe some people from the UK can let you know where they go and you can call those places (either for pick up if they are close to you or for delivery).

If you dog is on 3x per day dosages, and she is doing well, I would not drop it down! But that is just my opinion. That is strange that he said that, but that was not the neuro that saw Poppy first right? Just listen to the one you see all the time. My cav is on 2 x per day, but that is because she is just starting out and has not gone to 3x yet (though, I am noticing her scratching return 2 hours before her next does which is why I am thinking she will have to go up...but we are in trial and error phase with lots of stuff. It is supposed to last for 8 hours, but again, there are others who are much more knowledgeable on this than me who will probably respond and help you.

Keep on eye on here to see what others in the UK do, and keep investigating. It sounds like from others that have responded in the UK area, that you should be able to work this out. Good luck!