PDA

View Full Version : Gabapentin



cavluvver
5th October 2011, 04:24 PM
Hi everyone We are taking Rossi to Chestergates again on Friday as he has been getting worse. As you know Rossi was diagnosed in April by mri and has been on gabapentin 3 times daily with metacam for bad pain episodes. To be honest, although he hasn't had any bad pain episodes since he has been on it, his face rubbing and ear scratching hasn't stopped and have become more frequent and he has developed a bad limp on his front right leg. He can hardly move around after he has been resting and seems better when out for a walk. What are your experiences? Is gabapentin supposed to stop the scratching, rubbing etc.? I am going to ask the neurologist about a csf inhibitor as he hasn't even mentioned this to us and I know that most of your dogs are taking one. Our neurologist said thatRossi has a small syrinx, do you think that is the reason he has mentioned a csf inhibitor as he perhaps was going to suggest it if Rossi deteriorated?:-?

Kate H
5th October 2011, 09:44 PM
Did Rossi's MRI show that he had dilated ventricles as well as a small syrinx? My Oliver also has a small syrinx, but most of his problems come from his greatly dilated ventricles, which give him headaches and eye problems (he squints in strong light due to interference with the mechanism of his pupils). The dilated ventricles (rather then the syrinx) also seem to have affected the nerves in his right front leg, though this is much better now, 2 years on. I would definitely discuss a CSF inhibitor with the neurologist, as this could reduce the pressure of the ventricles (if Rossi has a problem here!).

Kate, Oliver and Aled

cavluvver
5th October 2011, 11:09 PM
Thanks for your reply Kate. Our neurologist never mentioned dilated ventricles to us so I don't know anything about them, but I will ask him about thyem on Friday.

Kate H
6th October 2011, 11:34 AM
When Oliver was scanned at Chestergates (this was just a mini-scan designed for breeders to know whether or not their breeding stock have SM - I'm not a breeder but just wanted to check on Oliver), we were given a certificate which showed the results of the scan at the bottom. There is a list of symptoms that are ticked if present: cerebellar herniation, dilated ventricles, syringomyelia. middle ear disease. If you were given a similar certificate, you will be able to see if Rossi was ticked for dilated ventricles (and how big they are - Oliver's are 3 times bigger than normal).

Kate, Oliver and Aled

cavluvver
6th October 2011, 02:14 PM
We weren't given anything at all Kate, Luca just told us that Rossi had syringomyelia and showed us the herniation and the syrinx and prescribed gabapentin.

Margaret C
6th October 2011, 02:27 PM
We weren't given anything at all Kate, Luca just told us that Rossi had syringomyelia and showed us the herniation and the syrinx and prescribed gabapentin.

If this was a full MRI scan for diagnostic purposes ( cost about £1,500- £2,000 ) then there will have been a report sent to your Vet and you can ask for a copy.

The continuing scratching and rubbing & now the limping would suggest that the SM symptoms are getting worse, and obviously the gabapentin is either not working well for Rossi or the dose may need to be increased.

My Tommy had to go from 100mg three times a day to 200mg x 3 when his symptoms worsened. He now needs Lyrica which I think could be described as a newer, stronger and more expensive successor to gabapentin.

cavluvver
7th October 2011, 10:37 AM
Thank you so much, Margaret and Kate for your very helpful advice. Rossi did have the full MRI. We are now off to Chestergates feeling much more informed and with a list of questions. We feel much more confident thatat we can make sure that Rossi is in as little pain as possible, thanks to you, your help is invaluable.:D

Ylan
7th October 2011, 02:31 PM
Hi all,

My Lily's on Gabapentine with Dexamethazone for the scratching. We saw a specialist dermatologist as well and the result was that Lily's also got dermatitis which causes her to scratch and rub her nose aand chin, lick her paws etc. This doesn't explain the limping (unless he happens to have a self-inflicted via too much licking or accidental injury) but it might also be at play. Additionally dermatitis can make them more sensitive in their ears (where there is of course skin too) and where your dog may or may not also have PSOMS which could have shown up on the MRI.

Good luck with it. It's hard to narrow everything down but try and stay hopeful; it might be a more benign and more easily treatable cause.
Ylan

Kate H
9th October 2011, 04:51 PM
Hi

How did you and Rossi get on on Friday?

Kate, Oliver and Aled

sarahsum
9th October 2011, 06:44 PM
This forum is so helpful! I hope your little guy got some good news at the neurologist.

cavluvver
11th October 2011, 04:57 PM
Hi everyone sorry it's taken me so long to get back, I've got such a lot on at the moment with my son waiting for surgery to remove a thyroid tumour, I don't know if I am coming or going. The neurologist at chestergates has booked Rossi in on Thursday for a mini MRI this time to check on the development of the syrinx. If it has got a lot bigger since April he wants to discuss surgery [ putting in a shunt] If it hasn't he wants to discuss different medications. When I mentioned CSF inhibitors and that I had been on this forum he gave me a look of disapproval and said that I was getting lots of people's '' opinions''. I told him that I valued your opinions as you have experienced syringomyelia and were seeing the effect of certain medications on your own dogs. He said that omeprozole can cause stomach tumours and didn't like to use it for more than 6 weeks, but was willing to give it ago if Rossi's syrinx hadn't got much bigger. He also said that he didn't think Rossi's limping was nuerological and he asked Francois who deals with orthopedics to examine him and he now wants Rossi to have a CT scan on Thursday too. So we could be dealing with two conditions now, rather than one. So now we just have to wait and see what's happens on Thursday. There seems to be nothing but worry at the moment, it's exhausting, as long as my son and my dog are okay that's all that matters. Thanks again and I'll let you know how we get on on Thursday:xfngr:

Kate H
11th October 2011, 08:02 PM
Sorry you're having such a hard time, and hope your son's operation will be completely successful.

Oliver developed spondylosis (osteoarthritis of the spine) at the same time he had his first recognisable SM symptoms - his three affected vertebrae are more or less above his small syrinx! The spondylosis gave him quite a lot of pain in his lower spine and very wobbly back legs, but several weeks of crate rest helped enormously.

Kate, Oliver and Aled

Sabby
12th October 2011, 12:53 AM
Just to say that my Harley was diagnosed with CM/SM (he got a 3mm syrinx and a secondary ventriculomegaly) And all he done was limp on his front leg for a month. As he was an agility dog we thought it was an injury. They done X-Rays, blood tests and took fluid out of his shoulder bone. The MRI Scan showed SM but the vet who is also an orthopaedic surgeon was not convinced that the limping was coursed by SM. The limping disappeared all by itself without medication. All he is on at the moment is Zitac to hopefully slow the progression of SM.
One other thing donít let him push you into surgery. Take time to think about it and weigh up the pros & cons and talk to people about it. Clare Rusbridge actually suggested to my vet that I go on this Forum and talk to people about their experiences.

cavluvver
12th October 2011, 10:20 AM
This is what I am worried about. The neurologist seems all for surgery as he says why keep giving Rossi different medications when the surgery '' could '' make him a lot better. But I'm unsure. he himself says that they don't get much feedback from patients owners after about one and a half years after surgery but that most seem to do well up till then. I just don't know, what do you all think?:confused:

sarahsum
12th October 2011, 11:30 AM
Gosh that's a dilemma, one that I think we will face. If meds are working well then I myself am loathe to go down the surgical route. But I suppose until your scan comes through and you see if the csf inhibitor makes a difference, then you have a bit of breathing space to think about it. I know my dog vastly improved on omeprazole.

cavluvver
12th October 2011, 05:38 PM
The neurologist says that if the syrinx has increased in size quite a lot he thinks we should think about surgery. Rossi has never had a CSF inhibitor since he was diagnosed in April but his scratching and face rubbing has got a lot worse just recently. I just want to do the best thing for Rossi but what ''is'' the right thing. I can tell that the neurologist prefers people to listen to his advice alone and not to other people's experience and is definately uncomfortable if I mention Claire Rusbridge who I think he disagrees with on certain points. But I disagree and want to be armed with as much information as I can and that is where you all are of great help. Let's see what tomorrow brings:(

ByFloSin
12th October 2011, 10:13 PM
This forum is so helpful! I hope your little guy got some good news at the neurologist.

I have been looking for an update too. Fingers crossed :thmbsup:

cavluvver
14th October 2011, 11:40 PM
Hi everyone, been run off my feet since we got back from Chestergates yesterday. We dropped Rossi off at 10.30 then took our 2 year old grandson, who I look after full time while his Mum is at work, into Chester for the day. we were called back at 5.20 pm and were told good news and bad news. The good news was that Rossi's syrinx hadn't got any bigger so the increase in his clinical signs was due to him not responding to gabapentin so the neurologist wants him to try Tramadol now but he still doesn't want him to have a CSF inhibitor which surprised me. The bad news was that the CTscan showed that Rossi has a haitline crack in his tibia which is usually found in cocker and springer spaniels. I can't remember the name of this condition as it was rather a mouthful but we were told that, if left, the leg would eventually break so Rossi now has to have an operationto pin the leg to strengthen it. Unfortunately the surgeon is at a conference for 10 days so we have to watch Rossi hobble around till he comes back. It's heartbreaking. We also now have to put in a seperate claim to the pet insurance for a different condition now and were told that the the cost for the op would be from £1,500 to £1,800 so lt's hope the insurance cover most of it. It cost over £1,500 for yesterday's tests. Coupled together with the worry of waiting for my son to get a date for surgery to remove a thyroid tumour, we are exhausted mentally and physically. I will never complain again when life gets a little boring. hurray for boring!!! Anyway, do any of your dogs take tramadol, on it,s own or alongside any other medication and, if so, does it do any good? I am anxious to know. Thanks again for all your support and advice. I don,t know what I'd do without you. :luv::lotsaluv::lotsaluv::lotsaluv::lotsaluv::lots aluv:

Pat
15th October 2011, 12:34 AM
Couple of questions to clarify:

1. What is his current dose of gabapentin and how often does he take it? If he is on a low dose and/or only twice a day dosage, did you discuss increasing the dose and/or moving to three times a day?

2. Is the Tramadol in addition to the gabapentin or instead of the gabapentin? I've used Tramadol long term for geriatric dogs for pain from arthritis and disk disease and I know many that use it for their dogs with SM, but as part of a multi-drug regime rather than as a single agent for SM. It seems to work well for most dogs, and it appears to be a pretty safe drug from what I've researched. What is the amount of Tramadol prescribed and how often?

3. When discussing surgery, did you really mean to say that it would be shunt surgery rather than decompression surgery? That is surprising to me as I did not know that anyone was still doing shunt surgery.

Pat

Karen and Ruby
15th October 2011, 11:40 PM
Hiya,

Sorry for your mixed bunch of results.

Tramadol as Pat said is normally given as a 'top up' drug alongside another ie Gabapentin.

I have a prescription for Tramadol although havent had to use it but its there if needed.
Dr Rusbridge said to me that once you have started on Tramadol its hard to wean them off it again ( at least that is what my memory serves me but that was a year ago nearly?

And Ruby is still doing well on Pregabalin and Metacam so for mow Im keeping my options open- the less we use now the more we have to look to in the future.



If your Neurologist doesnt like the CSF idea then why not take Dr Rusbridge treatment althorism to your normal vet?

I find it strange that some arent being prescribed a CSF inhibitor as it was the first thing I was given for both my dogs before they were put on any pain releif.

But then you dont want to go behind your neuro- but at the same time the whole pont in a CSF inhibitor is to reduce the progression of the disease.

I hope little Rossi has his leg seen to soon and that you get some more options as to his treatment!

cavluvver
16th October 2011, 12:31 AM
Thanks again for your input, it's greatly valued. The neurologist has given us tramadol to be taken on it's own. He never mentioned upping the gabapentin [Rossi was on 100 mg x3 daily]. He just said that it looked like it wasn't helping Rossi. I mentioned CSF inhibitors at the last appointment but, as I said, he was very reluctant to use one and said that omeprazole can cause stomach tumours. I don't know how long tramadol takes to work but Rossi has been on it 2 days now and his symptoms are just the same. I just don't know whether to really push for getting on a csf inhibitor as it may really help Rossi but I am very scared of causing another really serious problem as I think Rossi has enough at the moment. It's terrible when you know that their well being depends on your decisions when there are so many conflicting ideas of what routes to take. I just don't know what to do:-?:-?

Karen and Ruby
16th October 2011, 01:09 AM
Cimetidine (also known as Zitac) is reletively safe and recommended by Dr Rusbridge. Ruby has been on it for 3 years and Charlie for 14 months and neither have had any side effects.

One of the most sensible things anyone has said to me was when I was talking to Dr Rusbridge about my fears of giving long term Metacam to Ruby and she simply said to me


"what would you prefer, for dog to live a long existance on safe medications that dont really work and they live in pain and discomfort than to give her everything you can, give her the best possible chance and have her live a normal life for less time?"

And well Ruby has been living her normal life for over 2 years, with no side effects from the meds, she has a blood screen done very 6 months to check her organs. She does every thing that other dogs do and is pretty much pain free for the majority of the time.

And I still have options left, Trocoxil, Tramadol,Steroids etc etc for the future if needed.

So I would do anything you can to make him comfortable as ehat would you prefer?

At the end of the day, what ever we do there is a chance it will cause other problems- just watch the news, we cant drink wine, eat chocoate as that MAY cause cancer!! Do we care? No as I like Wine and chocolate!!!

Im sure Rossi wouldnt care if you asked him?

cavluvver
16th October 2011, 11:56 AM
Thanks Karen for your advice. I am so angry that I didn't push to try a CSF inhibitor just because the neurologist makes me feel so uncomfortable when I mention the forum and especially if I mention Claire Rusbridge. He just looks at me as dissaprovingly as if I should be listening to him and nobody else, He seems so reluctant to try one and when I them before he gave me the ''look'' and said, ''which one'' and as I was put on the spot, like a child in the classroom, I could only remember omeprazole, to which he replied, ''that can cause stomach tumours''. He said that he would never put a dog on that for more than 6 weeks. But why did he not mention the other csf inhibitors that don't seem to cause terrible problems? He just doesn't make me comfortable discussing other drug options and he seems to have the attitude that HE knows best. I so wish we lived nearer to The Stone Lion so I could have dealt with Claire. Anyway, if Rossi doesn't seem to respond to tramadol by the time he goes for his leg op I am going to ''man up'' as they say and insist that we try cimetidine. I am just not happy!!!:mad:

Holly
16th October 2011, 02:09 PM
If I'm not mistaken, wasn't that study with the Omeprazole and the stomach cancer done on rodents? I think some people will do a period of time on it and a period of time off of it, to reduce the risk, just in case. Scarlett, who is severely affected, has been on Gabapentin, Previcox, and Omeprazole (with an occasional Tramadol, if needed), for about 2.5 years and her bloodwork always comes back perfect-- knock on wood. I also agree with the person who said that they would rather their dog have a good quality of life for the time she is here, using meds that do truly help her.

How about contacting Dr. Rusbridge for a consultation? You can send her the MRI results and explain what is happening and she can get you on the right meds regime. I don't think a consult is too expensive and it would give you peace of mind.

In my experience, I think the CSF inhibitor is very important for these dogs.

Nicki
16th October 2011, 03:44 PM
I totally agree with Clare, quoted by Karen


"what would you prefer, for dog to live a long existence on safe medications that don't really work and they live in pain and discomfort than to give her everything you can, give her the best possible chance and have her live a normal life for less time?"


I have never heard of Tramadol being used in isolation, it is generally given in addition to other medication, and usually only for palliative care, as it is very addictive.

If you are not happy with the treatment prescribed, then it is your decision and your choice to consult with different practitioners. It is sad that Mr Skerritt is so against the forum, I have learnt so much here, there is a lot of feedback here about the results of treatments.

Do you have the treatment algorithm printed out?


You are right Holly - see below!


Omeprazole - in humans there is a risk of bowel cancer with long term usage :( Pulse therapy is recommended, where you have 4-6 weeks on, 1-2 weeks off. It's not known about long term risk in dogs.
I also found that high doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine - again in humans.


A few years ago, 2007 my vet contacted Gregg Kortz DVM Diplomate ACVIM - Neurology about the long term use of Omeprazole - at that time he had only be using it for about a year, but had not seen any problems in that time. He kindly sent some a few of the articles on Omeprazole toxicity.


Neuroendocrine cell hyperplasia and neuroendocrine carcinoma of the rodent fundic stomach.
Poynter D, Selway SA.
Glaxo Group Research Ltd., Ware, Herts, U.K.

Certain substances when given orally to rats have effects on the neuroendocrine cells of the fundic stomach. Such compounds also have effects on acid or its secretion, which is to a greater or lesser extent suppressed, with a consequent rise in serum gastrin, followed by an increase in the number of histamine-secreting ECL cells. These changes are seen with the histamine H2 receptor antagonists loxtidine, SKF 93479, ICI 162,846 and ranitidine; with the hypolipidaemic agents clofibrate, ciprofibrate and benzofibrate; with sodium bicarbonate and pentagastrin; and with omeprazole, a potent inhibitor of the parietal cell proton pump mechanism. Changes in the pH of the rat stomach stimulate the neuroendocrine G cells of the pylorus to secrete gastrin, which acts on the ECL cells of the fundus causing the production of histamine, which in turn stimulates the parietal cell. This sequence leads to an excess of circulating gastrin, which is detectable within 5 days. Subsequently increases in the number of ECL cells occur, the hyperplasia being related to hypergastrinaemia and the degree of acid suppression. The hyperplastic response is rapid, being so obvious with loxtidine at 39 days that there is good reason to suppose it could well be detected earlier. Using omeprazole, hyperplasia was found at 28 days after oral doses of 140 mg/kg/day. In order to get an equivalent degree of acid suppression with ranitidine it was necessary to deliver 420 mg/kg/day by subcutaneous infusion using an osmotic minipump, when hyperplasia occurred. Interestingly, only omeprazole produced a hyperplastic response of G cells. Such results reflect the covalent binding of omeprazole to the proton pump as opposed to the competitive binding of ranitidine to the histamine H2 receptor site. In addition to ECL cell hyperplasia there is ample evidence from lifetime studies in rats and mice that neoplasia may result. Neuroendocrine carcinomas (carcinoids) of the rat fundic stomach have been observed with loxtidine, omeprazole, SKF 93479 and ICI 162,846. They are seen late in the 2-year rat studies and are most unlikely to have arisen purely as an extension of the hyperplastic response. It is possible that the prolonged disturbance of gastric homoestasis resulting from achlorhydria result in the production of a carcinogen or carcinogens, in which event it is not too surprising, in view of the neuroendocrine hyperplasia, that the tumours seen are neuroendocrine carcinomas.(ABSTRACT TRUNCATED AT 400 WORDS)




Pharmacology and toxicology of omeprazole--with special reference to the effects on the gastric mucosa.
Carlsson E, Larsson H, Mattsson H, Ryberg B, Sundell G.
Omeprazole is a long acting inhibitor of gastric acid secretion in different species including rat and dog. Due to the long duration of action, steady state inhibition at repeated once daily administration is reaches within 4-5 days in dogs and in about 3 days in rats. Daily dosing at high dose levels results in virtually complete 24-hour inhibition of acid secretion in experimental animals. The elimination of the inhibitory feedback effect of acid on gastrin secretion leads to hypergastrinaemia. Because gastrin has a trophic effect on the oxyntic mucosa, the hypergastrinaemia results in a reversible hypertrophy of the oxyntic mucosa and an increased capacity to produce acid following maximal stimulation with exogenous secretagogues after discontinuing treatment. Despite the increased capacity to produce acid, basal acid secretion seems to be unchanged. The pronounced hypergastrinaemia which occurs during long-term treatment with high doses rapidly normalizes after discontinuing treatment. The hyperplasia of the oxyntic endocrine ECL cells, and the eventual development of gastric ECL cell carcinoids after lifelong treatment of rats with high doses, can also be attributed to the hypergastrinaemia developing after almost complete elimination of gastric acid secretion in these animals.




Toxicological studies on omeprazole.
Ekman L, Hansson E, Havu N, Carlsson E, Lundberg C.
As part of the safety evaluation of the gastric antisecretory drug, omeprazole, toxicological studies have been performed in several species of animals. The acute toxicity after oral administration to rodents was low. The oral LD50 value was above 4 g/kg. The general toxicity after repeated administration has been studied in rats and dogs. No clinical signs of adverse reactions were seen. Some minor changes in hematology parameters were observed. In rats and mice decreases in the erythrocyte count, hematocrit and hemoglobin have occasionally been found at doses of 125 mumol/kg/day and more. Hyperplasia of oxyntic mucosal cells, concomitant with increases in stomach weight, oxyntic mucosal thickness and folding, has been observed in the species investigated, the dog, rat and mouse. In addition, slight chief cell atrophy and eosinophilia of the chief cell granules were observed in rats. The oxyntic mucosal effects were reversible upon treatment being discontinued. In the oncogenicity studies, gastric carcinoids occurred in the rat but not in the mouse. Investigations of the carcinoids showed that the vast majority of the endocrine cells could be characterised as ECL-cells. The hyperplasia of oxyntic mucosal cells, including hyperplasia of endocrine ECL-cells and development of gastric carcinoids in rats, is attributable to the pronounced hypergastrinemia produced as a secondary effect of almost complete inhibition of acid secretion by the large doses of omeprazole used in the toxicity studies. In agreement with this hypothesis, the hyperplasia of the oxyntic cells was prevented by antrectomy. The reproduction studies performed in rats and rabbits showed no sign of fetal toxicity or teratogenic effect. The results of the short-term mutagenicity tests, Ames test, the micronucleus test in mice and the mouse lymphoma test were all negative.




A review of the effects of long-term acid inhibition in animals.
Carlsson E.
Gastrointestinal Research, AB Hšssle, MŲlndal, Sweden.

Studies with H2-receptor antagonists have revealed a trophic effect on the gastric mucosa - an effect which has been ascribed to hypergastrinaemia secondary to acid inhibition. Such hyperplasia of oxyntic mucosal cells has also been demonstrated in chronic toxicity studies following profound, long-standing inhibition of gastric acid secretion with omeprazole. The central role of gastrin in this effect was clearly demonstrated in the omeprazole studies, as antrectomy prevented this effect in both rats and dogs. The hyperplasia was fully reversible in both species. The close correlation between serum gastrin and hyperplasia of enterochromaffin-like (ECL) cells in the rat oxyntic mucosa has been demonstrated in a large number of experiments using different means to induce hypergastrinaemia, including administration of exogenous gastrin, treatment with antisecretory drugs and partial fundectomy. The hyperplasia of ECL cells was fully reversible even after 1 year of sustained gastric acid inhibition following treatment with a high dose of omeprazole. Marked long-standing hypergastrinaemia explains the findings of gastric ECL cell carcinoids in the life-long rat toxicity studies with both omeprazole and other inhibitors of gastric acid secretion.

Nicki
16th October 2011, 04:05 PM
It seems to be only in recent years that it was discovered that some of these drugs reduced CSF pressure, I don't know if they are being used in humans with SM yet, but that is why there is very little info around about them. There are not any studies at present, it is unlikely that there will be so as it would be very hard to tell how things would have developed with or without the Cimetidinel.

Many of these drugs will never be licensed for use in the treatment of SM, as licensing costs a considerable amount of money which would not be recouped as there is only a limited market for the product. Cimetidine is licensed in dogs due to its existing use in gastric issues.

Sabby
17th October 2011, 11:37 AM
To start off you are paying a lot of money seeing this neurologist. You say he made you feel like a kid in a class room. I am sorry itís time to see someone else. Like everybody said tramadol doesnít do anything by itself and it wonít do a thing if gabepentin has stopped working. My Harley was on tramadol for nearly a month and it didnít do a thing only made him sleep. After seeing Clare he is now on Zitac. When Clare wrote the report for my vet she mentioned this Forum and that there is a wealth of knowledge on here. I wonder why he is so disapproving of Clare and this Forum.

Brian M
17th October 2011, 12:28 PM
Hi

Pls Pm me your phone number so we can speak .Dont forget Daisy went to Chestergates in August
of this year ,she was prescribed Frusemide but is now taking Zitac .I dont really want to post
what happened with Daisy ,Chestergates and me so it will be much better if we speak privately .

sins
17th October 2011, 12:29 PM
I know it's not easy to keep stress at bay when you're trying to get the right treatment for your dog,especially if they're already in some degree of trouble.
I often feel myself,like we're always just one step behind with medication,just as we seem to have gotten it right,then things change and we have to be flexible again.
Sometimes SM causes different symptoms from dog to dog and some manage quite will with little or no intervention,but for those who have symptomatic cavaliers,remember,medicating for symptoms is still in the experimental stage.There's an increasing array of meds being offered,depending on what's needed.
What may suit one dog,may not suit another.It's really down to the owner to work with your specialist to report back on what does or doesn't work.
My Daisy can't tolerate Rimadyl and does poorly on Metacam.Frusemide leaves her wiped out and worn.
Yet,other dogs fly on it.Gabapentin works well with no notable side effects for her.
If your specialist prescribes a medication,then I feel try it,note any changes and if it's not helping,then go back and say so.
It's still trial and error to find what suits best.
Don't be disheartened though,you'll get things sorted to your satisfaction very quickly.
Sins

sarahsum
17th October 2011, 01:55 PM
Hi, I've just had a glance through the last two pages, I'm sorry you have been put into a pickle with the neurologists attitude, its not fair to you as you have enough worry already. is there a chance he has been prescribed the tramadol more for the pain in his tibia? When Blue was first thought to have a disc problem causing his limp & scoliosis my vet put him on tramadol. I can say it just zonked him out & made his gait worse. After the scan & correct diagnosis we were put on a 5 day course of omeprazole to protect his tummy from the meds (steroids, gabapentin etc), and within 3 days he was showing considerable improvement. Then when the course finished, within five days he was almost immobile. I asked my vet to represcribe it on a permanent basis after seeing it on here & Clares site, he mentioned about the long term side effects of cancer...but like i said, he won't have a long term if he cant flipping walk & is in pain!! So we got the omeprazole & literally in the space of four days he went from a dog who had dull eyes, couldn't stand to be touched, wouldn't eat or walk, had horrendous front limb drag.....to a dog I took round the fields this morning for 30 minutes without a limb drag, who can run upstairs & is continuously shoving toys under my feet. We go to Chester gates on wednesday, but if anyone even suggests taking him off this drug they will get told NO, NO WAY.:mad:

Kate H
17th October 2011, 02:06 PM
Sabby wrote: I wonder why he is so disapproving of Clare and this Forum.

I would guess because - quite unintentionally - this Forum sometimes comes across as a Fan Club for Clare Rusbridge!:p We go to see another neurologist having looked at Clare's algorithm, saying (or thinking rather too obviously!) 'I'm told frusemide isn't the best drug', 'Dr Rusbridge says...' - all said with the best intentions, but it can come across as not trusting the expertise of the neurologist you are consulting. So it's hardly surprising that they can get defensive. Yes, we do have a lot of practical expertise on this Forum, which can be wonderfully helpful, but we are not trained neurologists. A vet has his/her training, but a lot of their expertise comes from experience, of what drugs and treatment have worked in the past, and this will colour what they do now (though they should also be open to considering something new). For example, Oliver has been doing well on frusemide, but when his eyes started getting a bit worse, my vet consulted Dr Rusbridge about trying another CFS inhibitor and was told to keep him on frusemide until he could be scanned again. So Zitac isn't always the right thing for every dog. SM is a difficult condition to treat because it presents and progresses in so many different ways; different neurologists will have different ideas, and finding the right medication always seems to take time and experiment. If you're not happy with your neurologist, you can always get a second opinion elsewhere, but whoever you go to, you will still need to work with them over several weeks or months to tackle your particular dog's problems.

Kate, Oliver and Aled

Margaret C
17th October 2011, 02:15 PM
Neurologists will have different ideas according to their own experiences in using different medication.

Geoff Skerritt is a very experienced senior neurologist, he has been a great friend to the cavalier breed in pioneering the first low cost MRI scans and talking to breed clubs all over the Country. He deserves our thanks and gratititude for all he has done.

Clare Rusbridge is the neurologist that oversees Tommy's treatment. She is very client friendly and open to suggestions from owners of the cavaliers she treats, and as most of you know I help her research through the Cavalier Collection Scheme.

Clare Is a wonderful vet and I am really thankful I live close enough to be able to consult her when necessary, but I feel that we must be careful to acknowledge and respect all the specialists that have helped our cavaliers & not create a feeling of artificial division between them.

Sabby
17th October 2011, 03:33 PM
Neurologists will have different ideas according to their own experiences in using different medication.

Geoff Skerritt is a very experienced senior neurologist, he has been a great friend to the cavalier breed in pioneering the first low cost MRI scans and talking to breed clubs all over the Country. He deserves our thanks and gratititude for all he has done.

Clare Rusbridge is the neurologist that oversees Tommy's treatment. She is very client friendly and open to suggestions from owners of the cavaliers she treats, and as most of you know I help her research through the Cavalier Collection Scheme.

Clare Is a wonderful vet and I am really thankful I live close enough to be able to consult her when necessary, but I feel that we must be careful to acknowledge and respect all the specialists that have helped our cavaliers & not create a feeling of artificial division between them.


I agree with what you and Kate are saying, and I know he is an experienced Neurologist. But when Rossis mum is saying things like this;
He just doesn't make me comfortable discussing other
drug options and he seems to have the attitude that HE knows best. and I was put on the spot, like a child in the classroom

I think when your dog is in pain and you are tearing your hair out with worry it would help if you could deal with someone more human. Thatís why I drove 3 hours to Clare and I think if it would be an 6 hour drive I would do that as well.

Margaret C
17th October 2011, 05:03 PM
I agree with what you and Kate are saying, and I know he is an experienced Neurologist. But when Rossis mum is saying things like this;
He just doesn't make me comfortable discussing other
drug options and he seems to have the attitude that HE knows best. and I was put on the spot, like a child in the classroom

I think when your dog is in pain and you are tearing your hair out with worry it would help if you could deal with someone more human. Thatís why I drove 3 hours to Clare and I think if it would be an 6 hour drive I would do that as well.

Fair points

RodRussell
17th October 2011, 05:38 PM
I agree with what you and Kate are saying, and I know he is an experienced Neurologist. But when Rossis mum is saying things like this;

He just doesn't make me comfortable discussing other
drug options and he seems to have the attitude that HE knows best. and I was put on the spot, like a child in the classroom ...

If he is inclined to discuss his views, I would like to know what their sources are. In effect, put him on the spot. Does he rely only upon his own experiences with his other patients? Or, does he read and rely upon research reports? Has he published any research studies? If he does not like Dr. Rusbridge's views, what research does he prefer?

If he just blows off questions like these, then I'd probably move on to another specialist.

cavluvver
17th October 2011, 08:36 PM
Thanks again for all your input, I value it very much as I feel like you are the only people I can turn to at times. I have had a terrible day. I came downstairs to find that Rossi had vomited all over the hallway carpet, more than once. I found him in the front room and he looked terrible. He could hardly move and since we came back from Chestergates his leg has been so much worse but we have to wait for the surgeon to come back on the 26th to operate. Rossi has only been on tramadol for a few days so I don't know if that has made him ill or something else, but I've only had him in the garden for slight exercise and there's nothing bad out there for him to eat or anything. I look after my 2 three year old grandsons so when they arrived I was mopping up sick. Rossi was prescribed tramadol (which I am now horrified to discover is highly addictive) alone because he wasn't improving with gabapentin, he seemed to be getting worse. I was told to give metacam if the leg got worse. Today he wouldn't even drink and turned away from food even his favourites. He clung to me like glue and seemed to be unable to get comfortable anywhere. He was even nodding off sitting up. I was distraught and found it really hard to give my attention to the boys who, even at 3 were very understanding when told Rossi was sick. I didn't give him tramadol in case it was that which made him ill, I will try it again in a few days. Just to clarify it is not Geoff Skerrit that has been seeing Rossi but another neurologist there. I am not trying to tell him that anyone knows better than him as he is the specialist and I had every faith in that. But I just think he should be open to discussion on other meds and be willing to discuss people's experiences(yours). I just want to do the best by Rossi. I DON'T KNOW WHAT TO DO AT THIS POINT. I have just managed to hand feed Rossi a few of his biscuits and he has had a drink. He is still hobbling around on his bad leg and keeps hiding under my legs. I will give him some metacam for his leg and I will see what tomorrow brings. All I do know is that I am really going to push to try a CSF inhibitor. Please, please give me all your views, it really helps me. Jackie:hug:

Jasperxxgabby
17th October 2011, 09:04 PM
Hi Jackie
Regarding Rossi's stomach issues :-

Since June my Jasper as been on/off Tramadol and Metacam and he was having stomach issues but for the last month he as been having Antespin Tablets which I dissolve in water and syringe into his month, it coats the stomach and as made a difference for the good, I give it just before the morning tramadol and just before the evening tramadol with food, I tend to give him the Metacam early afternoon again with a little food. I know these stomach issues alone can be really miserable I do hope that things settle down.

Thinking of you and Rossi I truly hope things improve :hug:

Kate H
17th October 2011, 09:46 PM
Jackie wrote: I am really going to push to try a CSF inhibitor.

I'm sorry Rossi is having such a hard time and hope he's feeling better. However, a CSF inhibitor is a long-term medication - it will (hopefully) reduce the CSF, but it won't make a great difference immediately, so I doubt if not being on a CSF inhibitor is making any contribution to Rossi's present problems, which sound like a reaction to the particular medication he is on. If the neurologist you are seeing is the young Italian on the staff, he may just be a bit inexperienced with SM (it is, after all, not the only neurological disease, though it may seem so to us Cavalier owners!) and trying to explain things in his second language. If you want to stay with Chestergates for practical reasons, I would have a word (by phone or email) with Geoff Skerritt himself and explain - without any tone of accusation or complaint - that you feel it is important that you develop a good relationship with the neurologist who is treating Rossi and that you are finding this difficult with this particular chap - as often happens between people, you just aren't connecting. Perhaps you would be able to see Geoff himself, or could be tactfully moved to another neurologist - I saw Ulrika Michal and she was very nice and helpful.

Kate, Oliver and Aled

Brian M
18th October 2011, 10:16 AM
Hello jackie

How is Rossi today ,your last post made me so sad .:(

Brian M
18th October 2011, 10:31 AM
Hi Jackie

Just another thought last year Rosie saw Martin Deuchtland at Chestergates a neurologist who I got on with fine ,but has since gone back to Germany ,and apart from having a full MRI which found she has CM also confirmed a problem with a couple of discs which were giving her pain
which may have needed surgery and MD commented to me "if I need a surgeon he knows a good one not far away" .So we took her to
http://www.nwsurgeons.co.uk/contactus.php and saw Ben Keely who was great ,and thankfully with rest only Rosie did not need surgery,
so if Rossi needs surgery for his leg NWS are another choice for and they are only down near Runcorn so for you straight down the M6.
Also NWS is the place our Cavalier Club Cardiologist is based who is very good and handy for us lot who live in the NW

cavluvver
18th October 2011, 11:49 AM
Thanks everyone again for your great advice. I felt so desperate yesterday and was so glad to be able to talk to you all. Rossi is still limping badly but has eaten this morning. I have given him gabapentin and metacam today but will try the tramadol again when I am sure his stomach has settled. I have decided that, when we see the neurologist again in three weeks I am going armed with a list to discuss and if he seems reluctant I have decided that I will try to see someone else. (thanks for all your suggestions on that too) I just want to feel comfortable enough to be able to discuss what is best for Rossi. I am going to visit my son now who STILL hasn't got a date for the removal of his tumour. Life just has got to get better eh? Thank God I have you to turn to.:hug::hug:

sarahsum
18th October 2011, 01:01 PM
I'm going there tomorrow, i'll let you know how we get on.....we can compare notes :)
I'm glad Rossi feels up to eating xx

Blondiemonster
18th October 2011, 03:58 PM
Thanks everyone again for your great advice. I felt so desperate yesterday and was so glad to be able to talk to you all. Rossi is still limping badly but has eaten this morning. I have given him gabapentin and metacam today but will try the tramadol again when I am sure his stomach has settled. I have decided that, when we see the neurologist again in three weeks I am going armed with a list to discuss and if he seems reluctant I have decided that I will try to see someone else. (thanks for all your suggestions on that too) I just want to feel comfortable enough to be able to discuss what is best for Rossi. I am going to visit my son now who STILL hasn't got a date for the removal of his tumour. Life just has got to get better eh? Thank God I have you to turn to.:hug::hug:

How heavy is rossi? 100 mgs of gabapentin is not that much.. Raising to 150 may help if 100 is nor doing it. Even though your neuro wrote it off... Thats my opinion from my own experience with my dog,


Sent from my iPhone using Tapatalk

cavluvver
18th October 2011, 05:53 PM
Rossi is very large for his breed, he is 14kg and there is no fat on him.

cavluvver
18th October 2011, 05:59 PM
Thanks Sarahsum I look forward to hearing how you went on and who you saw to see what response you get from them.

Karen and Ruby
18th October 2011, 06:06 PM
Jackie wrote: I am really going to push to try a CSF inhibitor.

Perhaps you would be able to see Geoff himself, or could be tactfully moved to another neurologist - I saw Ulrika Michal and she was very nice and helpful.

Kate, Oliver and Aled

A friend of mine sees Ulrika Mchal too and she is very happy with her- she has an extremely poorly Cavalier who has painful CM and disk disease and has been through two cruciate surgeries this year!
I think when you are dealing with multiple problems it can be even harder to get the right person to help!

Blondiemonster
18th October 2011, 06:41 PM
Rossi is very large for his breed, he is 14kg and there is no fat on him.

My cavalier is 12 kg and is on 150 3 times a day. Lower than that didnt help but 150 does the trick ! My neuro says we could go up to 175 even. Lynn


Sent from my iPhone using Tapatalk

cavluvver
19th October 2011, 11:25 AM
Just wondering how you give your dog 150mg of gabapentin? I only have 100mg capsules.:-?

sarahsum
19th October 2011, 06:39 PM
We have been to Chester Gates and saw Mr Skerritt, it was a good visit and we had a great discussion. He had no problem with us continuing on our course of treatment of omeprazole etc. I'll post more details on my collie post later. He was a very pleasant man to consult with.

Karlin
19th October 2011, 08:23 PM
Just wondering how you give your dog 150mg of gabapentin? I only have 100mg capsules.:-?

It's not difficult, you can get 600mg tablets and use a pill cutter to split in 4 or split a 100mg capsule in half.

Karlin
19th October 2011, 08:31 PM
My cavalier is 12 kg and is on 150 3 times a day. Lower than that didnt help but 150 does the trick ! My neuro says we could go up to 175 even. Lynn


Lynn, you could certainly go much higher than that and you may gradually find that you will need to, as they tend to progress and/or a starting dose stops dealing with pain. Leo only weighs about 7.5 kg and he is on 200 mg 3 times a day and could go up to 300 mg if necessary–although I am just about at the point to try switching him over to pregabalin anyway.

Clare's protocol reads:


Start gabapentin at 10-20mg/kg orally 2-3 times daily (typically a 8-12kg CKCS would be started on 100mg capsule twice daily) with or without NSAIDS

Which for a dog of 12kg would mean up to 240mg per dose, 2x or 3x. Leo started at 50mg 2x and moved up gradually over 6 years. :(

cavluvver
20th October 2011, 02:58 PM
Could someone please tell me about enlarged ventricles. I have seen this mentioned a few times but, although Rossi has had 2 mri's now they have never been mentioned to me, What are they and what do they cause? Also a lot of people say that they have a copy of their dogs mri, should I have been given one? these are all more reasons why I am unhappy with my neurologist:(

RodRussell
20th October 2011, 04:17 PM
Could someone please tell me about enlarged ventricles. I have seen this mentioned a few times but, although Rossi has had 2 mri's now they have never been mentioned to me, What are they and what do they cause? Also a lot of people say that they have a copy of their dogs mri, should I have been given one? these are all more reasons why I am unhappy with my neurologist:(

They are discussed here: http://www.cavalierhealth.org/syringomyelia.htm#What_SM_is

Brian M
20th October 2011, 05:00 PM
Hi

When we took Rosie who saw Martin last October he gave us copies of her full MRI on a disc ,but
when Daisy saw Mr Skerrit this August he gave us an Xray sheet with some of her scans on it .I did
phone back the next day and asked for a disc but was told the facility that scans to disk had stopped
working so only the Xray sheet was available.

Love my Cavaliers
20th October 2011, 05:02 PM
You can always ask for a copy of Rossi's MRI. My neurologist doesn't routinely give copies out unless you ask for one. All four of my dogs have had MRIs for various reasons, but I've only asked for copies of Riley's MRI. She's the only one with SM. I wanted one for a second opinion and then I sent it on to England for cavalier research but it arrived cracked. Riley's neurologist gave me another copy without charging me. So, if you want a copy, I would just ask for it. They may not know that you want one.

sarahsum
20th October 2011, 05:19 PM
My vet couldn't send me the disc images via email etc but i took a couple of photos using my camera on my phone when i visited him, off his laptop.

Kate H
20th October 2011, 11:20 PM
You should at least have been given a print-out of the MRI (like an X-ray sheet, as Brian said). Oliver is one of the Cavaliers who gets mentioned from time to time because of his dilated ventricles. The Chiari Malformation at the base of the skull pushes into the bottom of the brain (the cerebellum) and pushes it down into the top of the spinal cord (this is called herniation - just like a hernia in humans pushes through the abdomen). This prevents the cerebral-spinal fluid circulating properly round the brain. It should go smoothly round the brain, through the ventricles (the hollow chambers at the top/front of the brain) and then back down again to the spinal cord. CM and the herniation it causes slow down the flow, so that the CSF moves slowly and can accumulate in the ventricles, pushing them outwards to accommodate the extra fluid. This can cause pressure on the skull (hydrocephalus, such as Blue the collie has) and behind the eyes (which is Oliver's problem). The sluggish CSF also creates abcesses in the spinal cord - that's what a syrinx is. This is why CM alone can cause a great deal of pain if the ventricles are badly dilated - Oliver's are three times as large as they should be.

Hope that helps!

Kate, Oliver and Aled

cavluvver
21st October 2011, 11:51 AM
I wasn't told anything about ventricles and feel so much less informed than most of you. I want to know everything about this condition so that I can get the best treatment for Rossi. I know often, when I look at him he seems to squint and seems to find it difficult to raise his eyes. Could this be anything to do with his ventricles?:mad:

sarahsum
21st October 2011, 10:44 PM
Oh it's so difficult for you, with everything you have got going on. You must make a list of questions to ask the vet, you are perfectly entitled to ask them, you are the one paying the bills and it is your dog. If your vet is off hand or dismissive then I would go over his head and ask to see someone else. It's not a time for him to get on his high horse, it's all about Rossi and what will help him the most.

sarahsum
21st October 2011, 10:47 PM
And five weeks ago I knew nothing about this condition, I have scoured the Internet!! :-)

Kate H
21st October 2011, 11:05 PM
Cavluvver wrote: when I look at him he seems to squint and seems to find it difficult to raise his eyes

I got Oliver at a year old and right from the start he squinted in strong sunlight or when looking up at bright light - when I breed showed him and he was looking up at me in the ring he would squint if he was also looking directly at fluorescent lighting in the ceiling. Neither I nor my vet thought anything of this at the time - it was just the way Oliver was. Now I know that his dilated ventricles interfere with the mechanism that controls his pupils - they close too slowly and don't close completely, so that he can't prevent strong light getting into his eyes. Fortunately - so far - there is no damage to his retina. He's fine on our normal walks, as he usually has his nose to the ground so isn't looking at the sky and sun. But when he is lying down looking out on sunshine, even if he is in the shade himself, he starts to squint and is obviously beginning a headache. After one really bad episode, I keep a watchful eye on him and either move him away from the sun or put his sun hat on (a fetching tan baseball cap!), so the problem is pretty well under control.

So what that rather long explanation is saying is yes, keep an eye on Rossi's squinting - it can be just a normal reaction to sunlight, to protect the eyes, but it could be yet another symptom of his SM (the list does seem to be endless...).

Kate, Oliver and Aled

cavluvver
25th October 2011, 06:07 PM
Well we're off to Chestergates again with Rossi tomorrow for the operation to put a screw in his leg to prevent it breaking. I am dreading it, we have to leave him overnight and pick him back up on Thursday. I hope he's not going to be in a lot of pain afterwards. What with this and his sm which doesn't seem to be improving with the tramadol either. As I said before, when we see the neurologist again I am going to ask him if we can try omeprozole. My son still hasn't got a date for the removal of his thyroid tumour yet either. It's disgusting, he had his pre-op almost 2 months ago. It's just one thing on top of another at the moment but you can get through anything if you have support can't you?:hug:

sarahsum
25th October 2011, 07:28 PM
Wow you are under so much stress at the moment. We'll be thinking of Rossi tomorrow, once he gets over the hurdle of his leg op then you can focus on his sm. As for your son, well I think it's disgraceful that you are left waiting for a date, poor lad. Hope everything goes ok tomorrow xx

Sabby
25th October 2011, 08:08 PM
Will be thinking of you tomorrow and hoping that your son is going to get the date for his op soon.

I am sorry but in my opinion you need to change your neurologist

cavluvver
27th October 2011, 04:08 PM
Thanks everyone for your good wishes. We are off to pick Rossi up shortly, it's an hour and a half drive, but I can't wait to get him home. Apparently, the surgery want well and the screw is noe in place to hold the bone in his leg together so it won't break. He's been there since yesterday morning at 8.30 am and I have missed him so much and keep thinking I hear him following me around the house. They say he hasn't eaten anything, even when they try to hand feed him, so that means that he hasn't had any food since Tuesday teatime. Oh my poor baby I just want to get him home and comfort him. Then it will be dealing with the sm again and finding the right meds. I let you all know how he is later.:(

Love my Cavaliers
27th October 2011, 06:08 PM
Oh I hope he eats when he's back in the comfort of home. I'm so glad the operation went well. What kind of restriction is he on for movement? So glad he's coming home and you'll be able to cuddle him.

Margaret C
27th October 2011, 07:04 PM
Thanks everyone for your good wishes. We are off to pick Rossi up shortly, it's an hour and a half drive, but I can't wait to get him home. Apparently, the surgery want well and the screw is noe in place to hold the bone in his leg together so it won't break. He's been there since yesterday morning at 8.30 am and I have missed him so much and keep thinking I hear him following me around the house. They say he hasn't eaten anything, even when they try to hand feed him, so that means that he hasn't had any food since Tuesday teatime. Oh my poor baby I just want to get him home and comfort him. Then it will be dealing with the sm again and finding the right meds. I let you all know how he is later.:(



He will soon be home with you and you can spoil him, cuddle him and give him all his favourite things to eat.

At least this will be one of the complications in your life dealt with for now.

Give Rossi a gentle hug from me.

sarahsum
27th October 2011, 10:46 PM
Ahhhh let us know how he goes on? Xx

cavluvver
29th October 2011, 05:48 PM
Sorry I haven't posted till now but the last couple of days has been so hectic. Thanks again for all your good wishes. We picked Rossi up on Thursday teatime and the surgeon said that all had gone well. We couldn't believe how lively Rossi was and that he was walking perfectly well on the leg, no limp at all. The surgeon told us that Rossi was to be walked on a tight lead, 4 times a day for 10 mins and he was not to be allowed to jump om furniture or knees, one jump could mean the screw implant would break. We were also to be vigilant in watching the wound, which is open to the air, for any signs of infection. Rossi was not to lick it so has to wear an elizabethan collar when we are not with him and he totally freaks when it's on him. We have to carry on with the tramadol that the neurologist had now prescribed for his sm, which doesn't seem to be helping by the way, and also give him antibiotics. Rossi wolfed down the food that I had taken for him as he hdn't eaten for 2 days and had the longest drink of water I had ever seen him have. He also slept all evening as he seemed exhausted. The only problem has been keeping a very excitable dog like Rossi from jumping up on furniture and on people. As i look after my 2 three year old grandsons it was a nightmare trying to give them my attention while following Rossi from room to room making sure he didn't jump up. I felt like I was nagging the boys most of the time and felt very guilty when they had gone. We have noticed also since yesterday, Rossi has started limping again. We are not sure if he has damaged the screw or if it a reaction to moving around more. We are going to have to see how he goes this weekend and if we don't see an improvement by Monday morning give the surgeon a ring. Nothing is ever straight forward is it? Last night I had a good old cry but we have to keep going for them, don't we?:(

Margaret C
29th October 2011, 06:19 PM
Sorry I haven't posted till now but the last couple of days has been so hectic. Thanks again for all your good wishes. We picked Rossi up on Thursday teatime and the surgeon said that all had gone well. We couldn't believe how lively Rossi was and that he was walking perfectly well on the leg, no limp at all. The surgeon told us that Rossi was to be walked on a tight lead, 4 times a day for 10 mins and he was not to be allowed to jump om furniture or knees, one jump could mean the screw implant would break. We were also to be vigilant in watching the wound, which is open to the air, for any signs of infection. Rossi was not to lick it so has to wear an elizabethan collar when we are not with him and he totally freaks when it's on him. We have to carry on with the tramadol that the neurologist had now prescribed for his sm, which doesn't seem to be helping by the way, and also give him antibiotics. Rossi wolfed down the food that I had taken for him as he hdn't eaten for 2 days and had the longest drink of water I had ever seen him have. He also slept all evening as he seemed exhausted. The only problem has been keeping a very excitable dog like Rossi from jumping up on furniture and on people. As i look after my 2 three year old grandsons it was a nightmare trying to give them my attention while following Rossi from room to room making sure he didn't jump up. I felt like I was nagging the boys most of the time and felt very guilty when they had gone. We have noticed also since yesterday, Rossi has started limping again. We are not sure if he has damaged the screw or if it a reaction to moving around more. We are going to have to see how he goes this weekend and if we don't see an improvement by Monday morning give the surgeon a ring. Nothing is ever straight forward is it? Last night I had a good old cry but we have to keep going for them, don't we?:(

Yes, you do have to keep going and so you must make it a little easier for yourself.

With two lively little boys and an excitable dog it feels as if you may be trying to do the impossible. You need to make a pen or buy a crate to keep Rossi in when you are busy and unable to watch him.

He may not like being shut away but you should harden your heart because it is for his own good. A little tough love is needed until that leg has healed.

sins
29th October 2011, 07:54 PM
Margaret is absolutely right,a little tough love is exactly what's called for.
Perhaps some of the pain relief is starting to wear off and he may be feeling it a little so keep him calm and stress free.
A lot is down to the skills of the specialist,the rest, just time and good care at home.
You have so much to contend with at the moment,just be kind to yourself and everything will fall into place in the end.
I'm so glad you have him home.
Sins

cavluvver
30th October 2011, 12:53 PM
You are right, I have to try to make things easier as I just can't keep my eye on the boys and Rossi at the same time. I have a large travel cot so I'll pop him in that when I can't watch him. he will be able to see us through the mesh but I don't know if that will stop him jumping up and spinning round, he's such an excitable dog. As for the leg, he is STILL limping and, as I have said, he didn't when we brought him home. I haven't seen an improvement since he started limping again on Friday, the day after we brought him home. I'm still so worried because, if the screw has broken, what damage may it be doing to his leg? Thanks Margaret and sins for your advice and encouragement.

Margaret C
30th October 2011, 04:19 PM
. I'm still so worried because, if the screw has broken, what damage may it be doing to his leg? .

To be certain, and to put your mind at ease, take him to your vet tomorrow and get the leg checked.

cavluvver
1st November 2011, 10:08 AM
Rossi has just been dropped off at our vets to have an x ray of the leg to see if the screw has snapped. He is still limping badly this morning. I will post again when I find out the results.

Margaret C
1st November 2011, 08:23 PM
Rossi has just been dropped off at our vets to have an x ray of the leg to see if the screw has snapped. He is still limping badly this morning. I will post again when I find out the results.

I have had my fingers crossed. Any news yet?

sarahsum
2nd November 2011, 12:24 PM
any news on little Rossi yet?? Hope everything is ok xx

cavluvver
2nd November 2011, 12:57 PM
Hi everyone, the screw in Rossi's leg is NOT broken. The x rays show that it is still intact, which is great news. The vet said that the strong meds that he would have been given after the op would still have been in Rossi's system for a while after we brought him home and when they had worn off and was just on his syringomyelia med ( tramadol ) and antibiotics, he would probably been in more pain and that's probably why his lamenous was worse. I am still glad though that we had thex ray done as it has given us peace of mind that we were not damaging Rossi's leg and that the screw is tougher than we thought. We are taking him back on Monday and the vet is going to take his stitches out and give hime a thorough check. We then go back in a months time to ChesterGates to see the orthopaedic surgeon again and I am also going to see the neurologist again to discuss how Rossi has been on tramadol, but I am really going to push to try a csf inhibitor and, if he is not keen, I am going to insist as I am not happy that we haven't tried one yet, so I am not going to let his 'attitude' bother me this time. After all Rossi is MY dog and I want to try all avenues to cause him the least suffering and I truly believe that all your advice is invaluable after all this forum is like one big study of dogs with syringomyelia and how effective different meds are, isn't it? Thanks, yet again for all your support, I really do not know what I would do without you, as you probably have found too, people get a bit fed up sometimes of listening to you talking about our dogs, but not you guys. love you all loads, Jackie, I will keep you posted:updte:

Love my Cavaliers
2nd November 2011, 02:32 PM
That is such good news!!!!! Amazing that not one of us thought of that as the reason for his limping. I actually had foot surgery a few years ago and the surgeon gave me a nerve block and for the first 24 hours after surgery I had absolutely no pain. Should have thought of that for Rossi. But I'm so glad you had it checked out and he's doing o.k. Just get through his recovery and then you can deal with his SM meds.

Margaret C
2nd November 2011, 05:16 PM
I'm so pleased the vet found the screw in Rossi's foot is still okay. That is one big worry off your mind.

Give him a gentle hug from me.

sarahsum
2nd November 2011, 09:29 PM
Great news about his leg....and you go girl!! Stick to your guns, he's your baby and there's every reason for you to want the best treatment for him xx

sarahsum
7th November 2011, 09:19 PM
I haven't been on here for a bit, how is Rossi?