View Full Version : Atmospheric Pressure and Pain
12th December 2011, 06:40 AM
As we begin to learn all the things that cause flare ups of Mooby's SM I find myself with more and more questions. During a cold front last week Mooby had a couple of really bad (for her) days. After "normal" blood tests, on a whim we gave her tramadol. It turned out to be the right thing for her.
Now we have another "winter storm" coming in tonight with low pressure, rain and cold. Knowing that it is coming when should I start upping the gabapentin or giving the tramadol? Do I wait for obvious signs of more pain or do I treat before? If I treat before, when?
12th December 2011, 09:13 AM
I don't know when the right time to give medication would be, but I would try to give in advance. Atmospheric pressure will drop before a storm, so you may want to use local barometric pressure instead of weather. Keeping in mind that pressure changes are more likely to cause problems than stable low, or stable high pressure.
I would ask your neurologist about whether you should be using gabapentin, or tramadol. It may be that if you know in advance you start increasing gabapentin, but if mooby already is showing discomfort you use tramadol.
12th December 2011, 10:01 AM
I am getting so angry about the ignorance of my local vet, but because of the closeness of the cancer surgery I have to stick with this awful practice for the time being.
When I took Rebel in for his 3 monthly check up a couple of weeks ago she found he had a throat infection, so treated it with antibiotics, giving us a return appointment for last week and only giving 14 days supply of Frusemide. When we went back last Thursday Rebel was having an awful day. I suspected atmospheric changes due to the high winds combined with the very cold weather were causing the problem.
When we got there the very good nurse/receptionist usually always there had been replaced by a surly disinterested young woman, who seemed to dislike both people and animals. After waiting over an hour, with Rebel in obvious distress, we were called in to see the vet, who quickly told me she has recently arrived from Poland and instructed me to 'speak slowly, in short words and very clearly please'!
By this time Rebel had taken an instant dislike, was tense and was howling. She said I must keep him still while she listens to his heart. I told her this had been checked 2 weeks ago and that he was there to check the throat infection had cleared and to be prescribed a further 3 months of Frusemide on monthly repeat. She insisted that he did not need more Frusemide and that the usual vet had only prescribed 2 weeks 'because she must have wanted to get him off it.' The atmosphere in that room was becoming hostile.
I told her of Rebel's worsening SM and that I thought he should have Gabarpentin. She said 'What is this syringomyelia? We do not have this in my country!' I curbed the urge to ask what she was doing over here then and suggested that she read his notes, adding that a cursory look at his MRI pictures shows CM, a syrinx between C1 and C5 and curvature of the spine. She didn't want to view his history, reluctantly going into his records to see the MRI results, then telling me the syrinx is minor. OMG!!!
She said she did not think he needed pain relief or any other medication. She could not understand why he needed Frusemide. I had problems understanding what she was saying, being torn between keeping Rebel still and hearing over his howling. The door was then opened and clearly I was expected to go through it and out. I collected and paid for the consultation and took the bottle of Frusemide. When I got home I saw that she had only given 2 weeks supply.
So I did what they do on the tv shows - I 'phoned a friend with experience of the condition. She agreed that this is all wrong. She has an unwanted supply of Gabarpentin which I can try and another experienced friend has e-mailed me a suggested treatment regime. By Friday morning the winds had dropped, although it was still quite cold, but Rebel was back to his normal laid back self.
If I had any doubts about atmospheric changes affecting SM, they were dispelled during the very long conversation I had with a fellow exhibitor at LKA yesterday. She has a dog of similar age to Rebel, but with probably more advanced symptoms. She has been using Gabarpentin successfully for some time, but now thinks some further pain relief is required for her dog during atmospheric changes. She thinks I am right to use it for Rebel.
I know that I must change vets. There is no way I will take my other dogs there and have decided on a surgery across town where I know that Rebel will get the considerate and informed treatment and care that he needs. I also know that I have the right to complain about the circumstances in the present surgery, but I am not in a position to cope with any more hassle, so I will take no action.
Since I seem to have become Rebel's temporary physician I wonder whether anybody more experienced could tell me whether I should administer the Gabarpentin on a regular twice daily basis or whether I should in fact only need to use it when adverse weather conditions are forecast.
12th December 2011, 11:22 AM
Reaction to pressure change is very common in dogs with SM. Gabapentin is a pain preventive - ie it is given to maintain a level of pain control so that the pain doesn't surface into consciousness An extra one can help at times when pain is likely to increase (as in pressure change), but the normal use is to give it very regularly (at roughly 8-hour intervals), not use it as a one-off pain killer (which it is not designed to be).
Flo: before you start Rebel on gabapentin I would encourage you to see a neurologist who would know far better than your local vet what is involved. Could you get a referral to the Willows? I should think if you stand and demand it from your present vets and refuse to take no for an answer, they'll refer you just to get rid of you! Frusemide and gabapentin (or equivalents) are the basics for any diagnosed SM, even if the drugs have to be tweaked and juggled to find the mix that is right for your dog. The pressure seems to have been particularly bad in the West Midlands this week - even my Oliver, who isn't normally worried by it, was very uncomfortable. At least fighting to sort out Rebel's problems could take your mind off January!
Kate, Oliver and Aled
15th December 2011, 05:16 PM
hope rebel is a bit better today , Ive been tracking when emily has fits and it does seem to be on days when they pressure changes. she had one the other day. she is on gabapentin twice a day as a seizure medication , I think the vet said she could have it 4 times if the fits continued. hopefully will have sent a report to her vet so I can ask.
had trouble with a polish vet myself last year , He did the wrong procedure on my dog ,then altered the consent form to say we had asked for it and her heart stopped during it but he thought we should be grateful that he had brought her round again.
15th December 2011, 08:25 PM
Oh lord AT your Polish vet seems even worse than the one I got. So sorry to hear about it. I always thought it was the vet who deided what procedures should be performed on their patients and not the owner? Silly me, I must have got it all wrong.
We have had pressure changes and high winds this week. Rebel howled for a while yesterday when it was so very cold, but this morning he is back to normal because it has got warmer. 100 mg tablet morning and evening seems to have made a big difference already. He is a much happier dog and is sleeping better. The scratching has entirely stopped.
Kate, it just isn't possible for me to stand my ground with this awful vet to insist on a referral to The Willows. I am just not fit enough to take on a verbal battle at the moment. I also have had problems organising new sofas and removing the old ones. Now the new colours mean that I have to redecorate the living room before January, which will take up most of Christmas. There are many other arrangements I have to organise to cover eventualities while I am in hospital too.
Today I went back to the vet to get Holly's claws trimmed. While I was there I mentioned to yet another but more pleasant nurse I have never seen before that Rebel has not been given the proper amount of Frusemide. Fortunately I was able to come away with enough for 8 weeks.
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