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murphy's mum
15th December 2011, 07:27 PM
Misty has been scratching a lot more since last Friday, ever since it's got colder here. I called one of the Neuro's at Glasgow, and she recommended we start Metacam, as well as her Gabapentin and her Zitac. I still don't feel she's doing any better. I have to call them back tomorrow if I feel she isn't doing better, and the other option they offered last week was to put her back on steroids.

After her MRI Misty started on 100mg of Gabapentin 3 times a day, which didn't reduce the scratching, so she was then started on a short course of steroids. As we reduced the dose she scratched more, so it was put back up, however, the side affects i.e waking up in the middle of the night and howling, scratching at the cupboards drove me crazy. We then asked if there was any other medication we could try her on.

So she's been on Zitac three times a day along with the Gabapentin and it's worked fine, until last Friday. I just don't know what to do, I really don't want her on the steroids, but if it's the only option....

The other thing is her harness seems to be aggravating her symptoms too, she scratches lots whilst walking on it. I couldn't put it on this morning as it was wet(had to wash the cow poo off) so I popped her collar on and walked her the 2 minutes round the corner to the field. She never scratched once while she was on the collar and lead on. I put her back in her harness at lunch time, and she was scratching as usual. I wanted to test out my theory so I put her back on the collar and lead and took her back out. Not a scratch the whole way round. I'm wondering if the harness is pressing on one of her syrinxes?

I feel like I'm back to square one again, she had been doing so well.

BrooklynMom
15th December 2011, 08:31 PM
I am so sorry and I don't have any advice but just to say that I will say a little prayer for Misty...this is all so unfair to such a beautiful girl :(

Someone else on here (I apologize, I cannot remember) who's pup has SM also an only use a collar because the harness aggravates it. Usually a harness is better as you have heard, but sometimes as others have found, depending on where the syrinx is, a collar is better. There is no solid rule, you just have to do what you feel is best and what you know helps Misty. Obviously not scratching on a collar would say for now, that is the better option she is telling you.

I am so sorry. Thinking of you and sending hugs.

Margaret C
15th December 2011, 09:34 PM
Tommy is better with a collar than a harness.

When Gabapentin stopped controlling his SM symptoms he went on to Lyrica. It is an expensive drug, and he is not insured, but it has made such a difference to his level of comfort.

Kate H
15th December 2011, 10:49 PM
100mg of gabapentin is actually a low dose - the one most dogs newly diagnosed with SM start on. Before you go down the steroid route again (I avoid them as much and as long as possible, as they do compromise the immune system), you could ask your vet or neurologist about doubling the dose of gabapentin and see if that helps. Many people also - even at the higher dosage - find giving an occasional extra gabapentin can help if air pressure changes drastically or there is some other reason why the dog is extra uncomfortable on a particular day.

Kate, Oliver and Aled

Karlin
15th December 2011, 11:24 PM
Also, if metacam doesn't do much, Trocoxil is a newer NSAID that Clare Rusbridge feels works particularly well for dogs with SM. It only needs to be given once a month. Have you downloaded her treatment algorithm. There are many many things she lists way before suggesting prednisalone (steroids). It's generally the last option when nothing else is helping. As noted 100 mg 3x is a fairly moderate dose of gabapentin, so I'd talk to the neurologist about increasing it to 150 or higher, about trying Lyrica, using a stronger painkiller than metacam such as trocoxil with the gabapentin or with Lyrica, etc etc. Generally it takes time to work out a useful mix. Steroids can really help dogs when nothing else is helping but has many potential side effects with longterm use.

moobywan
16th December 2011, 03:44 PM
Have you tried coming down on the steroids to the lowest dose possible that helps make a difference? Mooby has been on steroids for over 6 months now, and while it's not ideal both her neurologist, dermatologist and internal medicine specialist feel that it is the best course of action for her. She's on 5mg every other day, and they said at that dose it should have no impact on the immune system --- I forget the word for it, but the dose is similar to what the body normally makes. They said that she could be on this dose forever, and some dogs are without problem.

I know how hard it is, and I really feel for you. Every change in weather is bringing a new learning lesson for us all. Hope your little one can get some relief soon.

Pat
16th December 2011, 06:14 PM
She's on 5mg every other day, and they said at that dose it should have no impact on the immune system --- I forget the word for it, but the dose is similar to what the body normally makes. They said that she could be on this dose forever, and some dogs are without problem.

The alternate day therapy is key here, and the quote above is absolutely right. The difference is an immunosuppressive dose versus an anti-inflammatory dose. 5 mg. every other day is not an immunosuppressive dosage. Also, at a dose like that you are unlikely to see the side effects of increased appetite, thirst and urination.

Pat

murphy's mum
16th December 2011, 06:51 PM
Just off the phone to Allison(Neuro) she couldn't get back to me any sooner, she's been super busy today.

I spoke to her about increasing Gabapentin and/or trying Trocoxil. She said as the Gabapentin only comes in 100mg tablets, she wouldn't want to make the jump to 200mg doses. I know someone on here splits the 100 down into 50's, but couldn't remember who, and how easy it is to do. As for the Trocoxil, she personally isn't all that keen to prescribe it, I don't think she likes the fact it is given once a month. Her main concern would be having to wait for it to leave Misty's system if we needed to change her to something else as it's only given once a month.

She's going to call my vet and see if they have Rimadyl in stock, to try that. We've to stop the Metacam over the weekend so she can start it on Monday. We'll trial that and see how she does, if not she still thinks the next best option is steroids, trying to manage her on the lowest possible dose.

Sabby
16th December 2011, 11:24 PM
You should try to get Misty on Lyrica before trying Steroids. It has made a huge difference for some dogs on this Forum. I know itís very expensive but if it makes a big difference in your dogís life I think it be worth every penny. Sometimes it must be hard trying to convince another Neurologist to try what other people suggest. Every dog is so different thatís why I think this Forum is a wealth of knowledge and different experiences and this is priceless. I am very thankful I am dealing with C Rusbridge and even in the report she wrote to my vet she advised to look at Cavalier Talk.

murphy's mum
19th December 2011, 05:19 PM
We've given her her first lot of Carprodyl(carprofen) we've to try her on two a day for a week, and then see how she does on one a day.

I haven't spoken to Allison about Lyrica, but if this doesn't work I'll be mentioning to her :)

Soushiruiuma
19th December 2011, 06:42 PM
There are pill splitters available very cheaply, ask a pharmacist where to get one, or google it. It's very easy to go through and do a weeks' worth of meds in a few minutes.

My grandfather is extremely economical, and insists on buying the highest dose pills, then splitting into eighths. But it saves a tiny bit of money, so it's worth it to him.

murphy's mum
19th December 2011, 07:10 PM
There are pill splitters available very cheaply, ask a pharmacist where to get one, or google it. It's very easy to go through and do a weeks' worth of meds in a few minutes.

My grandfather is extremely economical, and insists on buying the highest dose pills, then splitting into eighths. But it saves a tiny bit of money, so it's worth it to him.

Thanks :)

Nicki
20th December 2011, 04:00 PM
gabapentin comes in 600 mg tablets, or 800mg tablet; capsules are in 100mg or 300mg [and 400mg].

I think Karlin was getting the 600mg tablets and splitting them, I have split capsules in the past - you can obtain empty capsules from a pharmacy [or off E-bay!] I just use a piece of paper and a knife to divide the capsule contents, then pour it into the capsules. It's not going to be 100% accurate but my vet said that it would even out over the day.

There seems to have been more of a move away from steroids over the last couple of years, Teddy was managed on steroids with other meds for quite some years [PTS almost 2 years ago]. I know everyone hates steroids but they do have a place. They can sometimes be given alternate days which helps the body to normalise between doses.


Carprofen [Rimadyl] and Metacam are both non-steroidal anti-inflammatory drugs (NSAID Used for alleviation of inflammation and pain in both acute and chronic musculo-skeletal disorders.


Kayleigh has been struggling since the cold weather started too :(