View Full Version : What do you do for SM itchiness?
16th May 2012, 03:23 AM
This is my first question here although I have been reading posts for awhile now, very informative. My 2 yr old cav has been mri diagnosed with SM 5 mo ago :( It was excruciating watching her go through all that pain I can only imagine what it felt like for her. She is now on gabapentin and omeprazole and has bounced back to life and is back to her old self running and playing :)))))) But for the past couple weeks she has been scratching alot (underbelly, ankles,under tail, buttocks, armpits) and it is becoming more frequent. In some areas like under the tail and ankle she bites so much it has scabbed over. I have been putting peppermint oil to soothe the itchiness and allows her some peace but seeing as its getting worse I wanted to know, is this due to the SM or is it something else that I should be checking into ? She doesnt have fleas and I have been giving oatmeal baths. Also she is on a grain free diet and nothing has changed diet wise. Does anyone else have a similar problem and is there any solution? I would rather have a more natural remedy to try as she used to be on steroids and blew up like a balloon and was very lethargic. Thank you for any responses. I would just like to know if there are things I can do to try to make her more comfortable.
16th May 2012, 12:45 PM
Has Mochi had her anal glands emptied recently - if they're overfull or infected, they can cause a lot of biting around the rear. Another possibiity is a fungal infection - any sign of small sooty patches around the tummy and genitals area? With SM, scratchiness is usually a sign of pain or nerve irritation, ie coming from inside, so that's what needs to be treated rather than the skin. But Mochi's could be external and unrelated to her SM - anal glands, an infection, an allergy. What do your vet/neurologist think?
Kate, Oliver and Aled
16th May 2012, 03:08 PM
We use the following product which we find superb ,not sure if they ship to The US. Just checked and they do .
16th May 2012, 03:22 PM
I think your first port of call needs to be the vet -- this is pretty severe damage that Mochi is inflicting and a sign of a lot of discomfort and possibly could be pain. You need to work through possible causes with a vet. They could be unrelated to SM, but are some of the kinds of things people commonly report. Often medication declines in effectiveness -- this is well known with gabapentin -- so it could well be that Mochi needs to have meds reviewed by your neurologist amd the dosages increased in one or another, or a new medication introduced to the mix. Most dogs need a mix of meds, often a painkiller on top of a CSF inhibitor and gabapentin or Lyrica.
Thus I'd make a vert appointment asap, review the situation with your vet and then your neurologist as needed.
If nothing is obvious to the vet (eg mites, fleas) I would first try increasing or changing SM medications (working with your neurologist) as I think most likely, pain breakthrough is causing the chewing/biting/scratching. If the situation resolves by doing something like adjusting the gabapentin dose, then you will know right away that is the case. But yes, do have anal glands checked too. Biting until the tail scabs over is pretty severe for anal glands though -- but unfortunately is known with SM dogs whose pain isn;t being adequately medicated. Most neurologists start with a fairly low dose for dogs of things like gabapentin and for many dogs, this is only adequate for a short period and sometimes not at all. Medications need to be regularly reviewed with the neurologist when there are any signs of discomfort.
Putting something on the skin will do nothing to address the cause if it is allergy, fleas, mites, or SM pain. As Kate indicates, the scratching of SM is caused by neurological pain and discomfort; it doesn't have anything to do with the skin per se. :thmbsup:
16th May 2012, 06:06 PM
Also, make sure you are REALLY rinsing out ALL the shampoo when you bathe her. Any residual amount can cause extreme itchiness.
16th May 2012, 11:34 PM
Thank you all so much, I will have her anal glands expelled, I did not think of that. I called our vet when this started getting bad but he said this is common in SM dogs and to treat it with hydrocortisone as she isnt having any breakthrough pain ( shes not stiff, yelping, walking slow) and its best not to up the Gabapentin untill further signs. I think I should make an appt. with our neurologist however as he is more familiar with SM. I always thought we would need to up the medication when she starts exhibiting those obvious signs like crying and limping since every time I talk to our neuro he asks about those things to see if the current meds are working.
Also thank you Brian for the Dermacon recommendation, it seems perfect for helping her till we get to the bottom of this, do you recommend the cream or spray?
And Kate, I dont see any sooty patches, just scabbiness. Im going to ask the vet to do a panel to check for allergies, I'm giving her the best quality food I can find and she is still a picky eater about it so I hope it's not that, I dont know what she'll want to eat then :/
17th May 2012, 12:27 PM
I called our vet when this started getting bad but he said this is common in SM dogs and to treat it with hydrocortisone as she isnt having any breakthrough pain ( shes not stiff, yelping, walking slow) and its best not to up the Gabapentin untill further signs.
This is absolutely WRONG! :yikes All of these things you are seeing are likely signs the meds are not working and there is pain... This is the problem with having vets deal with SM -- they really have very little knowledge of it and very little training in neurological complaints, especially something that they would generally almost never see (outside the growing incidence in cavaliers).
This is so frustrating-- that vets give uninformed advice like this and leave dogs to suffer and owners confused as to why their dogs are doing something. The vet should have called your neurologist. Chewing at a tail until scabs form is a serious sign of discomfort -- at best -- and likely pain. This goes way beyond simply mild SM signs. For comparison -- I have a dog on considerably higher meds -- 600mg of gabapentin daily plus a painkiller plus cimetidine -- who never does any of the things your vet thinks are 'serious' or 'painful' -- but he has a significant level of discomfort and a serious level of SM. He scratches mostly as a sign of his pain but it is, as Clare Rusbridge argues, pain that causes severe scratching. It isn't a trivial symptom at all. :( Many dogs also will hide pain (a natural protective instinct) til it is so bad that you see more severe signs -- why a neurologist is really so essential with this condition as they can quickly ascertain levels of discomfort and symptoms that most vets will entirely miss or dismiss.
I think Mochi really must see your neurologist (as you plan :) ), and get proper medications. Hydrocortisone will do nothing to address SM pain. Please do not try skin care treatments and allergy for this as it is a total waste of your money right now, better spent on getting proper advice.
All this is not the fault of the vet in some ways -- this is a *specialist* condition and really a vet should only be there to help support your *neurologist's* diagnosis and medical recommendations, and the vet should always go talk to the neurologist if it looks like a change in care is needed -- as I would argue 100%, is needed right now.
You should steer your vet to Dr Clare Rusbridge's webpages too, as there's a whole section for vets which will at least leave the vet and practice better informed.
Please let us know how a visit with your neurologist goes and what recommendations are made for Mochi -- I would guess you would see a considerable improvement with proper medications and increased gabapentin or some other addition to the care regime. :flwr:
17th May 2012, 07:57 PM
I agree with Karlin. You can't leave your dog with this level of suffering. Hopefully, you can get an appointment with a neurologist soon and get to the bottom of this. Your GP vet is not addressing the problem.
8th July 2012, 05:43 AM
sorry for closing this up so late but I had a bit of family issues to deal with. I wanted to thank everyone and let you know Mochi is better now. On recommendation from her neuro we upped the gabapentin to 100 mg every night from 50, btw , she does'nt have a painkiller for any breakthrough pain since we tried Tramadol and that didn't work and our neuro said the only other option is Buprenorphine which he'd like to reserve for severe pain since that is the highest painkiller. I also purchased the Dermacton soap and spray which works wonderfully. Turned out it was a combination of dermatitis and too low a dosage of medicine. She is much happier now and that always makes me happy as well :)
8th July 2012, 11:03 AM
So glad she is better but the neurologist is not correct in saying that that is the only other option for treatment, if you look on Clare Rusbridge's site there is a treatment algorithm which is really helpful
8th July 2012, 06:17 PM
On recommendation from her neuro we upped the gabapentin to 100 mg every night from 50,
I'm hoping that you are giving gabapentin three times a day; it's hard to tell from your comments whether the drug is only given at night. Please read the information on Clare Rusbridge's site about medication options - I fear that you don't have correct and up-to-date information on medications and dosage recommendations. Gabapentin effectiveness only lasts from 6-8 hours. Scratching/biting as you describe is a clear sign of the typical response to pain in SM dogs - and your vet and neuro seem to be confusing this with itchiness.
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