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rubles
3rd October 2012, 03:50 PM
Charlie has been put on omeprazole along with gabapentin. The omeprazole is mixed in a suspension by the chemist and is pricey. He takes 2.5 ML (5MG) per day and is cost prohibited for long-term use. Charlie is responding favourably and I'd like to keep him on it. It is available over the counter in 2.5 MK packets that are mixed in water for humans.
So has anyone had experience mixing ths drug for their Cavs?
If not how is this drug administered?

Brian M
3rd October 2012, 08:15 PM
Hi rubles
My Daisy is on the same meds plus Zitac .August 2011 she went on Zitac 50 mg three times a day which didn't seem to me to benefit her from what I could see
then this June her Neuro added in Gabapentin 100 mg twice daily and again to me it seemed to have no effect on her then August we added in Omeprazole 10 mg
and bingo hardly any scartching at all .We go back early Nov and her Neuro may take her off Zitac but as this and her Omeprazole work in diffferent ways ie one
lessens production of CSF and other controls amount of CSF already produced I don't know what she will advise .

I have taken a photo of her Gabapentin and the Omeprazole that she takes and as you see the Omeprazole is only a small tablet ,both are given wrapped in a tiny
bit of cheese to tempt Daisy so she has no trouble taking either .

My wife Dawn has been having some medical problems recently and one of her meds is Omeprazole 20 mg and apart from the amount of med in each they both seem
identical in the drug compounds used so I can't see any reason why the human variety you suggest can't be given .When my girls are given any meds not yet tested and
passed for animal use the doggy hospital always give me a verbal warning about this together with an info sheet about that particular drug .

Hope of some help ,there are many here with far greater knowledge than I so if any of my comments are incorrect I am sure someone will be one very shortly to correct
anything that is wrong .My best wishes to you and Charlie in dealing with this terrible thing though with my Daisy she also has a Grade 4 murmur which I consider that to
be her biggest challenge by far ,but I must also say that neither problem so far seems to have any effect on her zest for life so she is still the same mischevious Daisy she
was when a pup .

http://farm9.staticflickr.com/8320/8051069620_24ac725c1c_n.jpg (http://www.flickr.com/photos/22730263@N07/8051069620/) Gabapentin 100 mg and Omeprazole 10 mg (http://www.flickr.com/photos/22730263@N07/8051069620/) by brianmurtagh49 (http://www.flickr.com/people/22730263@N07/), on Flickr

Charlifarley
4th October 2012, 07:00 PM
If you were to use the one that gets mixed in water, you could put it in a syringe and gently swish it into Charlie's mouth. I give Bosco Lyrica, which my vet can't get at the moment, so I've been buying it from my pharmacy - same drug as humans get. It seems vets are low in the pecking order when there is a shortage of drugs :(

rubles
4th October 2012, 09:53 PM
Brian
Thank you for posting the pictures of the two medications. They're both helpful.
Omeprazole requires a prescription. Ranitidine (cimitidine over the counter) comes in the size I need. The vet learned about Omeprazole and cimitidine via this site and Clare Rusbridge's website. The Ontario Veterinary College didn't prescribe them to Charlie either so they're off label use my vet isn't knowledgeable about. She's very co-operative and open to suggestions and did prescribe the Omeprazole. So if the ranitidine is similar ................
The amount precribed is vastly different too. Is your wife's Omeprazole available over the counter without prescription?
Charlie has 0.7 millilitres of Gabapentin every 8 hours--a fraction of Daisy's dose. The Gabapentin capsule comes in 100 and the chemist mixes it in a suspension lasting about a month and a half to prescribe the smaller amount. That amount is hard to understand when compared to what Daisy successfully takes.
I'm glad Daisy and wife are doing well. How old was Daisy when SM diagnosed?
Thanks again for all your help.

Brian M
4th October 2012, 10:49 PM
Hi Rubles
My wife get her med thru her doctor and I get Daisy's through our vet .Daisy only takes 1 @ 10 mg daily so if your Charlie is n 5.6 mg every 8 hours or 16,8 mg every 24
hours he is on much more.

Bri

rubles
5th October 2012, 12:24 AM
Hi Brian,
I didn't write that very well.
Charlie has 2.5 ml/5mg of omprozole once a day
and 0.7 millilitres of gabapentin three times a day.
I get really confused with the measurements.

Kate H
5th October 2012, 11:37 AM
My Oliver doesn't have omiprozole, but giving it as a suspension seems to me unnecessarily complicated (and more expensive), when it's so easy to give tablets - my two wolf them down wrapped up in a sliver of liver pate! Also you should be able to get tablets very much cheaper from an internet pharmacy that does veterinary medicines and will sell prescription drugs. You just get a prescription from your vet and then order them from the pharmacy and post the prescription to them (for some medication, they will keep the prescription for you, but my vet won't/can't prescribe human drugs like gabapentin for more than one month at a time).

The gabapentin dose seems very low - about 1mg according to your maths (unless it should be 7ml, not 0.7 - I find ml/mg conversion so confusing!) - but Oliver started on 100mg x 3 when he developed painful symptoms.

Kate, Oliver and Aled

rubles
9th October 2012, 03:49 PM
Charlie's gabapentin is dispensed as 100 mg in each ml. So he's have 70 mgs three times a day. So he could go up to 100 mgs three times per day.

Karlin
14th October 2012, 04:19 PM
Agree with Kate -- have never heard of this much fuss either from a vet to put omeprazole in solutions! -- why not just either get a prescription for small tablets if they are this small, or cut tablets, or buy over the counter? It is regularly on sale at the major pharmacies and is available as a generic. Sometimes prescription is still cheaper. It isn;t cheap but neither is it a really costly medication.

I'd say it is very likely your dog will need to go up to 100mg 2x or 3x on gabapentin anyway -- don;t know of any that have ever stayed on smaller doses any length of time as the condition progresses/effectiveness of gabapentin weakens. Much easier and cheaper to get pills. If you are seeing symptoms I'd go to 100mg 3x and switch over to capsules as they are likely far cheaper and less fussy than oral solutions. On the other hand some like the solutions so to each his or her own. :)

Shirley -- Vets internationally can't dispense gabapentin or Lyrica directly as far as I know at all, as neither is approved for vet use yet -- and if they did, they would almost certainly be more expensive than sourcing from various chemists! It is always cheaper in my experience to get a prescription even for vet meds from a vet and then buy them online from a verified source (many in the UK etc) -- significantly less expensive than paying through the vet who does another markup. I am actually thankful that at least with these more expensive meds I have the opportunity NOT to have to buy them from the vet!

rubles
14th October 2012, 07:37 PM
Karlin
I agree entirely. In Canada there is no generic for Omeprazole and I'm told it's not available in tablets. The cost is $100.00 a month (not sure how many pounds that is). The gabapentin has been increased three times since January so will probably continue. The vet college here doesn't recommend Omeprazole or cimitidine for SM so my very cooperative vet is questioning its use. Another client with SM dogs questioned Charlie`s low dose of gabapentin too.

Karlin
14th October 2012, 09:22 PM
Hmmm -- I checked and it does seem omeprazole is available in Canada?


Health Canada is informing Canadians of the results of its review of safety information for Losec (omeprazole)... In Canada, omeprazole is also sold in generic form as Apo-omeprazole, Ratio-omeprazole and Sandoz-omeprazole.

http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2008/2008_34-eng.php

At least one of these is in capsule form; Losec at least is available in tablet form. But surprised if it would be available OTC in the US and not Canada. The price you are paying sounds very expensive!! Any other Canadians know more?

I'd talk to your neuro/vet school and vet about Clare Rusbridge's website and her treatment algorithm. Cimetidine is actually more often used than omeprazole which causes tummy upsets in many dogs and can have side-effects. Cimetidine is OTC and generic in most places as well. I am sure the vet school could contact Clare directly if they want to know more. Clare's algorithm is the most widely used approach and seen as the gold standard for SM care. I must say at this point, if professional neurologists are up to date on research in this condition, it amazes me they don't prescribe at least one CSF inhibitor as a matter of course. :confused: It can be very frustrating.

I think those of us with SM dogs often find we have to be pretty firm advocates for our dogs, on pushing for certain treatment approaches. :(

Charlifarley
15th October 2012, 04:12 PM
Shirley -- Vets internationally can't dispense gabapentin or Lyrica directly as far as I know at all, as neither is approved for vet use yet -- and if they did, they would almost certainly be more expensive than sourcing from various chemists! It is always cheaper in my experience to get a prescription even for vet meds from a vet and then buy them online from a verified source (many in the UK etc) -- significantly less expensive than paying through the vet who does another markup. I am actually thankful that at least with these more expensive meds I have the opportunity NOT to have to buy them from the vet!

Interestingly, my vet has been able to source both until about two months ago, but my pharmacist was explaining to me today that there has been a change in the law/rules re prescribing both to animals, and as you mention, I won't be able to get Lyrica from my vet for now. Funnily enough, the price has been similar, so maybe I have an expensive pharmacist or a cheap vet -unlikely :))

rubles
15th October 2012, 05:58 PM
Hmmm -- I checked and it does seem omeprazole is available in Canada?



http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2008/2008_34-eng.php

At least one of these is in capsule form; Losec at least is available in tablet form. But surprised if it would be available OTC in the US and not Canada. The price you are paying sounds very expensive!! Any other Canadians know more?

I'd talk to your neuro/vet school and vet about Clare Rusbridge's website and her treatment algorithm. Cimetidine is actually more often used than omeprazole which causes tummy upsets in many dogs and can have side-effects. Cimetidine is OTC and generic in most places as well. I am sure the vet school could contact Clare directly if they want to know more. Clare's algorithm is the most widely used approach and seen as the gold standard for SM care. I must say at this point, if professional neurologists are up to date on research in this condition, it amazes me they don't prescribe at least one CSF inhibitor as a matter of course. :confused: It can be very frustrating.

I think those of us with SM dogs often find we have to be pretty firm advocates for our dogs, on pushing for certain treatment approaches. :(
Karlin
Thanks for the info about Health Canda.
Pharmacist told me specifically there is no generic and doesn't come in tablets. I will bring that to his attention. The low dose of Gabapentin originally supplied by the vet college is also disturbing. My vet is cooperative and I did refer her to Clare's website. She looked there and told me cimitidine and omeprazole are not recommended by the college for treating SM. It's all very confusing.
I appreciate your help.
Sandra

Karlin
16th October 2012, 01:16 AM
Hi Sandra: Boy, that's all very confusing, isn't it? You might try a different pharmacist. Or try cimetidine. A lot of people find this works when omeprazole doesn't (and vice versa...). I have used both on my most affected dog and neither does anything noticeable but I do give cimetidine 2 oe 3 times a day anyway as it does help inhibit CSF flow which is at the very least a good thing in itself...

Shirley -- Thanks for that -- interesting. My vets have never carried it and I've never heard of any vet anywhere (internationally) carrying it -- odd! I had always thought they could only write a prescription, not actually carry it for dispensing -- thought that was law as of a couple of years ago in Ireland, around the same time they made it illegal for non-vets to give vaccinations or microchip (rescues used to do both themselves). I think the law is a bit confusing for vets and chemists/suppliers of meds. Will have to ask next time I am in. I think maybe you have a vet giving you a good price. :) Can you get Lyrica from the pharmacist then? I know mine have no probs dispensing to a vet prescription but have heard others sometimes have an issue.

susandavis1
16th October 2012, 11:32 AM
Interestingly, Anicare dispensed gabapentin (neurontin) for me yesterday. I need to get a prescription for pharmacy for cimietidine.

Karlin
16th October 2012, 01:31 PM
Oh that's interesting -- I alway just get a prescription written (and confusion on interpretation of what the current laws mean in practice!).

I think there's a lot of variation in how vets deal with the issue of human meds. Interesting that they actually stock it however -- that alone is a sign of a significant number of SM dogs -- they don't really prescribe it for dogs for much else as far as I know. Anicare hadn't even heard of it when I went to them with Leo diagnosed with SM almost 8 years ago. They tell me now that they regularly refer cavaliers for MRIs and positive diagnoses for CMSM. :(I am very happy that they have always been open and interested in this emerging health issue, and are not one of the practices that don't believe this is a significant problem (and therefore never or rarely refer dogs for MRI, so that the dogs never get adequate pain care).