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View Full Version : Struggling to manage Thistle's pain



Soushiruiuma
27th February 2013, 11:26 PM
Things were going well for a few weeks. But Thistle has been in a lot more pain lately (the last 2 weeks). We went from 3x100mg of gabapentin to make her happy, then 4x100. Now 3x200mg just to keep her from screaming, even when she calms down she's laying and panting with her skin twitching uncomfortably. She can barely do anything without being reduced to scratching, and then the whimpering and screaming starts.

I just gave her another dose of the gabapentin, so today is an 800 mg day.

It can't go on like this, I need sleep. And it's just torture to keep Thistle like this. I keep saying it'll get better, but it just gets harder and harder to deal with.

What should I do?

Love my Cavaliers
28th February 2013, 12:37 AM
Riley has never been on Gabapentin, but I would talk to her neurologist about maybe switching to Lyrica. It seems like that a better medication for some SM dogs. I know other dogs on this forum are on Lyrica so maybe they'll be able to give you better advice about it. It she on any other meds also, like a CSF inhibitor? Poor baby.

MomObvious
28th February 2013, 12:53 AM
I have no advice other than you obviously need to chat with her neurologist about this but I'm so sorry to hear Thistle is not feeling well. Please keep us posted and sending happy healthy thoughts your way.

cavalover
28th February 2013, 03:40 AM
So sorry to hear about your Thistle's pain. Hopefully you can get a hold of your neurologist quickly! Thinking about you both, and sending my prayers

Kate H
28th February 2013, 10:42 AM
I think you are still in Belgium? In that case, you may have had the same area of high pressure that we have had for several weeks now, and many of our SM dogs are suffering. So you may find that Thistle's pain reduces as the pressure drops and it becomes manageable again. Lyrica could be one option, or adding a straight pain reliever like Rimadyl or Metacam on the bad days. I know how you feel - a couple of days ago I sat with my thoroughly miserable dog on my lap and thought 'I hate SM, and anyone who thinks it isn't a serious illness (potentially serious for every Cavalier) is a blinkered idiot!' I do hope your neurologist will be able to come up with some solutions.

Kate, Oliver and Aled

Soushiruiuma
28th February 2013, 05:34 PM
I have rimadyl, but it never seems to do anything. She is also taking omeprazole in the evening.

We are probably dealing with the high pressure Kate mentioned. I've been trying to keep an eye on the pressure, but the numbers don't really mean that much to me, and it never seems like we get a big change.

anniemac
28th February 2013, 06:29 PM
Riley has never been on Gabapentin, but I would talk to her neurologist about maybe switching to Lyrica. It seems like that a better medication for some SM dogs. I know other dogs on this forum are on Lyrica so maybe they'll be able to give you better advice about it. It she on any other meds also, like a CSF inhibitor? Poor baby.

I seem to always agree with you :). Ella was on several drugs but she got to the point that I was considering another surgery. I think I switched to lyrica around that time. All I know is lyrica was a miracle drug for her and I noticed a significant improvement. She even reduced some of her other meds (I think). I know for some that they is significant improvement, so much so we have to pay much more since there is no generic (I know the generic was coming out in 2013 so im not sure if changed). She also took tramadol for pain and other medications/acupuncture that are listed on treatment plan. I would definately see if lyrica helps but some dogs it doesn't but for Ella, I think it saved her.

sunshinekisses
28th February 2013, 07:13 PM
I feel so bad for you and little thistle. I think others have given you good advice. Clearly she is in extreme pain right now. Maybe you can try to add another pain medication just for short term, but it sounds like trying the lyrica might be the trick. I hope you can figure this out. I am not a strong person and I can't bare to have my dogs in pain. I don't know if I could do long term what all the other SM dog owners have done for their dogs. The crying breaks my heart.

Kate H
28th February 2013, 08:39 PM
'the numbers don't really mean that much to me' Average pressure in the UK is 1013 millibars. For most of the past two weeks it has been around 1036. It wasn't a sudden rise, just an inexorable creep, and it looks as if it's going to stay high for a few days yet.

Kate, Oliver and Aled

Jimmie Jones
8th March 2013, 03:01 AM
Can you tell me what dose of lyrica you have had success with? I am thinking that my Jimmie will need this change as the gabapentin only helps marginally.

Soushiruiuma
10th March 2013, 10:50 AM
Thistle struggles so much at night. It's like from 9 pm until 8 am she is in agony, but during the day she's quite comfortable.

I added 6 mg of prednisone per day (4 in the morning 2 at night). That was a miracle, for a few days. Then we stepped up to 8 mg, now 10.

I have contacted her neurologist, he agreed to letting me just up her doses as needed. He believes in the prednisone as the main way to manage symptoms. I'm not a fan of that, but it is keeping her quieter. We still have some breakthrough screaming fits, but it's usually after I give a dose, so I know she's close to getting relief when it happens.

Would it be crazy to try to readjust her meds so that she gets something powerful at night (like tramadol) to just guarantee quiet nights, and then try to get her off the prednisone, and maybe even step back the gabapentin (she's now getting 600-800 mg/per day(3-4 200 mg doses depending on how she's faring). It'd be nice to have her down to maybe 400 mg/day if that's possible. But maybe tramadol isn't a good choice for something to give regularly? The rimadyl (carprofen) that we have does nothing for her.

It's just during the day she's not that bad, only occasional scratching (at night scratching means she's going to start screaming in a few minutes), and she seems fairly comfortable. Her breathing is ragged when she's suffering but not screaming, but that's really only at night.

I just don't know what to do with her.

Edit: I just noticed that adding an opiate, tramadol or amantadine is the next step on the algorithm. But amantadine sounds like a horrible drug, so I'll ask for tramadol.

Soushiruiuma
10th March 2013, 10:54 AM
I feel so bad for you and little thistle. I think others have given you good advice. Clearly she is in extreme pain right now. Maybe you can try to add another pain medication just for short term, but it sounds like trying the lyrica might be the trick. I hope you can figure this out. I am not a strong person and I can't bare to have my dogs in pain. I don't know if I could do long term what all the other SM dog owners have done for their dogs. The crying breaks my heart.

I'm with you. When thistle starts screaming I can't do anything (it only takes a couple seconds to get her an extra dose), so I just sit there and cry. It's heartbreaking to watch her in so much pain.

cavie3
10th March 2013, 11:38 AM
I'm with you. When thistle starts screaming I can't do anything (it only takes a couple seconds to get her an extra dose), so I just sit there and cry. It's heartbreaking to watch her in so much pain.

I really feel for you, it is just awful to watch and it makes us feel so helpless. I hope you can get some help for Thistle soon.

MomObvious
10th March 2013, 01:30 PM
Well, when I'm sick or hurting I always feel worse at night.... I have heard of people trying Melatonin at night too. Maybe just a little with a small dose of Tramadol would work. Its all trial and error with these treatments and it must be awful to have a dog you love so much go thur this. Thistle is so lucky to have an educated Mommy, hang in there.

Soushiruiuma
10th March 2013, 04:22 PM
Well, when I'm sick or hurting I always feel worse at night.... I have heard of people trying Melatonin at night too. Maybe just a little with a small dose of Tramadol would work. Its all trial and error with these treatments and it must be awful to have a dog you love so much go thur this. Thistle is so lucky to have an educated Mommy, hang in there.

We tried melatonin. It's possible that it helped, a little. But it shouldn't be given while giving steroids, so that has been cut from our regimen for now.

Karlin
10th March 2013, 04:43 PM
Sorry Thistle hasn't found the right mix of medications yet. :(

Have you tried Lyrica rather than gabapentin? Sounds like she is already well up at about the limit of what she can take with gabapentin. Also is she on a CSF reducer? I would try her for a couple of weeks on each one, with support from your neuro or vet -- some people have good success with cimetidine, others with omeprazole. You might need to try different dosage levels. I know Clare tends to feel that many dogs need a regularly reviewed cocktail of two or more medications. She has a couple of painkillers that she uses.

I think it is really important to try and find a mix that works without worrying too much about the actual meds, though definitely go first with what you feel comfortable with -- many never get side effects or only minimal ones. I know a few neurologists that have prescribed amantadine.

One option is to do a phone consult with Clare, if you want a second opinion.

anniemac
10th March 2013, 07:45 PM
A second opinion might be a good thing. Ella was on a lot of medication but we found the right "cocktail". She was on several drugs you mentioned but I would still try lyrica. That got her off of amentadine for sometime. I can't remember the dosage of prednisone she was on but that helped with her mobility issues and pain (I feel).

She was also on tramadol and had frequent acupuncture that I believed helped. Everyone will say what works for one may not work for another. Ella didn't start on all this medication and there was a lot of trial and error. I do feel you should not do several changes at one time so that you can see what particular medication does what.

I am so sorry Thistle is in pain but if a certain medication made Ella feel better then that was the important thing. I hope things get better.

sunshinekisses
13th March 2013, 05:09 PM
Thinking of you. I hope thistle is doing better. (HUG)

Tania
14th March 2013, 10:44 PM
I have four dogs on cm/sm medication, there doesn't seem to be the same answer for all of them. All of them were on different doses of Gabapentin, Cimetidine and some were also on Trocoxil. I decided to switch them all over to Lyrica thinking it would make life easier medicating twice daily. Dougall who has cm, did not do very well at all, I even had his mri repeated to see if he had developed sm or to see if there was any damage to his spine. We increased the dose of Lyrica but it didn't make any difference. One night he started to scream! I put him on Tramodol, decided to put him back onto Gabapentin. Dougall is now on Gabapentin, Trocoxil, Cimetidine and a low dose of Tramodol which is new! Well he is now a changed dog, he sleeps through the night which he has never done before. There is slight sensitivity around his shoulders but the rest of the pain seems to be very much under control.



Each dog reacts differently, I am sure once you have found the right mix things will settle down.

mommytoClaire
15th March 2013, 04:03 AM
I don't have any experience, but just hoping and praying you find the right combo to help Thistle out.

I know it must be heartbreaking to go through watching the pain....