Need some help and advice please.

Hi,

I have been a member on here since Phoebe was a pup and she is now 6.5 years old. I often pop in for a browse and a read, but I don't post very often.

I have been trying to manage Phoebe's health issues on my own (I guess I've just not felt able to talk to others about it until now)

I really need support and advice from folks on here.

Phoebe is a poorly girl. She has Inflammatory Bowel Disease and was also diagnosed via MRI at ChesterGates with SM in December 2013.

Please forgive me if this is a lengthy post, but I need to describe the full picture.
We are limited with the drugs that Phoebe can have due to her IBD. Oral medication such as Metacam and painkillers/anti inflammatories cannot be tolerated by her stomach and the same goes for antibiotics. Everything gives her bloody diahorrea (sp?) within two days of starting a course. Goodness knows what steroids would do to her insides, I just pray that she never needs them.
At the moment her IBD is reasonably controlled with diet and Zitac. On the advice of her Consultant, she has Hypoallergenic Royal Canin kibble and also the tinned equivalent. And that's it, nothing else. I use a chunk of her tinned RC to squish her tablets into and this works well when administering her meds. To avoid a flare with her IBD, all meds are given with food.

I feel as if I'm walking a tightrope between managing her SM and managing her IBD.
I don't mind this because she's precious to me, but what I'm tired of is constantly having to be her advocate between her Neurologist, her Internal Medicine Consultant and her Vet. I am the only one who understands the nuances of her conditions, not just her symptoms, but how different meds can affect her and even make her violently ill. I am the only person who intimately understands the full picture regarding Pheobe's health. I am sure that many on here can relate to that feeling.
I think I must be feeling a bit lonely and tired about it today

Phoebe has 100mg of Gabapentin 3 x daily with food, plus Zitac 3 x daily.
Recently her SM symptoms have worsened. Face rubbing, scratching around neck area, limp on right front leg are all increasing, and there is the start of a head bob.
I rang her Neuro at ChesterGates for advice (Ulrika) but she is off sick at the moment. I was passed on to Lucca, who suggested either adding Tramadol to her current meds or swapping the Gabapentin for Lyrica. Because of her IBD, I opted for Lyrica so that I can keep the number of meds to the minimum.
I was told to give her 2mg per kilo of Lyrica 3x daily and that we should gradually increase the dose over time.

Well, I'm such a twit, I should know that Pregabalin only comes in capsule form and that the lowest dose is 25mg.
I take this drug for Fibromyalgia and ME!

Based on her weight (9kg) Phoebe needs 18mg of Lyrica 3x daily.
Do I open the capsules and remove approx. 1/3 of the powder? This isn't a problem for me and I know that it won't be forever, eventually she will work her way up to 25mg doses.
Having read as much as possible on here, I have noticed that most dogs on Lyrica only take this drug 2x daily not 3x daily.
Does Lyrica cover them for around 12 hours? If so, I would ask her Neuro about giving her the Lyrica only 2x daily. Obviously as she has to have all meds with food, medicating her less frequently means feeding less frequently and fewer concerns about weight gain....... I would be able to use less of the tinned Hypoallergenic RC (which I believe causes the weight gain) to administer her tablets.

I also need advice on how to make the transition from Gabapentin to Pregabalin please. I can't believe that you just stop one and start the other instantly. I rang her current Consultant to ask these questions and was advised that I would receive a call back.........2 days later and I'm still waiting!

I will of course speak to her Neuro again, but I would appreciate any information based on personal experience from all of you.
I want to make informed decisions on Phoebe's behalf so that I do the very best for her. Naturally anything I do will be with the full agreement of her Consultant.

I'm sorry about this huge outpouring! I didn't realise until now quite how isolated and sad I have been feeling about all of this.
There are other questions I wish to ask, but they can wait. I have included the most important for now within this post.

I need to know that I am doing the very best at all times for my little girl. I hope that some of you with more experience than I regarding SM meds (particularly with Lyrica) will be able to help me.

Kind regards,

Phoebe's mum. x

I wish I could help you with the Lyrica and the transition, but I have no experience with it. I do have experience with IBD with Oz and know how thin a line you have to walk with them. It has taken years of trial and error with different meds and diets to get to a pretty stable condition with Oz. The only diet he tolerates is Hill's D/D prescription diet. I can't stand the food, but they started him on it in the intensive care unit about 9 months ago and he has gained weight and kept it on and most of his symptoms have quieted down. They're not gone, but they're quieter. He is on metoclopramide 3 times a day and Prilosec once a day. When he went off the metoclopramide as a trial because he was seeing a homeopathic vet, he ended up in intensive care for a week. For his SM he is on Gabapentin 100 mg 3 times a day. I wish you luck. I know someone on here will be able to help you with the Lyrica.

Hi Bev,

I'm sorry to hear that you have been through so much with Oz.
I know exactly what you mean when you say the symptoms are quieter but not gone and can well understand Oz ending up in intensive care just because of a change in his meds. With Inflammatory Bowel Disease, the smallest change can make them violently ill can't it.
Phoebe was on Antepsin as well as the Zitac to try to calm her stomach. Then the liquid Antepsin became unavailable, but she is managing ok without it.

When Phoebe had the endoscopy her Consultant was pretty shocked at the state of her insides. She told me after the procedure that even attempting to introduce any instruments caused the gut lining to instantly flare bright red and then bleed. I know her Consultant was doing her best, but she wanted Phoebe on long term antibiotics for her tummy and I consented, knowing/fearing what the outcome would be. She lasted on them for two days before her bowel movements turned to bloody liquid. I had to refuse when Steroids were suggested, I was afraid that like Oz, she could very well end up in intensive care.

Do you get up some mornings with Oz and just know that he is going to refuse food and have a bad day? This is a real problem for me because Phoebe has to have her Gabapentin with food and I then worry that her SM symptoms will really kick in due to lack of medication. In desperation I sometimes have to mix up a small amount of water with the contents of her Gabapentin capsule, mixed with a tiny bit of tinned RC to make it taste tolerable and then syringe it into the side of her mouth.

How do you give Oz his medication? Does he also have it buried in a bit of tinned food? It isn't as if you can use something super tasty to encourage them to take their meds is it.

I'm pleased to hear that Oz is stable at the moment. I think things are probably as good as it's going to get with Phoebe's tummy as well, that is, with the minimum of medication and sticking rigidly to a single diet that suits their gut. If she suffers another bad "do" with it, I will ask her Consultant about Metoclopramide.


Thank you for responding to my post and I hope that Oz continues to do well for you.


Phoebe's mum x

Would you please delete this thread.

Thank you.