Lily and her SM.

Hi guys, I have few questions. My Lily was diagnosed with SM in June this year and it is quite severe. She was initially put on steroids, Prednisolone, 1/2 a tablet twice a day, but she was doing very poorly on it, she was very low, slept all the time, stopped being herself completely. She also had a regular accidents in the house, I wouldn't mind it too much, but she was getting really upset about it. So we changed to Neurontin (Gabapentin) 100 mg 3x a day. It was working quite well for us, there was still a bit of scratching now and then, especially when she got very excited, but other then that she was nearly back to her old self, sweet, happy doggie, just a bit calmer and sleeping more.. But in the last few days, she had two scratching fits when I actually had to hold her and restrain her. She calmed down quickly, but I'm obviously very worried about it. I was hoping we had it under control. I'm trying to make an appointment with our vets in Cork where she went for MRI, but just wanted to ask about your experience. I really don't want to put her back on steroids, so is there any other way i could help her? Different pills? Give her Gabapentin more often? Or higher dosage? If any of you had the same experience, can you please share with me what worked for your doggies? Thanks so much...

Hi Petra, welcome to the club that no-one wants to belong to, I'm sorry Lily isn't doing so well. It very often takes several weeks/months to find the right mix and dosage of meds - it varies with the degree of severity of the CM/SM and also the individual dog. 100mg x3 of Gabapentin is the lowest dose, so there is room to increase it - the usual top dose is 100mg x 6. Steroids are usually a last resort rather than the first drug given. Lily should also be on a cerebral-spinal fluid inhibitor - this reduces the amount of spinal fluid going round the brain, which helps to prevent it backing up in the ventricles at the front of the brain and also making more and larger syrinxes. The usual drugs given are cimetidine (Zitac) or omeprazole; these reduce fluid in the body generally, so you need to get a blood test done every 3-6 months to check that the kidneys don't get damaged. Was it your local vet who has been prescribing for Lily? If so, he doesn't seem to be very knowledgeable about CM/SM. The leading researcher, Dr Clare Rusbridge, produces a very useful treatment algorithm for vets - you can download it from her website and show it to your vet and ask him to follow it. You can find it at http://www.veterinary-neurologist.co.uk/resources/treatment_-algorthim_-2013-1.jpg Karlin will be able to give you names of Irish neurologists who are experts in CM/SM - MRI scans are sometimes done by radiographers who are not neurological specialists.

Hope this helps - I'm sure others will be able to help and support you to get Lily more comfortable.

Kate, Oliver and Aled (both with CM/SM)