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Blondie on gabapentin and question about pill dispenser

I'm sorry that the Vet felt it necessary to put her on the med at this point. I felt your pain when you said it hurt your heart to see her dopey and not wanting to play.

I can't imagine how that makes you feel. I hope you're able to work through it with the Vet and lower the meds quite a bit until, or if she ever needs more. Can it be something that is given every other day to start? Just curious. And like you said, you haven't seen changes in her.

I'm just sad for the progressions into the gabapentin at this point.

Give Blondie a hug from Claire and I.

Cindy and Claire
 
This is what I emailed him. Hope to hear from him soon.

"Hello Dr. W

This is Blondie's mom, Lynn. We saw you yesterday at Animal Medical Center.
I have a question about Blondie new medication: Gabapentin 150 mg 3 times a day.
When I look at Claire's R. treatment algorithm (http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf)
and talking to other cavalier owners with SM, it seems to be an extremely high dose to start off with...
I remember you said something about the medication not working at a low dose, but could you please explain more?
I know you are able to pick up on subtle clinical symptoms etc, hence why we come to see you,
but we have not noticed any clinical worsening (if anything I'd say she is more playful and active)
of Blondie since we saw you 6 moths ago and are wondering; why starting of at this high dose?
I do understand and acknowledge there must be a level of discomfort, but, referring back to Claire's algorithm, may I also ask
why the NSAID step was skipped and why the dosage is 150 mg 3 times a day rather than the recommended 100 mg 2 times a day?
She is reacting pretty "ragdoll" to the drug and I know she will probably get used to it, but I am also worried about jumping to fast to a high dosage
and having "nowhere to go" after."
 
mommytoClaire said:
I'm sorry that the Vet felt it necessary to put her on the med at this point. I felt your pain when you said it hurt your heart to see her dopey and not wanting to play.

I can't imagine how that makes you feel. I hope you're able to work through it with the Vet and lower the meds quite a bit until, or if she ever needs more. Can it be something that is given every other day to start? Just curious. And like you said, you haven't seen changes in her.

I'm just sad for the progressions into the gabapentin at this point.

Give Blondie a hug from Claire and I.

Cindy and Claire
Click to expand...

Thanks Cindy!!!! Yes, it's all a bit stressful, I am just trying to make the best decisions for her... I trust my vet but I also think that I know her best so I am gonna get to the bottom of this!!! :) It doesn't feel quite right to have the dosage this high. It's a gut thing.
 
Hi Lyn

How is Blondie feeling now? I remember Jack was very "dopey" for the first few days on gabapentin. He went to Dr. West after being put on 100mg twice daily by Dr. Marino. Dr. West wanted him on 150 3x's daily but said if I could do 100mg for a while and then increase to 150mg Jack was still symptomatic so then we went to 150mg 3x and finally 200mg 3x's. Jack weight ~21 lbs (yes a big boy)
I use a cat timer called "Animate C10 Cat Mate Feeder" that I purchased from amazon.com for around $24, it works great when I can't get home for his mid day dose. I too use the greenies pill pockets just for this dose (as Anne said, I get the large capsule size and break it up to cover all his pills; saves money) for all the other times, i use cheese or mix it in his food. I don't like to give the greenies too much because they are junk ingredients but work well for that one dose, since they dont need to be refrigerated
When I had to do the 150mg dose, I would just open the capsule and try to evenly distribute the amount, it was very frustrating to say the least. Does the compounding pharmacy where you get Blondie's omeprazole also do 150mg caps of gabapentin?
I am curious as to what he says about the dosage when you talk to him again. Surely he would agree to a 30 day trial on 100mg 3x day and then reassess?
I know how frustrating all this can be. I feel like of the two neuro vets that have seen Jack I don't agree 100% with either one:eek:. Obviously, I am not an expert but I love and know my dog more than anyone and that needs to count for something.
Hugs to Blondie
 
thanks Irene! Yes very frustrating it is! I am totally confused. Blondie is generally doing really well, not different than 6 months ago.:confused::confused:
I would feel much more comfortable starting at 100 mg twice a day like Claire recommends. Unless I am a total idiot I haven't noticed increase in symptoms in her. And I spend sooo much time with her... She does 2-3 strokes of air guitar scratching maybe once a day (not every day) and an occasional yelp when touched wrong but that hasn't changed as oppsosed to 6 months back.
 
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I think it's a good e-mail–polite but to the point. It's important to keep in mind that every neurologist may have their own approach, and I think that if you are seeing air scratching, you probably are at the point where you want to start gabapentin. On the other hand, just something like frusimide helps stop scratching for some cavaliers. If you aren't happy with the treatment approach, you can always go to a different neurologist for a second opinion.

For what it's worth, Leo was on less than 100 mg twice a day (he's a small Cavalier) for about a year before going up to 100 mg twice a day. It was quite a while before he had to jump to 100 mg three times a day, and we have gradually gone up from that. He started medication at around age 2, and now is about 7 1/2. He scratches daily from time to time, and very occasionally he can be sensitive to touch. He also has a heart murmur now.
 
Hey karlin. It is great to hear leo has been so succesfully managed. I know it may be against medical protocal but Last night i decided lower blondies dose to 100mg twice a day. After giving her the lower dose twice she is so much more herself. My philosphy is its easy to go back up but going back downis harder when on high dose too long. I think its an informed temporary decision from a concerned mother.:) I like dr west but a second opinion may not hurt. I had no idea aboutthe frumiside and will also ask. As for the scratching; blondie is very inconsistent with her symptoms. Mild Scratching comes and goes... Its so hard to know at what point do u treat and how....
 
If she is scratching, and occasionally shows pain, she definitely has symptoms, and needs to be treated. I think it's a good idea for any dog with SM to be on some kind of CSF inhibitor like frusimide, for reasons explained in various threads over time. There is some evidence that if you start it early you can halt the progression of a syrinx or at least slow it down in some dogs.
 
Hey Karlin. Agreed. ALso; do u have any opinion on what CSF works best? Do you think furmiside works better than omeprazole?
 
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