I've never used omeprazole so can't help on dosage, but if Charlie is showing signs of pain then you need to keep on with the gabapentin. Omeprazole and cimetadine are diuretics - they reduce the level of fluid in the body generally, and for CM/SM purposes, reduce the level of cerebral spinal fluid in the skull. This will reduce the risk of syrinxes forming and if the dog has dilated ventricles can reduce the pain these cause. But most of the pain displayed will only be affected by gabapentin, because it is specific for neurological pain - which ordinary painkillers don't help. And it is important to give gabapentin regularly so that it provides 'blanket coverage'; it is a pain suppressant, rather than an occasional painkiller. The immediate positive effect of gabapentin is sometimes taken as evidence that CM/SM is present, because it won't work on non-neurological pain such as arthritis, but can often have a quick and obvious effect on CM/SM pain.
Kate, Oliver and Aled
Oz is on 20mg omeprazole/day. Is there a reason you would want to stop the gabapentin?
Agreeing that gabapentin is generally a LOT more important than a diuretic like omeprazole for helping dogs with SM. I'd definitely want a very good reason for removing a dog from the single most helpful drug for addressing SM pain -- unless you are moving to Lyrica, which is a related medication. Almost all symptomatic dogs with SM need to be on gabapentin.
Steroids should be a last resort drug with this condition -- there's generally no reason to put a dog on them before trying other possibilities (and there are many).
Gabapentin should be given in the capsule. There are many dosage levels to try. What are you using? Very few dogs can manage just on a diuretic.
Omeprazole can cause stomach problems for some dogs. Frusemide is no longer recommended in Clare's current protocol. Cimetidine probably has the fewest sidde effects but not every drug works for every dog. Finding a good mix of meds takes trial and error and professional advice and supervision. Dogs on diuretics need blood tests every 3-6 months or so.
These are all reasons why really, these things need to be prescribed by a neurologist familiar with the condition and and the drugs and who can help to finetune them. Pain from CM can actually be tricker to address for many dogs, for some reason.
PS I think you really would want to be getting advice on treatment from a neurologist. :flwr: Radiologists generally don't have the expertise, their job is simply to read an MRI (and many don't know how to correctly read for SM). A vet definitely should not be leaving someone to guess their way through Clare Rusbridge's protocol! There is a neurologist who has worked with people with cavaliers with SM. Not sure if this is who you saw?
Dr. Donald C. Levesque
Veterinary Neurological Center, Ltd.
4445 North Rainbow Blvd.
Las Vegas, NV 89108-5711
Hi, I will definitely keep him on the Gabapentin. I will wait to hear from neurologist is to whether or not I should add a diuretic. Which is better, Gabapentin or lyrica? Also, Dr. Levesque is retired and the entire practice has moved to Phoenix, unfortunately.
Lyrica is a more refined version of gabapentin. It's usual to start a dog on gabapentin and then, if it either doesn't work well for a particular dog, or is no longer effective in dealing with pain, to progress to Lyrica. Unfortunately, Lyrica is pretty expensive - mainly because the drug company that produces it keeps hanging onto their patent and won't allow generic versions.
Kate, Oliver and Aled
Hi all, so has anyone ever noticed that their dog with SM/CM yelps if you pick them up a certain way? Charlie has done this since he was about 6 months old. He seems a little sensitive under his front legs, if you try to pick him up like a child. Obviously this could not be related at all to SM/CM, but I was just curious if dogs tend to have more joint sensitivity with is condition.
Yelping when being picked up is a recognised CMSM symptom.
Absolutely! Both Oz and Riley yelp when being picked up certain ways. I have told people in no uncertain terms not to pick them up any more because they don't know how.
Hi everyone, we recently moved backed to Philadelphia. Can someone forward me the link that lists canine neurologists that have experience with CM/sm? I tried clicking on the link above and it didn't work! I just want to have another opinion!