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Thread: Spencer

  1. #1
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    Default Spencer

    As you may remember Spencer was diagnosed with CM, though thankfully no SM, in mid-February. He’s been on Neurontin (gabapentin) for 32 days and is taking 200mg twice a day. He doesn’t scratch quite as often but definitely with the same intensity and for about the same duration (40-100 seconds- I've timed it!). I finally got to speak with our neurologist today. Gosh, was he hard to get in touch with! He was disappointed to hear that he’s still scratching though did say it was good that the episodes have decreased a little.

    He wants us to try 300mg of Neurontin twice a day for two weeks and I need to watch him like a hawk for any signs that his scratching is decreasing. I mentioned adding Tagamet to the Neurontin. He said that we could try it though he’s not sure if will help since Spencer doesn’t have a lot of CSF production and Tagamet is usually good at reducing this. But I’m going to try it anyway! If after two weeks I don’t see improvements he wants us to consider surgery. He said the damage is ongoing and irreversible but surgery would help avoid continuing damage. He does decompression surgery and lamanectamy. I really hope we don’t have to go down this road now but if we do I’m going to research whether it would be better to have Dr. Dewey do it since he’s using the mesh plate.

    Please send good thoughts our way. And to Molly and Bentley and all the other wonderful CM/SM furchildren on the board.
    Spencer and his mom, Whitney

  2. #2
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    I'm sorry to hear this. that is quite a high dose of Gabapentin.

    I was told that there can be residual nerve damage so the scratching may not go away completely anyway.

    THe other effect of Tagamet {Cimetidine} is that it decreases that rate at which Gabapentin is processed by the body - as you may be aware, it's generally given every 8 hours as it passes through very quickly.

    Once TedBear was on the Tagamet, we reduced his Gabapentin to every 12 hours, and he's doing fine. Previously he was on it every 8 hours, and for at least an hour before the next dose was due he would look very miserable and uncomfortable.

    It might be worth mentioning that to your neurologist too.

    I really hope Spencer will keep as well as possible - my personal decision was not to opt for surgery, but only you can decide that.
    Nicki and the Cavalier Clan Our photos www.scotlandimagery.com
    Supporting www.rupertsfund.com and www.cavaliermatters.org

  3. #3
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    Thank you, Nicki. Yes, Dr. McDonnell said to do the Tagamet 3 times per day. I asked about the 600mg of Gabapentin every day and he wasn't worried about. Spencer didn't expereience any of the groggy/out of it side affects when we started it and because of that Dr. McDonnell said he should be fine with the increased dosage.
    Spencer and his mom, Whitney

  4. #4
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    TN Spencer to VA Spencer: Feel better soon buddy!
    Lindsay
    Proud mom of Spencer (tri), Izzy (blen), Tilly (tri) and Howie the cava-cat

  5. #5
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    Wow, the tagamet three times daily? Mind if I ask the dose and Spencer's size? (I know you told me the latter before, I just don't remember).

    Frusemide works differently from tagamet so that might be a different option. Some find one works and the other doesn't. Many find frusemide is very effective.

    Leo's level of scratching has gradually increased so I am looking at whether he needs increased gabapentin or at other options. He is on a fairly low dose -- 100mg twice a day.

    PS I think often frusemide alone helps CM dogs that do not have SM... so maybe it is worth trying that rather than tagamet? I know I just read something on this in Clare Rusbridge's thesis so will see if I can find it.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  6. #6
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    Karlin- Spencer is my loving Cavzilla at 23.5 lbs. We're supposed give 1/2 of a 200 mg tagamet tablet 3 times a day. And 300 mg of the gabapentin 2 times a day.
    Spencer and his mom, Whitney

  7. #7
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    That's interesting, that is a MUCH higher dosage of tagamet than I have seen suggested in one of the club bulletins. Makes me wonder if a higher dose would help Leo. The dose on the bulletin is to take a 200mg tablet, dissolve in three TBSP water, and give an amount just under 1/4th a teaspoon daily. So this is a very, very low dosage -- it would take me several weeks of a once a day dose to get thru that ONE tablet in other words.

    I am really interested in this as I haven;t heard of other possible ways of approaching using tagamet.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  8. #8
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    Do you think this high a dosage is dangerous? When I asked about it he put me on hold so he could check the dosage. And he didn't say anything about dissolving it in H2O.
    Spencer and his mom, Whitney

  9. #9
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    I have been told that Tagamet is a very safe drug.

    It used to be used for dogs as an antacid - I actually give half a 200mg tablet when they have colic or colitis, it's very effective.

    This is the original dosage as appeared in the Cavalier bulletin:

    200mg tablet Tagamet dissolved with 1 1/2 oz (3 Tablespoons) water, keep in dark bottle in the refrigerator and give 0.9cc {0.9ML} per day.

    I make this up about every 5 days, keep it in a glass bottle in the fridge and give my boys 1ml daily as they are quite big – 21 and 23lb - I have a Cavzilla too . I find it works best given in the morning about 1 hour after breakfast.

    It does sound like he checked the dosage though - I really hope it helps Spencer, please keep us posted.

    The severely affected dogs I was aware of from the support group were generally on 200mg of Gabapentin 3 times daily - every 8 hours.
    Nicki and the Cavalier Clan Our photos www.scotlandimagery.com
    Supporting www.rupertsfund.com and www.cavaliermatters.org

  10. #10
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    I'd just check the tagamet dosage -- but I am quite interested to know if he feels a larger dose is more likely to be helpful. That .9ml is a tiny, tiny amount daily.

    As with humans gabapentin can be variable in how effective it is at certain doses for certain types of pain. Some dogs can be on quite high doses. For some it also may not help very much.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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