18th November 2008, 07:58 PM
The neurologist is of course the expert but this treatment approach just seems excessive to me. Unless the neurologist actually saw the scratching and assessed it as actually being a reaction to having a syrinx and thinks the stiffness is painful and definitely caused by the syrinx (both of which seem unlikely with a tiny syrinx, from all the conversations I've had in the last couple of years with researchers) I don't understand why she is even on a painkiller. Really, if all of us on the board MRId tomorrow probably a third or more might MRI with what you are seeing and most of those would have no symptoms at all. That is why I wouldn't recommend MRIing without understanding the broader context of what is being seen by researchers -- eg a high rate of affectedness but a lower rate of symptoms -- and understanding the various approaches to treatment, IF NEEDED.
If the neurologist truly believes Star is scratching from SM and has seen this for herself to separate out what is normal scratching, then perhaps she needs medications. Yet most dogs would simply be put on one of the CSF drugs and might never, ever need something like gabapentin. It also sounds like you are giving 100mg three times a day -- it took 4 years before Leo was on that high a dose, just to give some context, and he is showing a lot of definite symtpoms. A dog that just scratches a few times a day for 5 seconds or under is not scatching due to SM. SM dogs scratch for long, long periods and cannot be distracted from scratching.
If you go to www.smcavalier.com, all the treatment approaches are explained, all the medications are explained, and you can see videos of typical SM scratching, which does very much stand out from normal dog scratching. My clear dogs would scratch many times a day for a few seconds at a time, just for context.
I just do not believe a valuable painkiller that is known to lose effectiveness over time should be wasted by being used too early for a dog that isn't having any problems.
Keep in mind that dogs with the scan you received (and if the scratching is not SM scratching) would still be considered fine for breeding under the researcher recommendations -- this is not a bad scan at all from what you have described, and is a very minor syrinx. I just think you really need to clarify whether you re seeing SM scratching so as not to give medications that are not necessary.
In memory: Lucy
18th November 2008, 09:17 PM
I'm very worried about this now as have seen the diagram on meds and it says further down about Gabapentin 2 x daily for dogs between 8-12 kg.. Star is only 6 kg at the moment.
Is it worth me getting a 2nd opinion or just phoning the neurologist that dealt with Star and asking why she's put her on this drug to start off?
I need to keep an eye on the scratching (she also scratches at her side by her ribs) but she has yelped a couple of times for no apparant reason and she does bite at her hind quarters a fair bit.
18th November 2008, 10:05 PM
If the neurologist did a full assessment they will be able to tell you why they opted for this treatment approach. You should talk to the neurologist.
Puppies in particular often will seem to yelp for no reason and you'd want to have eliminated all possible reasons for her biting at her hindquarters before assuming this is SM.
The dosage is what is significant -- gabapentin comes in everything from 100mg on up. A 6kg dog would usually be trialed on 50-75 mg 2x. You will see Clare has a recommendation based on the weight of the dog AND the amount of drug per kilo. But that is only a starting point. Leo weighs 6kg and gets 100mg 3x. Many are on far higher.
I'm only going on what you have described; and it is hard to guess whether what you have seen is significant because board posts are not very useful in this regard. But what you have described just makes me doubt you are really seeing symptoms for Sm that are significant. But it is your neurologist who did the tests and has made a decision based on that. I would just be concerned if they are only recommending medications based on a description of possible symptoms they didn't see the dog exhibit, and that actually could be due to many other reasons; and so many dogs would likely MRI with a small syrinx that I'd really want to be sure the dog needs gabapentin. That is all I am saying and it is simply my opinion; and also wondering if there are not really clear reasons to give gabapentin why other things weren't tried first. Usually gabapentin isn't started until there are very clear signs of chronic symptoms. But all neurologists will have their own approach.
The place to start is with your own neurologist. If you want a second opinion you can book that with a different neurologist and bring your scans.
In memory: Lucy
19th November 2008, 04:05 PM
Welll I phoned the AHT at lunchtime to speak to the neurologist but she wasnt about so am hoping she will call me back at some point today.
I'm very concerned now about Star's med and want to get my head round it and find out the reason, if any, why she has been started on such a high dose of painkillers when noone else seems to have the same treatment early on.