Advice please!

I am having a bad time with Jade. She is currently on Neurontin (100mg 2x day) and Furosemide ( 10mg 2x day) and I have started Metacam to help with pain. I have found that Omeprazole causes diarrhea in Jade, so I can't use it. She is having an attack almost daily and these usually escalate to yelping/screaming. What else can I do for her?? Does Neurontin control pain and if so should I increase her dose?

Kathleen said:

I am having a bad time with Jade. She is currently on Neurontin (100mg 2x day) and Furosemide ( 10mg 2x day) and I have started Metacam to help with pain. I have found that Omeprazole causes diarrhea in Jade, so I can't use it. She is having an attack almost daily and these usually escalate to yelping/screaming. What else can I do for her?? Does Neurontin control pain and if so should I increase her dose?

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What a nightmare for her and you. I have lived with a dog screaming with pain. It is heartbreaking.

Neurontin ( Gabapentin) does control neuropathic pain. The usual dose seems to be 100mg three times a day, given at regular 8 hour intervals.
I understand that some cavaliers are managed on an even larger dosage.

There are some that are not helped at all by gabapentin, such as my Matthew. His pain is controlled by steroids.

If Jade is yelping and screaming, and you cannot get advice immediately from your vet or neurologist, I would suggest you try increasing her dose & get her medication reviewed as soon as possible.

Let us know how things go.

Sorry to have missed this while I was away on holiday.

I assume by now you'll have checked in with your neurologist as you were very concerned about this. Let us know what helped.

But for what it's worth: I think that's a pretty low dose of gabapentin and needs to be reviewed. A daily screaming session is really a sign of extreme pain so I understand your concerns to have this addressed. There are a number of alternatives to omeprazole -- furosemide, cimetidine and other things -- and your neurologist could also consider a stronger painkiller than metacam as that is pretty low-level and is apparently not working very well.

Unfortunately meds often stop working or decline in efficiency and you will need to check in with your neurologist when you start to see that they aren't adequately dealing with pain. This is one of the heart-breaking and difficult things about SM -- obviously no one wants to leave a dog in such pain and a caring owner will keep making sure the pain sessions are eliminated through the right mix of meds. If they are no longer helping at all, then it might be the time to discuss the possibility of surgery if that is a consideration, or to weigh the most responsible step.

I'd say you still have much flexibility in adjusting medications -- gabapentin in particular can be increased quite a bit as needed, under supervision by your neurologist.

If you don't have it, you can download Clare Rusbridge's recommendations on medications here:

http://sm.cavaliertalk.com/treating/treating/meds.html

It has been 3 months since my post. I am happy to report that Jade is SO much better. The miracle drug for her is Prednisone. I have her on 5mg per day and can cut it down to 2.5 mg on good days. The difference is amazing! She still scratches sometimes, but now hardly cries at all. I know that this drug is not ideal long term, but if I can give her quality and sacrifice some quantity then it is worth it. It is so wonderful to be able to take her for short walks again. I am using a step-in harness and she isn't bothered by it at all. Thought you would all like to hear my good news. Although she still has the occasional bad day, her good ones have really increased!

Oh I'm so happy for you and Jade. Prednisone is the miracle drug for my SM dog (Riley) also. Like you, I will sacrifice quantity for quality, although I sure am hoping for both!!

Really pleased to hear that Jade is feeling so much better now, and that the Prednis is helping her.

So glad that you have found a good solution that is working for Jade and for you. That is what is most important and you have time that you can enjoy again. :flwr:

So pleased to hear Jade is more comfortable.
Give her a gentle hug from me.

That is wonderful news, Kathleen. It is always good to hear of an SM dog getting more comfortable and owners feeling happier too. :w**h**:

Where abouts in South Africa are you? My stepson is currently living in Cape Town and we visited him in September. We also have friends in Kimberley. Great places for wildlife, history, scenery and friendship.

Cheers, Marie-Anne

I was also very pleased to hear that Jade is doing so much better now with the steroids. Chaos has also been on them for six weeks now and is much much better, I so agree with your comments about quality of life.
I was also wondering whereabouts you were in SA. I lived in Cape Town for 15 years and never really wanted to come back to UK, it is the most beautiful place I have ever been.

Thanks for all the positive feedback. I live in Benoni, Gauteng and fairly near O.R.Tambo Airport. This is the most wonderful country. I grew up in Zimbabwe and Africa is in my blood. I don't think I could live anywhere else! Judy and Marie-Anne I go to Cape Town sometimes as my work takes me there and I agree that it is a little piece of heaven!

Hi Kathleen

I lived in what was then Johannesburg from 1980 to 1990 - first in Joubert Park then in Turffontein. I worked for the church in a very multiracial distance learning college, so life at the height of apartheid was interesting! But a beautiful country and with some great people. I went to Benoni a couple of times as I knew the Anglican priest there, and Cape Town (where I still have friends) is my favourite city - soooo beautiful. Before Johannesburg I lived in Lesotho and KwaZulu. I got my first Cavalier in SA and used to show him, then brought my second one home to England with me.

Stay well!

Kate, Oliver and Aled