Medication advice

[jacies]

Hi All, I have a little girl called Chaos, who is nearly 6, who was diagnosed with SM about 18 months ago (although I now think she had it from a young age) when she took part in the drug trial at the RVC. I signed her up myself as my vet had not diagnosed her problems. I know that one should consult a neurologist about medications but unfortunately I had to cancel my insurance after they would no longer pay for SM and now she is registered with the PDSA and I get a prescription for her Gabapentin and buy it online. I really wish I could afford to take her to see Claire Rushbridge but just can't afford it.
For the past few months the Gabapentin, 100mg 3 times a day, does not seem to be helping her like it used to and she is getting very bad now with scratching and loosing her balance etc. A few months ago I added Omiprozole every morning and although this did not seem to make much difference to the SM it certainly has helped a lot with her dodgy tummy which she has always suffered from. She used to get an upset at least weekly, bloody motions and unable to eat and, touch wood, has not had a problem for a few months now.
I have an appointment to take her to the PDSA in a couple of days, although they are helpful they don't seem to know much about SM. I have been reading online to see what I can do next to help Chaos and am wondering whether to increase her Gabapentin, possibly just in the morning to start with as that is when she seems the worst. I was considering Prednisolone but having just read about the side affects online am not sure this would be a good idea.
Any suggestions or advice would be welcome.
Judy

[Love my Cavaliers]

I understand your reluctance to use prednisone. Reading about the side effects is pretty scary. But for Riley (7 years old) who has been on 5 mg prednisone daily for close to 6 months now for SM, they are a blessing. Her quality of life is so much better and if that's the one thing I can do for her right now (except for love her), then I will do it. It is the only thing that has helped her balance issues. It might be work trying Chaos on it for a while. It is pretty cheap and you might be able to go on it every other day or three times a week if it helps. I started a thread a while back about long-term side effects of steroid use and found many dogs who have been on them for years. Can't help you with Gabapentin because Riley doesn't seem to need it. She never scratches and doesn't seem to be in pain. I wish you luck.

[Karlin]

Is it too expensive to see a neurologist, or too expensive to get an MRI? You can see a neurologist without opting for an MRI, which might be a way to go.

You should at least find a PDSA vet willing to consult with a neurologist on medications. It is not wise to experiment. There are a range of regular tests that need to be done to make sure the medications such as gabapentin are not causing liver damage or other problems as well. At the very least I would have your vets work with Clare's treatment protocol which you can download from her website. Please don't make guesses about what to give and how much, as if your dog is having balance issues this is probably a fairly advanced case of SM and she needs that informed care. Nobody here has the knowledge to recommend what medications your particular dog needs and I'd not want anyone to give medical advice without medical training -- and all these medications have potential conflicts and side affects -- and not all are suitable for all dogs. You could place her more at risk of other problems to treat her blindly, but I am sure there's a way forward. Maybe your vets at the PDSA could get in contact with Stone Lion or Chestergates or elsewhere for direct advice? I am sure one of the neurologists on the lists of those in the UK would give advice to the PDSA. Did you bring the treatment diagram into them?

[jacies]

Hi Karlin, Chaos did have an MRI scan as part of the drug trial at the Royal Vet College where thankfully all the scans and medicines were free. I spoke to a very nice lady at Stone Lion who told me the cost of a consultation with Clare Rushbridge and was more than I could afford. I did take the treatment chart by Clare Rushbridge to the PDSA and all her notes from the RVC. The vet I saw did not even look at the treatment chart and they just gave me a prescription for Gabapentin.
However, when I take her to the PDSA again on Thursday I will take the chart again and try to get them to consult with a neurologist if they do not have enough knowledge themselves as to what her treatment should be.
I am just trying to do my best for Chaos as it is so upsetting to see her the way she is now. I have been battling her digestive problems since she was a puppy and the fact that she has been fine since she is on the Omiprazole is great as that caused her a lot of pain and hard to give her the SM meds when she could not eat anything.
Judy

[Karen and Ruby]

I found Ruby didnt do well on the Gabapentin and it caused her co ordination problems and stumbled alot on it- aoarently it can have that affect on some dogs. She has been fine since switching her to the Pregabalin although that probably isnt helpful to you as it has just cost me £150 for a two month prescription.
I would make your vet look at the treatment plan as its what my vet uses for Ruby and she has some SM experience from her own Cavvie aswell

All im trying to say is that it could be the Gabapentin causeing the problems with her co ordination rather than the SM itself

Karen

[jacies]

Just to let you all know that I have taken Chaos to the PDSA on Thursday. The vet I saw said she had recently read an article about SM and that when she got home she would read it again and then phone me to let me know what she recommends. She phoned on Friday and at first she said she could have 150mg Gabapentin 3 times a day and asked if I could cut them in half but when I said they were capsules she said she was prescribing 5mg prednisalone once a day and that she would order in some Tramadol for her as well. I think she said she wanted her to have the preds for a short while and they will let me know when the Tramadol is in to collect it. So I collected the preds this morning and have given her one today, I am hoping and praying that it does not upset her digestion but have to try it.
I did ask about Liver tests but she said a normal practice would do a test but that they did not do them.
Luckily at the moment we have Leyla her Blenheim friend staying with us so she is eating very well with the competition and is generally more cheerful with her here.
Judy

[Love my Cavaliers]

With the prednisone, Riley is on 5 mg pepcid every day to counteract any stomach problems related to the steroid. Even when she was on it (prednisone) for just a couple of weeks, her neuro wanted her on the pepcid. May be worth a phone call just to see - or wait to see if she does have problems with it. Riley was better almost immediately after she started the prednisone. I think they only check the liver when they have been on steroids long-term. Riley will be having hers checked every 4 months and she is also on Denamarin to protect her liver. I hope everything agrees with Chaos and her quality of life gets better.

[Love my Cavaliers]

Just another note - prednisone makes some dogs pee a lot since they have a tendency to drink more. My German Shepherd could not take it because she had to pee all the time and would just go anywhere if no one was home to let her out. Riley so far has been fine on it. She seems to pee longer when she goes out, but doesn't seem to go out more frequently and she sleeps all through the night. Something to be on the lookout for.

[jacies]

Hi Bev, thanks for your reply. I am giving Chaos Omiprazole to help with her SM but it is also given for ulcers and since she has been on this Chaos's digestion has been much better. I do have a couple of bottles of pepcid type medicine for her as well but hope she does not need this, she has not needed any since she has been having Omiprazole. Since she was a puppy she used to get terrible indigestion with loud rumbles followed by diarrhea every 10 days or so, the vets and I could never get to the cause of it but she is a very nervous type and that might be the reason.
Judy

[jacies]

Hi Bev, just seen your second post about the peeing. I have always worried about Chaos because she hardly ever seems to pee or drink very much. When I let the dogs out in the morning she does not have a pee she waits until we get to the lake and then she will have one there and that is usually about 9.30. She does do it on command about 10pm before bed when she knows she will get a biscuit after she has been. I now add a bit of water to her dry food because I worried about her not getting enough fluid.
Judy