Tramadol

[Karlin]

Prednisalone is always a bit of a miracle drug -- the issue is the long term effects. However neurologists definitely say it may be the drug of choice in many situations and the goal is to find the lowest maintenance dose. If you see a big improvement maybe that is your best option.

But that is a bit strange that a vet, who is not a specialist, would not care to look at a treatment protocol from one of the leading specialists which is widely used by other specialists.

I'd ask the vet why she thinks Chaos should be on both Tramadol and preds. In your shoes I'd feel a lot more comfortable if the vet was willing to talk to the RVC neurologist rather than making guesses about how to treat -- generally neurologists are very wiling to advise the primary care vet. If you wanted to make that intervention yourself you could definitely try ringing the RVC and explain the situation.

It is so hard to know what to do. Many of us are not in the ideal care situation and live far away from our neurologist or need to switch to dealing with our vets instead. You are doing the best in the situation I think. I'd politely hold your ground to get the explanations you need to understand this vet's choices. She is clearly reading up etc which is great but the rejection of the established treatment protocol seems a bit odd.

[*Pauline*]

I am not sure if I would be able to talk to a neurologist but could try to phone the RVC and see what they suggest.

I went to the RVC and saw Victoria Penning who is happy to phone me back when she is free and I never have to wait more than a couple of hours. She invites me to phone whenever I like and I would never let a vet decide what to give Dylan.

On the scan issue, the software to print off our scan was down at the RVC when Dylan had his MRI. After claiming my insurance, the scan on film was available from the RVC, but the insurance would only have paid had it been included in the original claim. So I could pay about £50 for two films (he has two syrinx) or have a disc with 193 images for FREE! I chose that. Ask your neuro, who did you have?

[harleyfarley]

Harley was in awful pain yesterday so i took him to the vets, he was given tramadol too but only a few days supply, also he now has a plastic hood to stop him aggrevating his wound which he hates. The vet which was a lo-cum
was dubious about precribing him anything else until she speaks to the neuroloigist at the animal health trust to see what they recommend.

[jacies]

Pauline, at the RVC I saw a German chap called Holger Volk but am not sure if he is there all the time or was just running the drug trial that Chaos was on to find a new drug for SM. That is probably the reason that they kept the scan and all I have are copies of the notes which they sent to my previous vet. Don't know what is happening re the drug they were testing now but am pretty sure that Chaos got the dummy pill as it did not make any difference to her at all. Dr Volk obviously did not know which dog got which but he did tell me that some dogs had improved a lot.
Anyway, hopefully they will still have the details on Chaos and might be able to help me.

[Karlin]

Judy let us know how it goes. You can't lose by calling and asking. Vets are right to be cautious but generally the neurologists everywhere have been good about giving some basic advice to the treating vets for dogs they have seen and scanned.

A lot of vets would not know too much about using gabapentin as it is not licensed or has not been for animal use.

[antigone]

FYI, Levi is on Tramadol (among other things). You can order it (with a Rx from your vet---which they will call and fax for) from Drs Foster and Smith Vet pharmacy. There is no postage on meds sent from there in the US but I don't know their policy for outside the US. They sell it in a generic for $.30 (which would be .2 Euros). If it is legal to send rx drugs from country to country, this might be a solution. The tablets come in 50 mg so I split them in half for Levi. He gets 25 mg three times a day: at 7 am. 3 pm, and 11 pm. Every eight hours. Sometimes he has been on Tramadol every six hours but never more frequently than that and never at stronger doses. The tablets are not sustained release and are the same tablets he got at LIVS (they also split them in half). You don't usually give the proton pump inhibitor (Prilosec, famotidine, or medicam or ?---CSF reducers) at the same time as you give the Neurontin (gabapentin) because they interact in some way. That is NOT a hard and fast rule, I guess, and the interaction, if any, isn't dangerous.

Kathy

[patg]

Hi Judy,
Riley was just diagnosed 4 1/2 weeks ago. He was on prednisone 5mg twice/day and tramadol 50mg twice/day. The Neuro reduced his meds during the past few weeks and he is now on 1/2 prednison 1 x/day and tramadol as needed. Unfortunately some of Riley's symptoms started to come back last week. I phoned the Neuro and he put him back on the tramadol 2x/day. We are going back on Tues as the Dr. wants to see him. The prednisone was like a miracle drug but it seems now like the dosage is too low or he is having breakthrough pain. We have not been put on gabapentin as of yet.
Hope Chaos is doing better. Riley has been on tramadol before for post surgical pain and it is a really good pain reliever. Hope this helps in some way.