Seizures?

My baby was diagnosed with sm about 2 years ago (I posted about him a bit then). He was really bad at the time, but a low dose of prednisone every day has given him a normal, happy life back (albeit with a food obsession). He's only had one breakthrough pain episode about a year ago and almost no scratching.

His liver counts etc. have been fine so far (the last blood tests were 6 months ago). But in the past few months, some of his coat has turned very blond and dry. So I've been considering switching him to Gabapentin. Is Gabapentin a lot easier on the liver than prednisone? Does it cause any damage to the system in the long term? It's very difficult to get here in Finland, so I may try to order it from the UK if they accept prescriptions from abroad.

Anyway, my actual question was whether seizures are a common symptom of SM? I've noticed lately that Sammy's been scratching a bit again, and today, after jumping off the sofa, he suddenly started 'seeing things'. It was exactly like there were a couple of flies around him. He was jumping and staring and chasing and determined to find them. It was bizarre and frightening. Then I noticed one of his back legs giving way occasionally and thought it must be connected to the SM. Does this sound like a seizure to you? Has anyone experienced anything like that? Would Gabapentin help (I've heard it's used for epilepsy)?

Thankfully he didn't seem to be in pain, just excited. He actually wagged his tail at me when I asked him what was up. And eventually I managed to snap him out of it with the promise of treats Trust Sammy to care more about food than his hallucinations!

Wow, only now reading about Lyrica! And am amazed to discover it's actually available in my local pharmacy in 25mg capsules!! Yippee!!! Now to get him off the prednisone safely and without pain...

(and yes, also to ask my vet's opinion, although to be honest my vet knows very little about SM. In the beginning there seemed to be no hope for Sammy until I consulted this website. I brought my vet Claire Rusbridge's treatment protocol and we've been deciding together how best to apply it)

Hi Laura:

Sorry to hear about the strange trance/seizure.

Have you seen Dr Clare Rusbridge's treatment diagram?

http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

Generally you would try other things before steroids (prednisalone) because other things are generally more effective and less damaging to the dog over time. However some only do well on prednisalone but as you can see this is normally the very last thing to prescribe.

I would get your dog on to one of the CSF inhibitors like cimetidine or frusemide and try that with gabapentin or Lyrica and remove the prednisalone. Gabapentin often does fine for adog -- Lyrica is more expensive and stronger and so is more often what people move to after gabapentin is not working well any longer (often the dogs develop a tolerance for it).

If a two or three week trial of gabapentin doesn't work (you generally start low but it is typical for a cavalier to be on about 100mg or more daily, generally 3 times a day as it tends to wear off after about 8 hours) then you might want to try Lyrica but I'd try gabapentin first.

Sorry, I realized that I didn't actually give much back-story in my previous message.

Sammy was actually on gabapentin (100mg, 3 times a day) in the very beginning, but even at that dose it only seemed to work for about 5-ish hours after which he started scratching and rubbing his head again (he would rub himself bloody). I had to have it made up in a dogfriendly liquid version in Helsinki and delivered, so it was like gold dust. Rather than uping the gabapentin, we tried a very small dose of prednisone (2.5mg, with every third day free), and that made all of his symptoms vanish. The vet thought it would be safe at such a low dose - Sammy's a big boy, about 10.5kilos. And his blood counts have been very good so far.

But now, as I said, his coat is getting really dry, so I am afraid that he won't tolerate the prednisone for much longer afterall. The only other option that came to mind was to go back to the gabapentin, try a bigger dose (as long as that wouldn't cause just as much damage), and either pay the gold-dust prices or see if I could order it from the UK.

BUT Lyrica sounds really promising!! It is expensive too, but way cheaper than the gabapentin I was ordering. And if it's already more potent, it might be perfect.

Btw, is cimetidine and frusemide similar to omeprazole? He was also on that in the beginning, but my vet seemed to think it was only for short term use? It didn't seem to make much difference anyway.

Sorry to be a sponge here with all these questions...

I guess noone else has experienced hallucination/seizure episodes as part of SM?

Hopefully it was just a one-off occurance anyway and it isn't too bad a sign :xfngr: Will see what the vet thinks.

Cimetidine, frusemide and omeprazole all do the same basic thing (decrease the pressure of the cerebro-spinal fluid -- they are CSF inhibitors) but are quite different. Often one works better than another. Most dogs probably benefit from being on one all the time. Clare Rusbridge and others have reported syrinxes can slow, stabilise or sometimes even reduce on a CSF drug. They would not be considered a short term drug but something long term.

100mg 3x of gabapentin is actually a fairly low dosage. My Leo is on 200mg 3x for example. But Lyrica could indeed be a much better drug.

Clare Rusbridge feels most dogs do best on a cocktail of medications -- generally a CSF drug, gabapentin or Lyrica, and maybe something for pain. These all generally need to be adjusted over time -- often one thing stops helping and something else does.

Seizures are reported but not very often (I see Dr Marino of LIVS cites them in about 14% of cases). They seem to come up more commonly with PSOM (though still rare) which most cavaliers seem to have as well. So I'd wonder whether those seizures are SM related or PSOM and if they are really seizures or more, pain sessions -- neurologists disagree on this. Then there are behaviours like flycatching that are a neurological disorder, sometimes associated with SM. I think right now because there can be a couple of causes, it is hard to exactly attribute certain symptoms to one thing rather than the other. It is confusing!

My first cavalier that I thought was showing SM symptoms at under one is SM free at 7 (MRId twice) but has PSOM that seems to have caused him now to go deaf -- and always to scratch at his ears. It becomes an issue whether to do procedures for these things or not.

Thanks so much for taking the time to answer so thoroughly. I know you must get a lot of questions here from worried owners that aren't easy to answer.

Sammy is such a special little man. The most goofy, trusting, over-the-top-friendly little soul I've ever encountered. He deserves a painfree existence. I appreciate the help (and Sammy doesn't know it, but he appreciates it too).

From what I read of the flycatching syndrome, it sounds closest to what Sammy's episode looked like - and it seems to have coincided with a relapse of some SM symptoms in the past week (scratching, paw chewing and bunny hopping). But I will get the vet to check his ears aswell.

It doesn't really sound like a seizure to me. When a dog is having a seizure they can't be brought out of it by the promise of treats. During one, they are non-responsive, which is one of the characteristics of seizures. So thankfully it seems like Sammy probably didn't have a seizure. It is however a behavior worth monitoring to see if he has more, especially if it is the fly catching syndrome.

My SM girl was having what I thought was seizures - back and head arching in a backwards C, nystagmus (rapid eye movement), and she was non-responsive, but her neurologist called it a vestibular event rather than a seizure. Definitely related to her SM, but not a seizure, and they have been controlled much better with daily prednisone.

Hope Sammy checks out o.k. at the vet.

My SM girl does quite a bit of flycatching-- she will do it frantically when her symptoms are worse. She also does a trembling, "seizure-like" thing with her front legs. That doesn't happen often. The neurologist thinks it is all related.

Hi Laura sorry for not getting back to you earlier, Karlin has done some fantastic replies

Many believe that seizures are actually pain episodes now - I have had two Cavaliers who have had seizures, both were affected with SM. One had focal seizures, the other full seizures, I believe that these were seizures and not pain episodes, having also seen pain episodes

It's very hard as Epilepsy has many causes and obviously with so many Cavaliers affected with Syringomyelia there are going to be many with both conditions.

It would be very helpful to video any future episodes [although hopefully there won't be any more!] or at least write down exactly what happened to pass on to the vet or neurologist.


You might find this information helpful if it does turn out to be seizures:

this is quoted from my post on the forum

I have been doing some research on epilepsy and found quite a few interesting sites:


http://www.canine-epilepsy.net/basics/basics_index.html

http://www.canine-epilepsy-guardian-...m/site_map.htm

http://www.canineepilepsy.co.uk/Main_frame_set.htm

http://www.canine-epilepsy.com/Resources.html

http://pcfce.org/

Advice:

During a seizure, try to reduce external stimuli, ie shut the curtains, turn off radio and TV, keep quiet and calm obviously make sure the animal is safe, not likely to fall down stairs etc, and away from anything which could get broken causing injury.

Afterwards you can give ice cream - not sure if it's the sugar or the coldness that helps, but they certainly enjoy it!

Stop using all household cleaners, plug-in "smellies" etc maybe try something like a Polti steam cleaner instead.

Holistic approaches include:

Dr Bach Rescue Remedy - 1-2 drops in the mouth {small dog, 3 for a large dog}, and/or 3 in the water bowl {every time you change the water}. During an actual seizure, this can be administered on the skin of the ears or the nose, rather than in the mouth if not possible.

Vitamin B complex aids brain function - ¼ human dose {dogs and cats under 25lb}, ½ human dose {25 to 60lb}, full dose {dogs over 60lb}

Essential oils - Lavender, Neroli, Rose, Ylang Ylang, Melissa and Chamomile - in a diffuser, for about 1/2 hour, 2 to 3 times a day. Or dilute them in water, and sprinkle a few drops on the coat {chest area}

Amino acids can increase resistance to seizures, thereby reducing them.
L-taurine and L-tyrosine 5-10mg per lb bodyweight, 1 to 2 times a day.

Antioxidants:
Flax Oil - ¼ tsp per 10lb bodyweight

Evening Primrose Oil - 5-10mg per 10lb of body weight
OR Borage Oil - 5-10mg per 10lb of body weight OR both, at half this dose.


Homoeopathic remedies best to consult with a homoeopath for these. I obtain mine from www.gentletouchremedies.co.uk
NB these have to be kept well away from the essential oils, and not given at similar times.

If you have access to a video camera, maybe try to video a seizure, this can really help the vet/neurologist.




***Check with your vet/neurologist for all "holistic" remedies, just to make sure they won't clash with conventional medication***

***These are all just suggestions based on my own research and I'm not suggesting stopping conventional medication THIS COULD BE DANGEROUS - but that there are things you can try as well, which do sometimes mean that conventional medication may be reduced, or sometimes even stopped completely***

My SM girl does quite a bit of flycatching-- she will do it frantically when her symptoms are worse. She also does a trembling, "seizure-like" thing with her front legs.

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Sounds very similar. He was aware of me and responsive (even wagged his tail!) but just completely occupied with his invisible flies, which made him twist and jump and dart frantically. And his back leg was giving out and trembling a bit.

My SM girl was having what I thought was seizures - back and head arching in a backwards C, nystagmus (rapid eye movement), and she was non-responsive, but her neurologist called it a vestibular event rather than a seizure

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Just wanted to add I'm sorry to hear that; it sounds very distressing!

Hi Laura, I was sorry to read about the recent episodes your boy is experiencing. My Jack has CM a "pre-syrinx" and was diagnosed with "focal seizures"; his back leg (usually the Left) will spasm and he growls at it. I showed my vet a video and that is what he called it. He put Jack on Keppra and it has reduced the frequency. Jack also takes 200mg Gabapentin three times daily and 10mg omeprazole. Jack is about 21 lbs. He is so far living a quality life:xfngr: We also do bloodwork every 6 months to check his liver.
Hope you find the right combo for your boy.

Seizures are reported but not very often (I see Dr Marino of LIVS cites them in about 14% of cases). They seem to come up more commonly with PSOM (though still rare) which most cavaliers seem to have as well. So I'd wonder whether those seizures are SM related or PSOM and if they are really seizures or more, pain sessions -- neurologists disagree on this. Then there are behaviours like flycatching that are a neurological disorder, sometimes associated with SM. I think right now because there can be a couple of causes, it is hard to exactly attribute certain symptoms to one thing rather than the other. It is confusing!

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Thank you for posting this! My nearly three month old puppy has had a few seizures and we worried right away that it must be SM or perhaps epilepsy (although we hear it is very rare in pups her age). I hadn't heard about PSOM and will now begin more research. She is likely going to have an MRI soon.