Medication not working for Maggie

[Ddavis]

I hope this new lot of medication does the trick for Maggie.

[Pat]

Gabapentin once a day? Is that right or a typo?

Pat

[3cavies]

No Pat, that's correct. Her symptoms are still very mild compared to some. She shows no obvious signs of pain just the scratching. He did increase the Gabapentin from 25mg. to 100mg. Do you see that as a problem? This is my first experience with this, so any help is appreciated. Thanks.

[Pat]

No Pat, that's correct. Her symptoms are still very mild compared to some. She shows no obvious signs of pain just the scratching. He did increase the Gabapentin from 25mg. to 100mg. Do you see that as a problem? This is my first experience with this, so any help is appreciated. Thanks.

Stacy, I'm an SM novice as I've not lived with an SM Cavalier, and I hope that Karlin and others will chime in.........but my understanding is that Gabapentin is effective for about 8 hours, and it is usually given twice or even three times per day for effective symptom relief. 25 mg once a day is kind of laughable, and I think that once a day dosage in general is just not going to give a good demonstration of whether or not the drug is going to be effective. I know that Maggie's symptoms are mild, BUT you are actually considering surgery because you have seen no improvement and perhaps even worse scratching. From my novice perspective, the neurologist has prescribed a high dose of pred (and has hopefully told you about side effects including throwing a dog into Cushings) and has moved from a "nonexistent" dose of Gabapentin to a low dose of Gabapentin.

Did he say why he added sucralfate? Also, PLEASE tell me that he instructed you to give sucralfate either two hours before or two hours after any food or medication. It coats the stomach and greatly interferes with the absorption of medications. And it should be given away from food also in order for it to work effectively.

Pat

P.S. My personal belief is that Gabapentin (and Lyrica) are much "safer" drugs than steroids or NSAIDs, so I know that if I personally had a dog with SM, I'd want to give a higher dose of Gab or Lyr in order to try to avoid pred and NSAIDS. But that's just me, I know too many horror stories from steroids and NSAIDs (and even some from diuretics), esp. because of my years in the canine kidney diet group and the CHF group and reading thousands of stories. And, on that subject, I'd also be monitoring much more aggressively than the recommended blood chem screenings if my dogs were taking pred, NSAIDs or diuretics on a long term basis.

[Kathleen]

I agree about the Gabapentin. My Jade has fairly severe symptoms and what works best for her is Gabapentin 100mg 3x a day and she has to have Pred ( only 2.5 mg per day). The pred is a miracle drug for her and when we tried to wean her off it, her pain was much worse. I have the option of increasing the Gabapentin, but so far she is having a lot of good days. Jade is also on Puresis 10 mg twice a day. She can't take Omeprazole as it gives her bad diarrhoea. Hope this helps....

[Love my Cavaliers]

It's so hard when you get so much conflicting information, but the dosing of gabapentin is really most effective when given every 8 hours. I actually was on it myself for migraine prevention and took 300 mg every 8 hours. I've also been on Sucralfate and what Pat says about timing it around food is the same information I was given.

You probably will notice a difference though with the huge dose of prednisone. Riley was on that dosage for a while and she was like a puppy. She had so much energy and her symptoms almost disappeared. Her neurologist only kept her on that dosage though for about a month and then decreased it to her current dosage of 5 mg a day which she has been on for about 2 and a half years. She also is on Denamarin to protect her liver and Pepcid to protect against stomach upset. She has her blood checked every 4 months. Like Jade, Riley needs the prednisone. It is a miracle drug for her also and I will take any and all side effects at this point, which luckily have been minor.

Good luck through this confusing time. Remember, you know your dog best. But you also have to have faith and trust in your neurologist. We're here to help and give our opinions, but mostly we are here to give you our support. There's no one magic prescription for every dog. Wishing you and Maggie the best.......

[Kate H]

My understanding is that gabapentin is a pain preventive rather than a pain killer, so it needs to be in the body 24 hours a day. Dogs metabolise it at different rates, but the average is 8.5 hours. One dose almost certainly won't last 24 hours. 100g twice a day didn't really control Oliver's mild headaches; he does much better now he's gone up to 3 times a day. Perhaps your vet will up the gabapentin dosage when Maggie is eased off the prednisone? 'Among the skills required by vets is the ability to juggle'

Kate, Oliver and Aled

[3cavies]

Just an update: The increased medication has again had no effect. Surgery is scheduled for Tuesday morning I didnt want to risk waiting and it progressing to a point that she was in pain. I hope and pray this is the right thing to do for Maggie.

[Furrfoot]

I will say a prayer for you both- I hope it goes well.

[sins]

We'll be thinking of her on Tuesday Stacy.
She's a young fit and otherwise healthy cavalier and perhaps going down the surgical route now,may give her the best chance of a normal life.
I guess there's no right or wrong decision regarding surgery...it depends on the patient and the surgical facility/resources available to you.
Just to echo what Pat has said about NSAIDs.
Daisy didn't cope well with Rimadyl...she's been vomiting twice daily over the last ten days and we've now stopped it.
Looks like Gabapentin from now on.
Sins