Sm ?

[sally28]

Hi everyone,

My lovely cavalier pumpkin was diagnosed with syringomelia a few months ago by an MRI scan.
The only symptoms we first noticed was she was struggling getting up down the stairs and she seemed wobbly on her back legs. She then went onto have a seizure, to which my vet did a MRI scan and it was found.
At the time she was taking a low does of prednisolone which she has taken for 6 years due to having a stomach problem. So my vet suggested we higher the dosage on the prednisolone as she needs steroids for her stomach also.
And also to take frusemide twice daily. I noticed a difference within a week with her weakness in her back legs she has has no further seizures and generally in herself she seemed brighter and more lively. However her appetite massively increased and so did her weight she now weighs 12 kg. So tried cutting her food and treats back and more exercise however so far she hasn't managed to lose any. Also i found she was drinking tons of water and needing to go to the toilet alot more.
On my last visit to the vets 3 weeks ago my vet was concerned at the rate she is putting on weight and the excessive drinking. So she said to try a different steroid medrone and was wondering if anyone who has a cavy with SM has used this?. My little one now just doesn't seem her old self, so far she hasn't experienced any wobbly legs but in her self she seems very very tired and just generally she doesn't seem right.
I have also noticed she also get very hot ears could this or is this a symptom of syringomelia?
As i do notice she gets this alot and when she seems unwell but i haven't come across this being a symptom.
Thanks sally

[Karlin]

Hi Sally -- Sorry you got this diagnosis.

I think you really need to get her to a neurologist rather than using your vet for managing this specialist condition-- this is not really a normal or correct approach to take with meds for an SM dog, to just up steroids, for exactly the reasons you have seen. You can go for a neurology consult with your MRI. Vets usually do not try and treat this themselves as they have little training in neurology.

While steroids at low dose might be OK for the tummy issue (though I'd wonder too whether there are not better alternatives) there are many other effective drugs to try before using prednisone for SM, generally used as a 'last resort' drug. The frusimide is causing the excessive peeing -- that is normal as it is a diuretic. Generally you need to get the dog out around 30 minutes after a dose and the dog should be on the lowest possible dose, too. Never give it right before bedtime either. Frusimide also causes the drinking (your vet should have explained all of this to you?... as it can for obvious reasons worry owners who suddenly start to see this). But you'd really want to consider something like gabapentin, Lyrica or one of those plus a normal painkiller before using steroids for SM, which is why she needs to be seeing a good neurologist familiar with SM.

It may well be that some initial milder SM pain has been masked for a long time by the existing dose of preds, and thus you only saw it when it became extreme. Still, other things would almost always be tried before considering prednisone for SM because of the side effects you are seeing on a higher dose.

Was she blood tested for epilepsy? I ask because many neurologists do not think fits are directly connected to SM and I wonder if there are other issues there as well as some SM pain (the wobbly legs and stair problems could be SM or heart problems; I assume your vet has checked for murmurs?).

[RodRussell]

Hi Sally -- Sorry you got this diagnosis.

I think you really need to get her to a neurologist rather than using your vet for managing this specialist condition-- this is not really a normal or correct approach to take with meds for an SM dog, to just up steroids, for exactly the reasons you have seen. You can go for a neurology consult with your MRI. Vets usually do not try and treat this themselves as they have little training in neurology.

While steroids at low dose might be OK for the tummy issue (though I'd wonder too whether there are not better alternatives) there are many other effective drugs to try before using prednisone for SM, generally used as a 'last resort' drug. The frusimide is causing the excessive peeing -- that is normal as it is a diuretic. Generally you need to get the dog out around 30 minutes after a dose and the dog should be on the lowest possible dose, too. Never give it right before bedtime either. Frusimide also causes the drinking (your vet should have explained all of this to you?... as it can for obvious reasons worry owners who suddenly start to see this). But you'd really want to consider something like gabapentin, Lyrica or one of those plus a normal painkiller before using steroids for SM, which is why she needs to be seeing a good neurologist familiar with SM.

It may well be that some initial milder SM pain has been masked for a long time by the existing dose of preds, and thus you only saw it when it became extreme. Still, other things would almost always be tried before considering prednisone for SM because of the side effects you are seeing on a higher dose.

Was she blood tested for epilepsy? I ask because many neurologists do not think fits are directly connected to SM and I wonder if there are other issues there as well as some SM pain (the wobbly legs and stair problems could be SM or heart problems; I assume your vet has checked for murmurs?).

Ditto.

[meljoy]

So sorry to read this. You really need for Pumpkin to see a neurologist. With the right medication she may improve greatly.

Good luck

[Karen and Ruby]

I have to agree with the above as well- Steroids are normally a last resort drug due to the side affects that you have experienced.

I couldn't use Frusomide with my dog as it made her incontinent so we have her on an alternative called Cimetidine which works just as well alongside her painkillers which are Lyrica.

I for one will stay away from steroids for as long as possible for my little one and we are doing well so far, very nearly 2 years on from her diagnosis.

Hope you get to a neurologist soon for your little one to get her on something more suitable xx

[sally28]

Thank you everyone for all your replies.
I am due to take pumpkin to see my vet on Thursday, so i am hoping to discuss alternative treatment.
She has seemed a little better the last couple of days as i have increased her frusomide tablets to 1 x morning and 1 x night she was only taking 1 morning and just half a tablet a night and i think it has made some improvement.
I have printed out Clarie Rusbridge treatment plan so i am going to take that with me.

[sally28]

Hi,

Thought i would update on how i got on with pumpkin at the vets today.
My vet informed me that she had sent the MRI scan that she did earlier on in the year to a neurologist in Liverpool (sorry forgot his name). Anyway he advised that we carry on with frusomide twice daily and she will have to stay on a low dose of steroid as she has a stomach problem but maybe just every third day a low dose.
Which she was taking before we found out she had sm and her weight was normal then.
So he said to try gabapentin 3 times aday this was on clare rusbridges treatment protocol.
My vet said pumpkin could not go on NSAIDS as these drugs may aggravate her stomach problem.
So i feel happy that although she is not completely off steroids it is just a low dose and im hoping the gabapentin will help with the sm.
I have to take her back in 2 weeks so she can have a blood test that has to be checked that she is getting the right dosage of gabapentin in her body is this standard ?
I so hope this works so we dont have to rely on steroids as her weight ballooned and went up to 12kg and she was always so small she only weighed 7 or 8 kg but when she got weighed today she had lost half a kilo so thats a start.
I would like to get her weight to 9 or 10kg but that will take some time.
I was wondering how other cavys have got on with gabapentine as it helped the condition?
And i would just like to thank everyone as this board has been invaluable to me and pumpkin to learn about sm and also the treatment so she can have a happy and comfortable life.
Thanks sally

[goda]

Hi,

Thought i would update on how i got on with pumpkin at the vets today.
My vet informed me that she had sent the MRI scan that she did earlier on in the year to a neurologist in Liverpool (sorry forgot his name). Anyway he advised that we carry on with frusomide twice daily and she will have to stay on a low dose of steroid as she has a stomach problem but maybe just every third day a low dose.
Which she was taking before we found out she had sm and her weight was normal then.
So he said to try gabapentin 3 times aday this was on clare rusbridges treatment protocol.
My vet said pumpkin could not go on NSAIDS as these drugs may aggravate her stomach problem.
So i feel happy that although she is not completely off steroids it is just a low dose and im hoping the gabapentin will help with the sm.
I have to take her back in 2 weeks so she can have a blood test that has to be checked that she is getting the right dosage of gabapentin in her body is this standard ?
I so hope this works so we dont have to rely on steroids as her weight ballooned and went up to 12kg and she was always so small she only weighed 7 or 8 kg but when she got weighed today she had lost half a kilo so thats a start.
I would like to get her weight to 9 or 10kg but that will take some time.
I was wondering how other cavys have got on with gabapentine as it helped the condition?
And i would just like to thank everyone as this board has been invaluable to me and pumpkin to learn about sm and also the treatment so she can have a happy and comfortable life.
Thanks sally

Sorry to hear this, I believe Gabapentin is helping Luka, but as someone mentioned it functions best every 8 hours.

[Karen and Ruby]

You will probably find that a vast majority of dogs with SM are taking Gabapentin. It seems to be the tried drug of choice for many as it isn't overtly expensive and works rather well

It didn't work at all for my little one, it actually made her worse and she is one of a small minority of dogs I beleive that reacted in a negative way- it made her symptoms worse and didn't stop the scratching or head rubbing. She started getting very wobbly on her feet and tripping up curbs and other things. i rushed her back to Dr rusbridge thinking that she was deteriorating and fast but luckily it was put down to the gabapentin. With in a day of being on Lyrica she was a completely different dog, like a puppy again!
The only downside of Lyrica is that it is a lot more expensive but i am lucky to have very good insurance cover


I hope the Gabapentin brings little Pumpkin some welcome releif