The majority of neurologists recommend they are put on to a CSF reducing drug immediately as this reduces the pressure as Karlin says above.
Often there is a huge improvement in the dog just from using a CSF reducing drug - Clare Rusbridge recommends Cimetidine [Zitec] as being very gentle on their systems but also effective. There are dogs on the forum who were given a very poor prognosis who are doing well several years later, mainly it is believed due to these drugs.
I would certainly want my dog put on this, it is not going to do any harm. The other medications are for pain relief.
I've not heard of codeine being prescribed before either - have been dealing with Syrinogmyelia for over 12 years and have done a considerable amount of research into the condition and treatment. Does Dr Kline have much experience with the condition? It just seems strange that she is recommending a treatment program so diverse from other neurologists.
OK - still looking for the answer to my question, which is:
Has anyone else ever heard of a neurologist prescribing codeine or morphine or other opiates for SM pain? I'm not asking what codeine is. I've checked all my various veterinary textbooks and speakers' notes from AVMA, etc., but this is the first mention I've heard of any vet using this drug for SM pain. Is this a new protocol?
Again, when I first posted I wrote "codeine" but I was really thinking "morphine" - although both are opiates. I do know many vets that prescribe hydrocodone for coughing related to heart disease, collapsing trachea, and/or COPD:
But from what I've read, codeine is a pretty weak analgesic. I also googled to see about interactions between codeine, gabapentin and an NSAID - I'd want to get a good handle on understanding that if I were giving all three drugs.
Anne - regarding Tramadol - I've used this long term for several geriatric dogs - daily for many, many months for pain control - for several reasons such as severe osteoarthritis and in dogs with cancer where quality of life was my paramount concern. My understanding from my vet internist is that it is a safe drug to use long term. It may be habit-forming but that was not a concern in the cases where I used it.
Zyrtec - Generic Name: cetirizine - this is a different drug and is an antihistamine, but this is not used for SM.
Niki - did you mean Zantac - that is a brand name for another drug used for GERD:
Or perhaps Zitec is a UK brand name; I can't find it when I google for brand names of cimetidine.
Are you recommending Luka try Tramadol?
Sometimes your responses however helpful are a little insensitive. I am doing the best I can with what I know right now.
The vet put him on the Rimadyl, I don't see much of a change, I don't know about the codeine, it's there to help with his [pain and discomfort. I have given him extra pain medication in the past because he had obvious discomfort.
I don't know I need another opinion, but as of right now, I don't have the time nor the money.
I think Pat's question was a general one, aimed at anyone with a dog with SM, not anyone in particular. I also didn't take at all that she is recommending Tramadol; she was answering someone's question. Pat is one of the best informed members on canine medical issues here .
No, I haven't.Has anyone else ever heard of a neurologist prescribing codeine or morphine or other opiates for SM pain?
Tramadol is a far more serious painkiller. I keep it for emergencies with Leo but only needed it once when he had a serious pain session probably caused by a fall when he fell on his spine. The pain may have been directly or indirectly SM related or spinal/disk pain and unrelated. If current painkillers do not manage his symptoms it may be one to try but does have an addictive effect longer term for many dogs. Whether that matters or not? Probably not if the alternative is pain. There are many many options with painkillers.Are you recommending Luka try Tramadol?
Clare's treatment algorithm is really the best summary of treatment approaches and when to introduce what. She normally starts with CSF inhibitors. The original intent of meds like cimetidine or frusemide or omeprazole isn't really relevant to what they are used for with SM -- they all reduce CSF pressure. You really need to work with a neurologist on what to try and when but Clare's document is considered a gold standard by many, not least as she is so familiar with the condition and for a long period and has done much research in the area. She also manages conservatively, overall. A neurologist is bets to judge, by pain indicators and response, which meds are best and to recommend changes when they stop being effective.
Cavaliers: Jaspar Lily Tansy Libby Mindy
In memory: Lucy Leo
Cavalier SM Information site:www.smcavaliers.com
I have not heard of Codeine being used for treating SM. Just read up about and it seems that this is a narcotic and can cause addiction which Tramadol for pain relief would not. It would therefore seem that it would have to be withdrawn slowly if changing over. Chaos is on Tramadol for quite a long time now and it certainly has helped her.
Chaos B/T Cavalier girl (1.1.2004) Armani Chinese Crested girl (16.12.2002) Onyx Chinese Crested Boy (1.8.2009)