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Gabapentin

cavluvver

Well-known member
Hi everyone We are taking Rossi to Chestergates again on Friday as he has been getting worse. As you know Rossi was diagnosed in April by mri and has been on gabapentin 3 times daily with metacam for bad pain episodes. To be honest, although he hasn't had any bad pain episodes since he has been on it, his face rubbing and ear scratching hasn't stopped and have become more frequent and he has developed a bad limp on his front right leg. He can hardly move around after he has been resting and seems better when out for a walk. What are your experiences? Is gabapentin supposed to stop the scratching, rubbing etc.? I am going to ask the neurologist about a csf inhibitor as he hasn't even mentioned this to us and I know that most of your dogs are taking one. Our neurologist said thatRossi has a small syrinx, do you think that is the reason he has mentioned a csf inhibitor as he perhaps was going to suggest it if Rossi deteriorated?:-?
 
Did Rossi's MRI show that he had dilated ventricles as well as a small syrinx? My Oliver also has a small syrinx, but most of his problems come from his greatly dilated ventricles, which give him headaches and eye problems (he squints in strong light due to interference with the mechanism of his pupils). The dilated ventricles (rather then the syrinx) also seem to have affected the nerves in his right front leg, though this is much better now, 2 years on. I would definitely discuss a CSF inhibitor with the neurologist, as this could reduce the pressure of the ventricles (if Rossi has a problem here!).

Kate, Oliver and Aled
 
dilated ventricles

Thanks for your reply Kate. Our neurologist never mentioned dilated ventricles to us so I don't know anything about them, but I will ask him about thyem on Friday.
 
When Oliver was scanned at Chestergates (this was just a mini-scan designed for breeders to know whether or not their breeding stock have SM - I'm not a breeder but just wanted to check on Oliver), we were given a certificate which showed the results of the scan at the bottom. There is a list of symptoms that are ticked if present: cerebellar herniation, dilated ventricles, syringomyelia. middle ear disease. If you were given a similar certificate, you will be able to see if Rossi was ticked for dilated ventricles (and how big they are - Oliver's are 3 times bigger than normal).

Kate, Oliver and Aled
 
We weren't given anything at all Kate, Luca just told us that Rossi had syringomyelia and showed us the herniation and the syrinx and prescribed gabapentin.
 
We weren't given anything at all Kate, Luca just told us that Rossi had syringomyelia and showed us the herniation and the syrinx and prescribed gabapentin.

If this was a full MRI scan for diagnostic purposes ( cost about £1,500- £2,000 ) then there will have been a report sent to your Vet and you can ask for a copy.

The continuing scratching and rubbing & now the limping would suggest that the SM symptoms are getting worse, and obviously the gabapentin is either not working well for Rossi or the dose may need to be increased.

My Tommy had to go from 100mg three times a day to 200mg x 3 when his symptoms worsened. He now needs Lyrica which I think could be described as a newer, stronger and more expensive successor to gabapentin.
 
Thank you so much, Margaret and Kate for your very helpful advice. Rossi did have the full MRI. We are now off to Chestergates feeling much more informed and with a list of questions. We feel much more confident thatat we can make sure that Rossi is in as little pain as possible, thanks to you, your help is invaluable.:D
 
Gabapentine with Dexamethazone

Hi all,

My Lily's on Gabapentine with Dexamethazone for the scratching. We saw a specialist dermatologist as well and the result was that Lily's also got dermatitis which causes her to scratch and rub her nose aand chin, lick her paws etc. This doesn't explain the limping (unless he happens to have a self-inflicted via too much licking or accidental injury) but it might also be at play. Additionally dermatitis can make them more sensitive in their ears (where there is of course skin too) and where your dog may or may not also have PSOMS which could have shown up on the MRI.

Good luck with it. It's hard to narrow everything down but try and stay hopeful; it might be a more benign and more easily treatable cause.
Ylan
 
Rossi's chestergates appointment

Hi everyone sorry it's taken me so long to get back, I've got such a lot on at the moment with my son waiting for surgery to remove a thyroid tumour, I don't know if I am coming or going. The neurologist at chestergates has booked Rossi in on Thursday for a mini MRI this time to check on the development of the syrinx. If it has got a lot bigger since April he wants to discuss surgery [ putting in a shunt] If it hasn't he wants to discuss different medications. When I mentioned CSF inhibitors and that I had been on this forum he gave me a look of disapproval and said that I was getting lots of people's '' opinions''. I told him that I valued your opinions as you have experienced syringomyelia and were seeing the effect of certain medications on your own dogs. He said that omeprozole can cause stomach tumours and didn't like to use it for more than 6 weeks, but was willing to give it ago if Rossi's syrinx hadn't got much bigger. He also said that he didn't think Rossi's limping was nuerological and he asked Francois who deals with orthopedics to examine him and he now wants Rossi to have a CT scan on Thursday too. So we could be dealing with two conditions now, rather than one. So now we just have to wait and see what's happens on Thursday. There seems to be nothing but worry at the moment, it's exhausting, as long as my son and my dog are okay that's all that matters. Thanks again and I'll let you know how we get on on Thursday:xfngr:
 
Sorry you're having such a hard time, and hope your son's operation will be completely successful.

Oliver developed spondylosis (osteoarthritis of the spine) at the same time he had his first recognisable SM symptoms - his three affected vertebrae are more or less above his small syrinx! The spondylosis gave him quite a lot of pain in his lower spine and very wobbly back legs, but several weeks of crate rest helped enormously.

Kate, Oliver and Aled
 
Just to say that my Harley was diagnosed with CM/SM (he got a 3mm syrinx and a secondary ventriculomegaly) And all he done was limp on his front leg for a month. As he was an agility dog we thought it was an injury. They done X-Rays, blood tests and took fluid out of his shoulder bone. The MRI Scan showed SM but the vet who is also an orthopaedic surgeon was not convinced that the limping was coursed by SM. The limping disappeared all by itself without medication. All he is on at the moment is Zitac to hopefully slow the progression of SM.
One other thing don’t let him push you into surgery. Take time to think about it and weigh up the pros & cons and talk to people about it. Clare Rusbridge actually suggested to my vet that I go on this Forum and talk to people about their experiences.
 
Sm surgery

This is what I am worried about. The neurologist seems all for surgery as he says why keep giving Rossi different medications when the surgery '' could '' make him a lot better. But I'm unsure. he himself says that they don't get much feedback from patients owners after about one and a half years after surgery but that most seem to do well up till then. I just don't know, what do you all think?:confused:
 
Gosh that's a dilemma, one that I think we will face. If meds are working well then I myself am loathe to go down the surgical route. But I suppose until your scan comes through and you see if the csf inhibitor makes a difference, then you have a bit of breathing space to think about it. I know my dog vastly improved on omeprazole.
 
Sm surgery

The neurologist says that if the syrinx has increased in size quite a lot he thinks we should think about surgery. Rossi has never had a CSF inhibitor since he was diagnosed in April but his scratching and face rubbing has got a lot worse just recently. I just want to do the best thing for Rossi but what ''is'' the right thing. I can tell that the neurologist prefers people to listen to his advice alone and not to other people's experience and is definately uncomfortable if I mention Claire Rusbridge who I think he disagrees with on certain points. But I disagree and want to be armed with as much information as I can and that is where you all are of great help. Let's see what tomorrow brings:(
 
Rossi's results from chestergates

Hi everyone, been run off my feet since we got back from Chestergates yesterday. We dropped Rossi off at 10.30 then took our 2 year old grandson, who I look after full time while his Mum is at work, into Chester for the day. we were called back at 5.20 pm and were told good news and bad news. The good news was that Rossi's syrinx hadn't got any bigger so the increase in his clinical signs was due to him not responding to gabapentin so the neurologist wants him to try Tramadol now but he still doesn't want him to have a CSF inhibitor which surprised me. The bad news was that the CTscan showed that Rossi has a haitline crack in his tibia which is usually found in cocker and springer spaniels. I can't remember the name of this condition as it was rather a mouthful but we were told that, if left, the leg would eventually break so Rossi now has to have an operationto pin the leg to strengthen it. Unfortunately the surgeon is at a conference for 10 days so we have to watch Rossi hobble around till he comes back. It's heartbreaking. We also now have to put in a seperate claim to the pet insurance for a different condition now and were told that the the cost for the op would be from £1,500 to £1,800 so lt's hope the insurance cover most of it. It cost over £1,500 for yesterday's tests. Coupled together with the worry of waiting for my son to get a date for surgery to remove a thyroid tumour, we are exhausted mentally and physically. I will never complain again when life gets a little boring. hurray for boring!!! Anyway, do any of your dogs take tramadol, on it,s own or alongside any other medication and, if so, does it do any good? I am anxious to know. Thanks again for all your support and advice. I don,t know what I'd do without you. :luv::lotsaluv::lotsaluv::lotsaluv::lotsaluv::lotsaluv:
 
Couple of questions to clarify:

1. What is his current dose of gabapentin and how often does he take it? If he is on a low dose and/or only twice a day dosage, did you discuss increasing the dose and/or moving to three times a day?

2. Is the Tramadol in addition to the gabapentin or instead of the gabapentin? I've used Tramadol long term for geriatric dogs for pain from arthritis and disk disease and I know many that use it for their dogs with SM, but as part of a multi-drug regime rather than as a single agent for SM. It seems to work well for most dogs, and it appears to be a pretty safe drug from what I've researched. What is the amount of Tramadol prescribed and how often?

3. When discussing surgery, did you really mean to say that it would be shunt surgery rather than decompression surgery? That is surprising to me as I did not know that anyone was still doing shunt surgery.

Pat
 
Hiya,

Sorry for your mixed bunch of results.

Tramadol as Pat said is normally given as a 'top up' drug alongside another ie Gabapentin.

I have a prescription for Tramadol although havent had to use it but its there if needed.
Dr Rusbridge said to me that once you have started on Tramadol its hard to wean them off it again ( at least that is what my memory serves me but that was a year ago nearly?

And Ruby is still doing well on Pregabalin and Metacam so for mow Im keeping my options open- the less we use now the more we have to look to in the future.



If your Neurologist doesnt like the CSF idea then why not take Dr Rusbridge treatment althorism to your normal vet?

I find it strange that some arent being prescribed a CSF inhibitor as it was the first thing I was given for both my dogs before they were put on any pain releif.

But then you dont want to go behind your neuro- but at the same time the whole pont in a CSF inhibitor is to reduce the progression of the disease.

I hope little Rossi has his leg seen to soon and that you get some more options as to his treatment!
 
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