As we begin to learn all the things that cause flare ups of Mooby's SM I find myself with more and more questions. During a cold front last week Mooby had a couple of really bad (for her) days. After "normal" blood tests, on a whim we gave her tramadol. It turned out to be the right thing for her.

Now we have another "winter storm" coming in tonight with low pressure, rain and cold. Knowing that it is coming when should I start upping the gabapentin or giving the tramadol? Do I wait for obvious signs of more pain or do I treat before? If I treat before, when?