Page 3 of 5 FirstFirst 12345 LastLast
Results 21 to 30 of 45

Thread: Izzie has appointment tonight - Think it's SM

  1. #21
    Join Date
    Feb 2011
    Location
    Sydney, Australia
    Posts
    1,389
    Post Thanks / Like

    Default

    I know how frusterating this can be. It is a long and confusing road. On one hand you want to rule everything else out, on the other you don't want to slow the process.
    What pain medication do you have? I think that will help us to be able to answer your questions. For instance, Brooklyn's neuro did a trail of her on Gabapentin...which is for neurological pain (i.e. if she was doing better on it, that would be a good indicator of SM, but if she was not doing better it did not mean she did or did not have it, it just helps us to better understand). A generalised pain reliever might relieve any pain, but I would assume a neurological medicine like Gabapentin (or others similar) would point you more to neuro pain and it would not eliminate pain from say, a hurt leg.

    I could be wrong though...others are much more knowledgeable about this than I am so I will wait for them to chime in.

  2. #22
    Join Date
    Aug 2008
    Location
    Coventry UK
    Posts
    1,838
    Post Thanks / Like

    Default

    Yes, Brooky's mum is right. If the pain is neurological, then gabapentin should quite quickly make a noticeable difference - but it won't make any difference to a non-neurological pain. It is a good pointer to the source of the pain - though not all neurological pain is from SM, of course.

    Kate, Oliver and Aled

  3. #23
    Join Date
    Dec 2008
    Location
    Scotland
    Posts
    164
    Post Thanks / Like

    Default

    Thank you. He's only put her on Metacalm just now until we rule out everything else and then he would see about long term pain relief, I'll be sure to mention this to him on Thursday.

    I gave her her first dose this morning and to be honest she slept for quite a large amount of the day afterwards. This evening though while her scratching is still there I've found she's not biting her back end nearly as much nor yelping, so I'm very glad she at least seems to be more comfortable.
    Mum to Izzie and George

  4. #24
    Join Date
    Sep 2006
    Location
    Florida
    Posts
    115
    Post Thanks / Like

    Default Yelping on being lifted

    Barkleigh has always yelped if you lift him and touch him under his forelegs. I just thought it was a tender spot! He just had an MRI to find PSOM (and he had it!) He had gone deaf and they fixed it. His MRI showed that he had a small Chiari Malformation and the doc showed us a comparison with a serious SM Cav. She said that Barkleigh would never have serious symptoms. Of course, now we are treating for suspect epilepsy. He does not scratch much, but I worry when he does.

    Good luck to you both. Having done a big round of bills, insurance, and anxiety I know what it is like. Hope it is far less than you think.
    Barkleigh's Mum

  5. #25
    Join Date
    Mar 2005
    Location
    Dublin, Ireland
    Posts
    23,993
    Post Thanks / Like
    Blog Entries
    15

    Default

    Metacam is a pretty low level pain killer and generally doesn't work that well for SM on its own, so don't be surprised if there isn't too noticeable response. That's a pretty conservative starting point. I'd definitely see a neurologist if symptoms continue as working out the right mix of meds is a 'cocktail' approach for most dogs and one of trial and error, using medications unfamiliar to most vets (eg gabapentin) and not really in the knowledge realm of vets. The mix also generally needs to be monitored and changed now and then as well as one approach almost never lasts for the life of a dog with these conditions.

    She said that Barkleigh would never have serious symptoms.
    Unfortunately such predictions have not been backed by people's experience -- an older dog with only CM is unlikely to go on to develop serious symptoms with CM or get SM, but either can happen and have happened, and it is absolutely impossible to predict unless this one neurologist knows something no one else does! It is possible to say a dog is unlikely or less likely to have problems but you can never say 'never' with CM/SM, as all the main researchers have stated many times at seminars on the disease. It is why it is so frustrating and difficult for dogs, owners and breeders.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  6. #26
    Join Date
    Aug 2008
    Location
    Coventry UK
    Posts
    1,838
    Post Thanks / Like

    Default

    I can back up what Karlin says about even CM alone being a progressive disease. Oliver has had some discomfort from his CM ever since I had him at a year old. This has grown progressively worse; he was diagnosed with a small syrinx when he was 6, but now at 10.5 his neurologist still says that almost all his symptoms (headaches and light phobia) are due to his CM, although his syrinx may now have developed enough to be affecting his hind legs a bit. Some vets still don't seem to really have taken on board that CM/SM is a progressive disease, and that CM alone can cause considerable problems.

    Kate, Oliver and Aled

  7. #27
    Join Date
    Dec 2008
    Location
    Scotland
    Posts
    164
    Post Thanks / Like

    Default

    Thank you everyone. We are back at the vets on Thursday and I will let you know how we get on. Just one last question..

    As it seems our insurance won't be able to help (her symptoms started before taking it out), do you know how neurologists go about payment? Sadly I'm not in a position to pay out thousands of pounds, though I will be looking into measures to help me, for a MRI. I have a few hundred pounds put by which I can use but aside from that I'm at a bit of a loss..

    I'm going to discuss it all with my vet on Thursday, but do you know if any of them along you to pay it up? I hate to have gone through all this and then in turn can't get a MRI because we can't afford it, and does anyone know what that would mean for her pain relief? Would vets be willing to give her pain relief for a period of time without an MRI?

    I'm probably jumping the gun here a bit, since we still aren't sure what is going on. But what with us being referred I just want to be sure I know everything I can first, and I'm starting to feel sick at the thought that we're not going to get this sorted.

    Thank you again for all of your kind words, it means a lot to be part of such a lovely helpful community of people who have went through the same kind of thing.
    Mum to Izzie and George

  8. #28
    Join Date
    Mar 2005
    Location
    Dublin, Ireland
    Posts
    23,993
    Post Thanks / Like
    Blog Entries
    15

    Default

    Well, here is my view. Ideally, people want to get an MRI so that they know what is going on. But in the case where this is going to be very costly, and there are already some obvious symptoms, and a person is not going to be opting for surgical treatment regardless, for whatever reasons, I would make it clear to a neurologist that you cannot manage the cost of an MRI but that you would like to have a clinical exam done and have their opinion and then to start trialing some of the possible medications to see if those help.To be honest, all evidence indicates that 70% of all cavaliers would MRI with a syrinx by the time they are 6 or 7 years old. and almost every single cavalier is going to MRI with CM. That means for a given set of symptoms, for most dogs the conclusion is going to be that they have CM/SM, and they are going to be treated accordingly. For many different types of possible illnesses, vets will try medications to see if they help before doing invasive tests, and so I feel quite strongly that in the case of an MRI, which can cost people 1000 or 2000 pounds, euro, or dollars, for most dogs showing symptoms that are generally tied to this condition, it makes more sense to simply trial them on medications to see what works. This is of course after a vet has done everything else to eliminate other possibilities–allergies, disc disease, etc.None of the medications used to treat SM are particularly risky, and certainly there are not going to be significant side effects, if any effects at all, for most of them used for short-term trial periods. Some of the symptoms are just so typical that most of us that have affected dogs reach a point where we could probably say with a pretty high degree of accuracy whether some other dog, scratching or behaving in a particular way, has SM. When other possibilities have already been eliminated, I honestly do not understand sometimes why people are pushed to do a costly MRI unless they either want to have a confirmed diagnosis and understand the extent of existing damage, or they want an MRI to consider the option of surgery.Or to put it another way–I have MRI'd all of my dogs, some of them twice, for the purposes of both diagnosis and research. I have worked with a neurologist and with my veterinarian to treat those that have SM. I have not considered surgery for any of the 3 that have SM, for a variety of reasons. If that were to change, then those dogs would go for a full MRI. 2 of my dogs that have SM did not have this confirmed by MRI for a couple of years, until I took them to the UK to have all of them done for research (mainly to get a 2nd MRI on my 2 related Cavaliers, one of which has SM and one of which is clear for reseacrhers, and also to have an MRI done on my lovely, late Lucy, whom the researchers expected would be a clear older dog at 9 given the dogs in her pedigree–and she was–thus making her very helpful for the genetic work the researchers are doing). So out of 3 with SM, one got an MRI confirmation when he was only just over a year old, and he was then treated by medications from that point onwards with a confirmed diagnosis–and he is now 8.5. The 2 others, I was quite sure from symptoms and from response to medications, that they had SM and it turned out to be the case. But they were successfully helped by medications long before they had an MRI confirmation.I do think dog owners should politely hold firm if they do not feel they can afford an MRI And would not seek the option of surgery–ask for a clinical exam and ask trial medications if the neurologist feels, on the basis of the clinical exam, that the dog is likely to have SM. there are obvious downsides to this: it may be that an MRI will reveal the dog really has very little time or chance of much of a life unless surgery is performed, and without an MRI, the owner will not know and choices may become more limited down the road. So there are many things to weigh in the balance, and many considerations, but I personally feel not every dog needs to have an MRI in order to be effectively treated (especially older dogs–say, over 4-5– that are showing symptoms, especially if they are not really severe).
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  9. #29
    Join Date
    Mar 2005
    Location
    Dublin, Ireland
    Posts
    23,993
    Post Thanks / Like
    Blog Entries
    15

    Default

    Sorry for that solid block of text but board is quite glitchy at the moment! And took out all the paragraph formatting.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  10. #30
    Join Date
    Dec 2008
    Location
    Scotland
    Posts
    164
    Post Thanks / Like

    Default

    It's no problem Karlin lol, I still managed to get through it!

    It was extremely helpful, I will be certain to discuss all of this with my vet on Thursday and the neurologist I'm referred to. I'm happy to at least know that she will be cared for whether we can afford the MRI or not and it's not just black and white. As long as I know my Izzie isn't in the pain and we can understand it a little better if everything else is ruled out - I'll be content. Thank you!
    Mum to Izzie and George

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •