SM medication clinical trial

[Karlin]

My own opinion on participation is that I would not consider it at all for a dog with significant symptoms. Rimadyl on its own would do zilch for Leo for example and there is absolutely no way I would put him through having to be on that very low level, insufficient painkiller for two weeks of the trial. For me, that means for any dog needing medium to high level gabapentin- or lyrica- there's just no way I would consider doing this.

I think it is a good opportunity for dogs on low level doses of gabapentin, or not on gabapentin at all. For example I'd definitely put Lily forward if I could participate but obviously we can't do the clinical exam from here.

I just think dogs needing significant meds are going to withdraw from the trial pretty quickly in most cases. I know without even trying that Leo would have unacceptable symptoms within 24 hours of being just on rimadyl.

Two weeks also seems a very short time to trial a drug - I wonder why not four weeks? A lot of us find gabapentin doesn't start to work for two weeks, for example, or doesn't work til dosage is adjusted. Two weeks is incredibly short time for a clinical trial.

[Kate H]

Karlin wrote: A lot of us find gabapentin doesn't start to work for two weeks

But conversely a lot of people on this forum (especially those with newly diagnosed dogs) have said what an amazing difference gabapentin makes within a few days. And people have also said that before an MRI is done, an immediate positive reaction to going on to gabapentin has been taken as confirmation of the presence of SM. And perhaps one of the things they are researching on this trial is finding a drug which works quickly and doesn't need the weeks or months of adjustment that gabapentin can require with some dogs. Both of the drugs being trialled are human drugs, one of which is much used for humans with CM/SM, so it would be great if a quick-acting, effective drug was added to our SM armoury. With Oliver I'm increasingly sure that gabapentin isn't an efficient drug for him, so we would have to be trying something else for him anyway.


Kate, Oliver and Aled

[Karlin]

Yes those are good points too!

I am glad the trial is happening and would welcome alternatives -- though wonder if one of the drugs is actually something a lot of us already use anyway. There just aren't many drugs used for CM/SM in humans that aren't being used already with cavaliers. But there have been no clinical trials of either gabapentin or lyrica on dogs, for example.

I'll be very interested in the end result as all of us would welcome better knowledge of existing drugs or any new alternatives.

For most dogs where gabapentin doesn't work, the only alternatives are Lyrica or prednisone. So would be surprised if anything else already known about is tried as a replacement.

[Hopeful4now]

Karlin, do you know anything about a drug called Normast? I think it's available in Europe.

[Karlin]

Yeah there was a whole discussion on that elsewhere at one point. I do think drugs in that area might be useful for pain, but have a lot of questions about the company and the price they are putting on it (EXTREMELY expensive -- the same or more than Lyrica, so why not use Lyrica) and that all the information pro the drug comes from the guy who runs the company, who seems to spend a lot of time promoting it on various websites... hmmm.

It isn't widely used at all over here. I don't now anyone who uses it for human or canine SM.

There's a possible attempt at a clinical trial in the US but haven't heard any more about it. I'd like to see one done though!

As for uses, I only think it might be useful alongside what is already being given -- it isn't a huge breakthrough in other words, it is a known area of potential painkiller from cannabinoids that some researchers are looking at.