I thought people might like to follow Oliver's progress on the RVC Clinical trial of SM medication, so I'll start on a weekly update. We've just reached the end of Week 1, during which he has been off his normal daily dose of 200mg x 3 of gabapentin and started on a once a day dose of Rimadyl, which is a pain relief and anti-inflammatory. Well, two things have happened:
1. His SM symptoms really haven't been noticeably worse, though the pattern has changed slightly. Usually, on gabapentin, he seems to have a low grade headache quite often, usually showing while dozing especially with his head on his paws, when he starts whimpering slightly. It will often apparently stop if I turn him gently on his side, but evidently his high dose of gabapentin doesn't entirely deal with it. During this week, he has had fewer of the whimpering episodes, but slightly more episodes of jumping up to rub his head hard against a low table edge or a cardboard box. He started this a few months ago, and it seems to be a jab of headache, rather than the more prolonged (though perhaps lower level) headache that makes him whimper.
2. A real plus of this week on Rimadyl is that the wobbliness in his back legs has almost entirely disappeared. We weren't sure whether this was due to his SM or to the spondylosis (osteo-arthritis of the spine) that he also has. He hasn't been on regular medication for this since it first flared up over 4 years ago, when he had metacam and crate rest for about 4 weeks. It appears so far that the wobbliness could be spondylosis not SM, since it improved almost as soon as he was put on an anti-inflammatory specifically used for osteo-arthritis. I think his problem is stiffness after lying down rather than constant pain, as that is when he staggers most. He always walks a bit stiffly - I think because that is the most comfortable, rather than that he is having a great deal of pain. I haven't discussed this yet with our vet and neurologist, but it does look as if keeping him on Rimadyl or similar could really improve his mobility.
No other side effects at all. I just have to mark where I think he is on a line scale each week, but I'm also keeping a daily diary for my own information. We've now started on Drug A for two weeks (note to RVC: if you're trying to do a blind trial, with the participants not knowing which drug they're giving to their dogs, don't supply tablets clearly stamped 'Neurontin 100mg'!!). So for the next two weeks Oliver will be back on a smaller dose of neurontin/gabapentin. I'll let you know how he gets on, if people are interested.
Kate, Oliver and Aled