Hi, My cavalier was diagnosed with mild SM and PSOM about two years ago. Her neurologist put her on 50 mg Gabapentin and 5 mg of Omeprazole. We had to up the Gabapentin to 100 mg soon after as she still had symptoms. She has stayed on that dosage for 1 1/2 yrs. a couple months ago, the scratching and biting started again. I spoke to the neurologist and she increasesed her Gaapentin dose to 125 mg. it really hasn't made a difference. She is still scratching and biting. I am seeing her vet tomorrow and will make an appt with her neurologist. Her neurologist seems pretty conservative about meds. My cavalier also has liver disease and is on 3 other meds for that and a special liver diet. So, I am giving her medicine 8 times a day. My question is ( since she is my first cavalier): I was just wondering if some of you could give me an idea of how long it was before you had to increase the SM meds the first time, how much were they increased and and was the Gabapentin and Omeprazole both increased or just the Gab.? I know this is a general question and every dog is different and you have to find the combination that works for your dog , but I was just curious as to what other members on this board were doing. Also , how many times have you had to increase the meds.over the years? As I said, this is my first cav. , and I am just trying to see what others are doing . I hope this made sense. Thanks for any insight. Judy