Does this mean Charlie is in pain?

[rubles]

Charlie was given o.7 megs of Gabapentin and 0.5 mils of prednisone 4 hours ago.
He's restless, jumps down from my lap.
He walked up and down the chesterfield where the Ridgeback and the Griffon were sleeping like he wanted to jump up but didn't. When I called him over to me he indicated he wanted up so I positioned him so I could lift him up. The Ridge bounded over barking at him followed by the Grif. That's unusual behaviour for them and I wonder what they're detecting. Charlie's on and off my lap a dozn times a day on his own unnoticed by the other dogs.
So I lifted Charlie up to my lap and he settled in. His head is positioned lower than his body and he's breathing rapidly.

Is this a sign of pain/discomfort? His meds have been increased to 0.7 mils of Gabapentin every 8 hours and 0.5 mgs of Prednisone taken with foodonce a day initiated late last week because of air scratching when time for his meds.

[Kate H]

Sorry Charlie's having a bad day. My immediate reaction is to ask what your air pressure's like today in Ontario, because this is how my Oliver tends to behave when the pressure bumps up or down. Normally his medication controls his headaches pretty well, but on air pressure days he seems to feel more uncomfortable than usual. You might ask your neurologist/vet whether you can give Charlie an extra dose of gabapentin on these days - quite a lot of dogs with SM react like this to changes in pressure and if you keep an eye on the weather forecast, you can almost predict when these uncomfortable days will happen, if that's what's causing them.

Kate, Oliver and Aled

[rubles]

Ontario is experiencing a low pressure day--cloudy, with intervals of light rain. So you feel Charlie's symptoms are causing him discomfort--thanks for confirming what I'm thinking.
I will contact his vet for more information.
Thanks
Sandra

[Karlin]

Agree it could be weather. Many of us with CM/SM dogs see more difficulties around drops or rises in air pressure.

However would wonder why he's already on prednisone -- generally this is a drug given when the wide range of other choices no longer work or are not tolerated by the dog?

A neurologist is far better to work with than a vet if you are only working with a vet-- SM is a specialist condition that vets are fairly poor at managing (like having your GP manage a serious neurological illness. No GP would ever be managing SM in a human).

Personally I'd never put a dog on prednisone (steroids) except for short term management of inflammation/pain, or when other alternatives are not working. They absolutely have their place but would never use them as a first option, only as a last option.

On Dr Clare Rusbridge's treatment algorithm, predinsone is offered as the last possible medication option after quite a range of other approaches. I think many other things should be considered for air scratcing -- a CSF inhibitor as a basic starting point for ALL dogs with these conditions; an increase in gabapentin or trying Lyrica; the addition of an NSAID painkiller... only as last option is prednisone generally on the menu.

[rubles]

Hello Karlin,
Actually it was the neurologist that recommended the gabapentin way back in January that prescribed the prednisone to be administered if Charlie didn't respond to gabapentin on its own. I have enough for two weeks.
Charlie has never vocalized discomfort and the behaviour of the other dogs leads me to believe they detected something abnormal in his behaviour causing me to feel uncomfortable. Hopefully Charlie was responding to the air pressure. My philosophy doesn't embrace watching a dog suffer--it's not a dog's life and I daily question myself for trying to treat this horrible condition. He is more comfortable this evening--he jumped on my lap and is sleeping.
Thank you for sharing your knowledge. It's appreciated.
Sandra

[Karlin]

If that's the case, I'd certainly talk to your neurologist about Clare Rusbridge's recommendations and protocol which is pretty clear in listing prednisone as a last-ditch -- mainly because it has some potentially serious side effects if taken long term and even the milder effects (such as weight gain and a constantly hungry dog) can be hard to manage over time for many people. Most neurologists would put a dog with these conditions onto a CSF inhibitor like cimetidine or omaprazole (or both) as that alone sometimes is enough for a while without gabapentin and often is the crucial element that helps manage scratching. Then they would add an NSAID unless for some reason it is felt none of these are appropriate to a given dog's treatment.

Not all neurologists are that familiar with managing SM, and not all seem to be aware of the treatment algorithm that is now quite widely used.

Long term steroid use even at low dose often leads to diabetes, Cushings disease and other serious illness.

For some dogs this may be the best choice or only choice and many can manage steroids OK but the longer a dog is on them the more likely to be mild to serious side effects (as in humans).

[Kate H]

Sandra wrote: I daily question myself for trying to treat this horrible condition.

Please don't - it often takes months to get the medication right, a matter of trial and error until you and your neurologist find the right combination for your particular dog. But many of us have CM/SM dogs who live more or less normal and certainly happy lives, enjoying walks and activities like any other dog, and there are a lot of people in the UK, the US and Canada working hard to find causes, treatments and better medication. No life, human or animal, is going to be totally pain-free, but there is a lot that can be done to help many (though of course not all) CM/SM dogs. So hang in there for Charlie's sake!

Kate, Oliver (aged 11 but still going strong in spite of SM) and Aled

[Karlin]

Thanks for making those points, Kate!

[murphy's mum]

Sandra wrote: I daily question myself for trying to treat this horrible condition.

Please don't - it often takes months to get the medication right, a matter of trial and error until you and your neurologist find the right combination for your particular dog. But many of us have CM/SM dogs who live more or less normal and certainly happy lives, enjoying walks and activities like any other dog, and there are a lot of people in the UK, the US and Canada working hard to find causes, treatments and better medication. No life, human or animal, is going to be totally pain-free, but there is a lot that can be done to help many (though of course not all) CM/SM dogs. So hang in there for Charlie's sake!

Kate, Oliver (aged 11 but still going strong in spite of SM) and Aled

Kate's absolutely right, it is a lot of trial and error, and unfortunately it can sometimes take a while to get it right. I found myself feeling the same way back in January after Misty took a downward turn, we'd tried various different meds for her, but she still wasn't herself. I'd sunk to an all time low looking at her, wondering if I was being selfish, my Neurologist advised us to give her a few more weeks, and my Hubby agreed with her.

Misty is now doing well, and as long as her good days far outweigh the bad, then I'm happy that she's not suffering. She does still have bad days, changes in air pressure affects her, but she still a wee love bugs, who's obsessed with chasing her tennis ball.