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Thistle had several pain episodes this weekend

Anxiously awaiting word of Thistle. I keep thinking of her heartbreaking screams in the video and hoping that the neurologist will give her some pain relief. Within 30 seconds of Riley's appt, her neuro had diagnosed her with SM, but still confirmed it with an MRI so he could see the extent of the damage. Like Karlin said, it's better to know what you're up against.
 
UPDATE: saw the neurologist today. So before he saw her (she was in the carrier), we sat and talked. He basically said cavaliers have this disease, and it sounds like that. And I was like, yep.

So he did a work up on her. He said several of her motions were abnormal (not normal for a regular dog, or an SM dog). He said disk disease is almost certainly out of the question, those dogs are exactly as LoveMyCavs described, and Thistle is moving, and importantly not restricting movement in her neck. And basically, he suspects SM, but the MRI will reveal the answer.

The person who runs their MRI is out of town until tomorrow, so he'll book an appointment once they are back, aiming for January 17.
 
In the mean time, Thistle is really doing well, she's happy and cuddly, stealing and hiding Guinness' toys, and begging for cookies.

She does seem to be pretty sleepy, but that's not so bad.

I wonder if I dare to bathe her tomorrow. She likes to sleep by my head, so she usually is the one who gets noticed for being dirty and smelly.
 
Glad you were able to see the neuro so quickly. It's scary how her symptoms must came on suddenly. Lucky Thistle who has a Mom who is on top of the problems cavaliers are burdened with. Did you get any pain medications to help until the MRI can confirm diagnosis?
 
Glad you were able to see the neuro so quickly. It's scary how her symptoms must came on suddenly. Lucky Thistle who has a Mom who is on top of the problems cavaliers are burdened with. Did you get any pain medications to help until the MRI can confirm diagnosis?

Jut what I was going to ask. Her pain levels may be quite low at the moment but who's to say when they will go back up again. I will be thinking of you, and Thistle too of course, on the 17th. Let us know when you know please.
 
Don't worry about short term steroids -- it's what will help her most swiftly and a treatment regime can be sorted out after. It takes months to years of prednisone use for it to become a possible risk, though there can be some frustrating side effects like appetite increase right away. But it should give her very fast relief, faster than anything else.
 
Until the MRI she being managed with prednisone (we have pills now). I asked for painkillers, but the neurologist said tramadol would knock her out (better sleeping than screaming is my feeling, but apparently I'm alone in that sentiment), but after the MRI I will be insisting on something else, steroids are not something I will put her on long-term when other options are available.

I'm still learning to navigate the differences between the US and Belgium. I don't take any drugs regularly and I'm pretty healthy so this trip for Thistle was my first pharmacist interaction. It seems the vets don't stock their own pills, so I'm not sure the human pharmacy would have something appropriate for Thistle's size as part of a normal stock. I asked for tramadol (I thought that's what I remembered Karlin recommending).

I actually work in the pharmacology and drug delivery department at my university so I will get the inside scoop on pharmacies in Belgium and what doses of what painkillers I can expect a pharmacy to stock, so I can try to find something I can ask for by name that would be appropriate for her.

My work recently banned all printing for personal reasons, so I'll have to print the treatment algorithm over a weekend.

I really do need at least a few pills of something on hand to give her in an emergency. Or Guinness.

My neurologist is not known for his bedside manner (the vet described him as unpredictable, and not very friendly- the neurologist she usually refers to is out of town till February). But we talked about parvovirus and HIV (and SM), so I think he and I will get along. He's an academic, which is basically the only kind of person I know how to interact with anymore.
 
My son sees a specialist regularly who people generally do not like. His bedside manner is not so friendly and he's just a "different" type of person. However, he is amazing at knowing his profession and I trust him 100% in treating my son.


I'm glad she is feeling better and you are on track to get her squared away so quickly. Hopefully, you can get her on a medication system and have her as pain free as possible soon.
 
Very glad to hear that she's got some medication and can wait till the MRI is done. I also have a vet whose bedside manner isn't swell--and she has a very loud voice. My daughter dislikes her, but I keep taking Tess to her because she is very knowledgable about Cavaliers, and about heart disease in dogs. I figure I don't have to have dinner with her! But I do trust her when she educates me about Tess and what is going on with her heart.
 
Soushiruiuma wrote: 'Since the optic and oculomotor nerves arise from the mid-brain they would not be affected.' Unfortunately it doesn't work like that, because the CM on its own blocks the flow of CSF round the brain and causes it to back up in the ventricles at the front of the skull. This can cause painful headaches and eye problems such as light phobia (which so far Thistle doesn't seem to have - one thing to be thankful for!), entirely independent of the damage lower down being done by the syrinx. Hope your visit to the neurologist sheds a lot of light and gets the pain under control.

Kate, Oliver and Aled

That's a very good point, thank you. Although the brain and spinal cords structures are static, the CSF is dynamic, and problems anywhere will cause problems throughout.
 
Very glad to hear that she's got some medication and can wait till the MRI is done. I also have a vet whose bedside manner isn't swell--and she has a very loud voice. My daughter dislikes her, but I keep taking Tess to her because she is very knowledgable about Cavaliers, and about heart disease in dogs. I figure I don't have to have dinner with her! But I do trust her when she educates me about Tess and what is going on with her heart.

I don't know if I could deal with loud, I'm a very quiet person, and I like other quiet people. This guy is just different, really the only description I have is that he's an academic. I was told he would barely speak to me. When I said I had a PhD in neuroscience he just got very chatty, about Thistle, about the pictures in his office, what was my dissertation on, etc.
 
Sounds like you'll get along fine with him. :)

Tramadol is prescription only over here -- probably the same in Belgium but different countries have different regimes. How is she doing today?
 
Sounds like you'll get along fine with him. :)

Tramadol is prescription only over here -- probably the same in Belgium but different countries have different regimes. How is she doing today?

She sleeps a lot. If she isn't sleeping she's obviously not happy. She barely scrtaches, but she's barking at everything. She's getting 6 mg SID of the Medro (methyl-prednisilone), I'm hoping it will start kind of building up in her system once we're a few days in. I don't know if I should wait and see, or if I should call and try to get something else added in. Thistle used to be the happiest puppy in the whole world, nothing could stop her. It's really hard to see her listless.
 
Just got the call, Thistle's MRI is on Tuesday the 15th. We need to be at the Dr.'s office no later than 6:45 am. I'm definitely renting a car, forget walking.

I ended up giving her an extra 3 mg of prednisone last night (2mg at 1 am, and 1 mg at 5 am). At 1 am she was barking, and panting. At 5 am she was scratching so much it was difficult for her to potty (Guinness woke me up with the request). The prednisone is given in the morning, and it's obviously not carrying her 24 hours. I'm thinking I may move her normal dose back to later in the day, but I will have to wait till the weekend when I can keep an eye on her pain levels.

At least the MRI is soon.
 
Glad to hear that you have the date for the MRI which is not too long for you to have to wait, although long enough when a dog is suffering like this.

I only have experience of the symptoms of SM with the one dog, but this limited experience does tell me that you are learning the important lesson that I had to try to get right, which is of course to tailor the treatment to the symptoms the dog is having, because what works for one may not work for another, or may vary without any apparent reason. Well done you for staying with it and for doing what was needed to get Thistle comfortable again.

Thistle is a very lucky dog to have you. Remember we are all here for you as and when you need us.
 
Argh! This is so frustrating. I just gave her another 1 mg, but now I think she didn't need it.

She was scratching, on both sides, obviously in discomfort but it just wasn't the same- both sides, strong contact, but not that super distressed scratching. I haven't been petting her much I'm so afraid of hurting her. Now I notice her abdomen is hard. I think she has gas pain.

I'm not saying she doesn't have something major going on, just that maybe these 5 am ones are from other pain. A tummy massage seems to have put her at ease for now

Is this from the steroid? Or something in her diet? Can I add a probiotic or something to help keep gas from being a secondary issue?
 
Personally I would 'phone the vet before adding anything to Thistle's medications for possible problems with stomach gas. Colic can be such a difficult and dangerous thing to deal with I would never try to deal with it on my own. It may of course be a reaction to the medicines she is already receiving, a food issue or something completely independent; only a vet can be sure.
 
Try a bit of yoghurt with the steroid perhaps. A lot of us humans who take preds will either take with a stomach protector like cimetidine, omeprazole etc abpout 30 min before taking it -- or take some yoghurt. I use those probiotic drinks. Preds can upset the stomach. But night scratching is very common with SM.

Also VERY important to discuss splitting preds and giving at later times -- it isn't like a pain medication; it is replacing her cortisol which naturally is released by the body in the morning and hence is usually given in the morning. You cannot 'top it up' and giving at other hours can cause her to remain awake all night and cause sleeps disruptions. It also isn;t something where you should ever raise or lower the dose arbitrarily. It needs to be managed carefully. For some people and probably dogs, preds do not last the full 24 hours but it does build up and generally improve the situation. For some, it may be better to split the dose but never to give in the middle of the night etc and splitting needs to be discussed with a vet. I would really be pushing to get her on gabapentin asap if there's a good chance this is SM as that is better at relieving the scratching. You could likely get cimetidine or omeprazole over the counter and follow Clare's algorithm for giving that -- which also might make a big difference (or may not). Ideally I'd confirm doing that with the neuro's office or with your vet. Clare's algorithm is very well established as a treatment procedure.
 
Rereading your posts I think her night wakefulness and barking is probably DUE to the prednisone as her body adjusts to it -- night wakefulness (feeling wired and hyper) is a very common human side effect at first and/or at higher doses. Adding more preds in the middle of the night will just spike this higher. The earlier in the am you can give her preds tends to be better -- eg at 6-9 am and not 10-12 am. And as far as possible always around the same time. You want it to mirror as much as possible her natural cycle. It sounds like she is restless more than in pain in the middle of the night?
 
I think it's pain. Her behaviour will usually start with changing positions, she'll move from one area of the bed to another, with lots of sighing. Then she'll go on the floor and lay down in various places, with more sighing. Then she'll maybe start growling as she's laying somewhere. Then growling and barking. But she's not really "wired".

If she was wired I'd expect her to do something like try to wrestle with Guinness. But she just seems more like she can't find anyway to get away from discomfort.

I'll phone the vet about possibly adding a CSF reducer.
 
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