New to this forum & newly diagnosed CM & SM in NY USA.

[Rdituro]

I live in NY in the US. I am new to this forum & I don't know if anyone else here is from my area. I have a 3yr old male Blenheim Cavi named Winston. He was just diagnosed with CM & SM with an MRI. His neurologist has him on liquid Gabapentin 1ml 3x a day, Prilosec 5mg once a day & Tramadol 2x a day. The Tramadol was just prescribed because he was still having quite a bit of discomfort just on the Gaba. I can't even begin to tell that this dog had no symptoms until just recently when he started to scratch his neck & back. After the MRI the neurologist said his condition is the worst she's ever seen & she doesn't understand why he is not exhibiting more serious signs. I think he's been living with with this since birth & he was just used to the pain. He's such an incredibly happy guy. We have a second opinion scheduled for Friday 3/29 in another state(NJ) with a highly recommended neurologist. Winston also has a very slight Mitral Valve Disease & PSOM. I would consider surgery but my concern is first his other conditions & second the neurologist says his nerve is so badly damaged that it really won't help him. I do realize he will have to be on meds the rest of his life but if it would prevent future damage I would do it. He is so happy & not suffering on these meds I would want to do everything I could for him. Any advice?

[LilCav]

I am in your relative area (NY is huge!). If might PM you to ask which vet you went to.

It is very hard dealing with so many issues, especially in a dog that sounds as happy as you describe Winston. Wishing you the best of luck.

Also, welcome!

[Karlin]

Hi and welcome, though so sorry that you have found us with a cavalier having these problems.

In your area, you are in easy reach of LIVS on Long Island and that is where I'd probably go. That said, they tend to be very pro-surgery. I am not sure if that is who you saw.

Many neurologists say that some of the worst scans they see are on dogs that have surprisingly few symptoms. Dr Marino at LIVS has said in the past that he would not expect a dog that suddenly acquired such levels of syrinxes to be able to liv with the pain but that perhaps as they come on gradually the dogs adjust somehow to either tolerate the pain over time or their internal system adjusts or maybe both.

Three however is fairly young and if your fellow has a very poor scan that does raise questions for you about what to do and the time scale you might be looking at. Unfortunately no medications halt this condition or prevent further damage and it generally does keep progressing. Surgery can halt it but doesn't work for all dogs and can have risks. Humans find it extremely painful to recover from as well so I always have kept this in mind -- I too would not choose surgery lightly.

Is your neurologist following Dr Clare Rusbridge's treatment algorithm? Her website has this as a download alongside much other very useful information: http://www.veterinary-neurologist.co.uk/

I hate when people have dogs on liquid gabapentin as this is not something most of us are familiar with in terms of dose so I cannot really tell what that equates to per day in regular gabapentin -- BUT you can consider asking about increasing the dose or trying Lyrica, more expensive but often works better.

There are other painkillers to try than tramadol as well. Different things work for different dogs and it tends to be trial and error to get the right mix.

[MomObvious]

Well let me start by telling this forum is FULL of information and other cavalier owners dealing with all kinds of medical issues and you will be surprised how many people from all different areas are members. I personally have no advice except that the advice you will find here is sound. Please keep us updated. I think its nice to have some support from other cavalier lovers too.

[Sydneys Mom]

Welcome to the forum! I'm so sorry that Winston has so many medical problems, at such a young age too. I can't give you and advice as I have no experience with SM/CM, but the others nere who are unfortunately dealing with this are always happy to share information.

There are several members here who are from the NY/NJ area. I myself grew up in NY and am now in San Diego.

Please let us know how Winston is doing. We would love to see pictures too!

[cavie3]

Hello and Welcome, I too am very sorry to hear about Winston and I can only second what other have said that you will recieve immense support from others on this forum as I have found.

[rubles]

I'm sorry Winston has SM.
When my cav was diagnosed with Sm he was put on 600 ml liquid Gabapentin to start with prednisone as back up. This was NOT the best approach. So I took the advice posted here, sourced Clare Rusbridge's site and took a copy of her algorithm to my vet.
As a result Charlie's dose of Gabapentin was raised to 100mgs in capsule form administered 3x a day. The liquid was more expensive, formed clots and has a shelf life. He's also on Cimetidine 50mls 2x a day.

Since then Charlie is much better. We also have Tramadol for the days when atmospheric pressure is changing--those are his bad days.

You wIll receive excellent advice here and There are better days ahead for you and Winston.

[Love my Cavaliers]

It's good you're getting a second opinion. I too found this site shortly after one of my dogs was diagnosed with SM. I opted for decompression surgery and she is doing so well 4+ years after her surgery - she has had a new lease on life. It's not for every dog, but for Riley, it was absolutley the right decision. Most dogs do well on some cocktail of meds, but as Karlin said, the SM does keep progressing. However, Winston may live a long and happy life once you find the right mix of drugs for him. Even if you opt for surgery, he'd still have to be on medication after surgery. Riley takes low-dose prednisone daily. That's the only medication that helps her, even post-operatively.

[Pat]

I hate when people have dogs on liquid gabapentin as this is not something most of us are familiar with in terms of dose so I cannot really tell what that equates to per day in regular gabapentin -- BUT you can consider asking about increasing the dose or trying Lyrica, more expensive but often works better.

Brand (Neurontin) and generic oral solution gabapentin both contain 250 mg per 5 ml, so that dose would only be 50 mg. three times a day, which is a pretty low dose (depending on what he weighs).

I am going to start a separate thread, because I discovered that the oral solution contains xylitol, which is toxic for dogs. I also found that we discussed this here in 2009 (reference came up when I was googling) but this is a timely reminder because this is very serious.

Pat

[Rdituro]

Thank you all so much. My neurologist is Dr Georgina Barone at Veterinary Medical Center of Long Island. She did explain to me that Xylitol is in the Gabapentin that you would get at a regular pharmacy but the GABA I get from their office, since it is given to dogs, does NOT contain Xylitol. The reason we started him on the liquid is because he is so allergic & sensitive to many medications & vaccines, her thought was it would be easier to adjust for him. So we started him on .6 ml which didn't do much, so we increased it to 1ml 3 times a day, after 2 days he needed to start Tramadol. He was originally on a very low does of steroids which completely knocked him out, totally lethargic. The only reason Dr Barone didn't recommend LIV is because of the support & aftercare staff. The doctors at LIV including Dr Marino are supposed to be wonderful. She recommended the neurologists & staff in Redbank NJ. It's about 2hrs from us so it's not too bad. If we are going to consider the surgery & the expense then I would rather go with the best reputation all around. Thank you for all your advice & I will check out the Clare Rusbridge site. I'm not convinced he's on the right med cocktail right now. I can tell when the meds are wearing off & he definitely reacts more during periods of atmospheric pressure. He also has a problem on some nights getting comfy. I'll keep you posted. Oh & Livcav I am on eastern Long Island.