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Thread: UPDATE on Shiloh...Rapid decline in last 24 hours

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  1. #1
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    Default UPDATE on Shiloh...Rapid decline in last 24 hours

    Hi everyone.

    I'm writing this because my husband and I are at our breaking point. Or at least getting very close. Shiloh has now been on her medication about 3 weeks. After seeing some improvement initially, although not as much as we'd hoped, we are now seeing a pretty rapid decline. Yesterday and today were probably the worst days Shiloh has ever had. Despite being on 3 different medications. (We are currently giving her 100mg of Gabapentin 3x a day, Tramadol 1-2 times a day as she waits for her next dose of Gabapentin, and Rimadyl 100mg 1x a day. She is also getting a daily probiotic, Protegrity GI, to help her tummy, which has been much better.)

    Throughout this whole process, ever since her new vet told us we may have to put her down at some point, I have been asking people over and over, "How will we know when it's time?". Tonight during her episode, I finally understood. We will know EXACTLY when it's time. If she makes the same sound again that she did tonight, it will be very obvious that it's time. She really has lived her life in pain. Tonight was another level. It wasn't wimpering, or crying, or yelping, or screeching. It was WHALING. TORTURE. I actually felt my heart break inside my chest. It was such a horrible sound I didn't recognize it at first because she's never made that noise before. The last 24 hours have been a rather rapid decline. Today it seems like every 5 to 10 seconds she was air scratching, or displaying one of her other symptoms.

    She is currently sedated, hiding under our bed again. As it stands now, our next follow up with the vet is the first week in November. The next step is adding Prednisone, but the vet said this will be our last option. We are calling the vet first thing in the morning to see about starting the steroids right away.

    Is this normal to have such a rapid decline? It has been getting worse all week, but since last night she has taken a turn for the worst. When we told my brother, who absolutely ADORES Shiloh, it may be getting closer to the time where we have to put her down, he said, "What are you going to do? Just kill her?"... I know he doesn't understand the situation completely, but that comment just ripped me up inside. I know that at the end of the day it's a decision my husband and I have to make together. I understand that my brother doesn't have a complete understanding of SM and the horrible pain it causes, but it just was hard to swallow. I'm really starting to feel that if we truly love her, which of course we do, putting an end to her suffering is the only option. My parents observed her episode today and they told us that we may be out of options, as hard as that is. My mom went to Shiloh's vet appointment with me this past week and the vet explained SM to her and how painful it is. It was good to have her support.

    I guess I'm just writing this to gain support from this wonderful community of Cavalier lovers who also understands SM. Thanks for listening.

    Love and light to all
    xo,
    Dre AKA Lucky*

  2. #2
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    Oh I'm so sorry to read this update. I have heard that air pressure changes can make SM dogs have really bad days. I also know of a few dog who did rapidly declined as well and did not respond as expected to meds. I do not know too much about the SM meds but I call your vet and maybe something can be added or changed to help some. I'm sure you will get folks here with more info to give you some advice.

    I have only support to provide you. I know this must be heartbreaking.
    Melissa
    "If you don't own a dog, at least one, there is not necessarily anything wrong with you, but there may be something wrong with your life."
    -Roger Caras

  3. #3
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    I'm sorry you are going through this. Shiloh is actually on very low doses of her meds. You could increase her gabapentin (my Aled is on 200mg x 4) and perhaps also her rimadyl - most SM dogs can safely go up to 300mg x 3 of gabapentin, and beyond that there is the refined form of gabapentin called Lyrica, which works extremely well with some SM dogs. And if all else fails for pain control, there are steroids. You have not run out of options with medication. Have you shown your vet the treatment algorithm on Clare Rusbridge's website (www.veterinary.neurologist - someone else can probably give you the full link, I always forget it!)?

    If Shiloh is getting pain between her doses of gabapentin, you may need to up her to four times a day - it is important to get 'blanket coverage' because gabapentin is designed to prevent pain coming up to the surface, so to speak - it's not so much a painkiller that deals with the pain once it's being experienced. The average time for gabapentin to work through the body is 8.5 hours, but that is an average, which means some dogs will go longer and some dogs need it more often. Both of mine do better on four times a day. Talk to your vet now about increasing the dosage, or get a referral to a neurologist - or ask your vet to consult a neurologist who knows about SM.

    Melissa is right that rapid changes in air pressure can badly affect SM dogs. On those days I give an extra gabapentin. Air pressure has been known to affect a dog so badly one day that euthanasia was discussed, but the next day the pressure was less and the dog was very much better. Many of us with SM dogs become obsessive air pressure watchers!

    If Shiloh is in that level of pain, you need to get on to your vet quickly - we all have to fight their corner with our SM dogs and insist that the professionals get moving!




    Kate, Oliver and Aled

  4. #4
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    I agree with Kate. It sounds to me like Shiloh needs her medication upped and sharpish.

    Merlin is on Gabapentin (100mg) 3 times a day
    Metacam every morning
    Tramadol (at night or as and when he needs it, if having a "bad pain" day etc)

    Merlin is at the early stages of CM and these medications are working well, however it sounds like Shiloh is in need of a lot more and should be on higher dosages.

    As Kate told me ............fight their corner. Fight for your Shiloh and tell the vets what YOU WANT, not the other way around. You know Shiloh the best and you will know deep down how much more medication she needs to make her comfortable. Tell your vet how you feel, and don't give up on her, she's counting on you to get her help, dont let the vets fob you off, i've had it done many times with Merlin.

    Big cuddles for you and Shiloh.

    Gemma & Merlin xx

  5. #5
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    Oh no, sorry to hear Shiloh is still suffering. A rapid change in air pressure can cause pain. And as Kate said, Shiloh is on a very low dose of medication. Just upping her gabapentine may give her a better quality of life for quite a while. All is not lost. There is still wiggle room to tweak the meds. Please let us know what the vet says.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

  6. #6
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    I agree with everything that Kate said and also that you have to fight Sholoh's corner for her. Shout as loud as you have to but get some expert advice.

    Just for the record, my Rebel reacts badly to sudden air pressure variations and also to extreme temperature changes, which means I have to increase his Gabapentin to compensate.
    Warmest wishes
    Flo & the ByFloSin Cavaliers
    Rebel, Winston Alexander,Little Joe & Holly Poppet
    Birmingham, UK

  7. #7
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    For such a dramatic pain reaction you may want to get Shiloh on prednisone for a period of time. It may be enough to get her over the hump while you increase her other meds. Prednisone has worked wonders for Riley. There is still hope. I know it's hard to think it at such a time when you're heart is breaking to see her in so much pain. We're all in your corner too.
    Bev
    Oliver (blenheim, born 3/2001), Riley (black & tan, born 8/2002,), Madison (ruby, born 9/2003), and Oz (tri-color, born 7/2007)

  8. #8
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    Hi

    Have you looked at Claire Rushbridge's treatment sheet on cavalierhealth. Other drugs as well as what you are on now. I feel for your baby and you.

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