Page 1 of 3 123 LastLast
Results 1 to 10 of 23

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

  1. #1
    Join Date
    Sep 2013
    Posts
    26
    Post Thanks / Like

    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
    Join Date
    Feb 2012
    Location
    Yorktown, Virginia USA
    Posts
    1,430
    Post Thanks / Like

    Default

    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
    Join Date
    Aug 2008
    Location
    Coventry UK
    Posts
    1,907
    Post Thanks / Like

    Default

    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
    Join Date
    Aug 2013
    Location
    Nottingham. Uk
    Posts
    21
    Post Thanks / Like

    Default

    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
    Join Date
    Feb 2011
    Location
    San Diego, CA
    Posts
    1,499
    Post Thanks / Like

    Default

    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
    Join Date
    Feb 2007
    Location
    Birmingham, UK
    Posts
    828
    Post Thanks / Like
    Blog Entries
    1

    Default

    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
    Winston Alexander,Little Joe & Holly Poppet
    Birmingham, UK

  7. #7
    Join Date
    Jun 2008
    Location
    Chicago area
    Posts
    1,789
    Post Thanks / Like

    Default

    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
    Join Date
    May 2012
    Location
    Hampshire, UK
    Posts
    78
    Post Thanks / Like

    Default

    I don't have any experience of a cav with sm (yet, although I pray that i may never need too) but my heart breaks when I read your posts about Shiloh and how horrific it must be for you to witness and feel so utterly helpless to stop her pain.

    I just wanted to say my thoughts and prayers are with you and I so very hope that you can get her meds up to the right dose to spare her from her suffering. Jazz and I are routing for her
    Nicki
    Proud owner of Jazz

  9. #9
    Join Date
    Oct 2008
    Location
    Herts, UK
    Posts
    1,692
    Post Thanks / Like

    Default

    Im so sorry to read that Shiloh is so very poorly. You are doing the right thing by exploring every option before making that terrible decision we all dread. Remember there is always support here (plus a mountain of knowledge). Good luck and keep us uptodate.....take care. Mel x
    Mel
    Momma to Leonardo (Leo to his friends)

  10. #10
    Join Date
    Mar 2005
    Location
    Dublin, Ireland
    Posts
    24,067
    Post Thanks / Like
    Blog Entries
    15

    Default

    I will very much echo what others have said.

    This is a very low dose of gabapentin. And steroids would very likely greatly help. This must be terribly difficult for you.

    Please have your vet work TODAY from Clare Rusbridge's treatment algorithm (November or even tomorrow, is not acceptable). Given what you are seeing I'd ask to get her on short term steroids as this level of pain is truly not acceptable. I'd be thinking about getting her on maybe 200mg 3x of gabapentin right away as well. To be honest for a dog in this level of pain I'd just start right NOW giving her 200mg 3x and see if that helps -- it may immediately bring some relief to her. Normally (and I stress normally!) I would not advocate making adjustments without going thru the dog's medical carer but many of us experienced with SM have had to raise dosages ourselves of SAFE meds such as gabapentin at various points and confirm them with our vet or neurologist. I would NEVER advocate increasing any NSAID or other medication but gabapentin should be quite safe to increase under these very urgent conditions where a dog is clearly suffering greatly.

    I'd be considering Lyrica as well. It tends to be more effective than gabapentin and for a dog in a lot of pain, that would be my own next choice if a raised dose of gabapentin doesn't work. Some are on BOTH gabapentin and Lyrica but such fine tuning really, really needs to be done by an experienced neurologist if at all possible.

    With SM dogs you must be their advocate. If you see any return of pain, it is critical to get on to the medical professional and insist that meds be adjusted RIGHT AWAY. Too many vets have no idea of the level of pain this disease can bring and all of us with SM dogs have learned we often have to come out fighting for our dogs (and change vets if they have a problem with very active management -- this is NOT a disease that tends to remain still, with a consistent tratment plan. They need to educate themselves about SM. Best way is Clare's website materials).

    You will not hurt a dog by opting to increase the gabapentin dose as advised. I stress again that in your shoes I would right now, bring it to 200mg 3x at her next dose. If that doesn;t help., and your vet is not responding, I'd increase to 300mg 3x until you can get in to see them. Or get a new vet.

    Often rimadyl doesn't do too much. There are also some other options than tramadol.

    You have a lot of short to medium term options before thinking about euthenising Shiloh. That said, yes, they can decline quickly and this is a totally unpredictable condition. For some dogs,surgery is a much better option but also sometimes the opportunity has passed if too much damage has been done. These are considerations to make with a neurologist.

    But there are MANY options ahead with meds to try and greatly improve Shiloh's life. Do not hesitate to ring your vet and ask for an emergency appointment today to adjust her meds. Discuss short term steroids. And increase her gabapentin right away.

    We know what you are going through. Don't despair yet. But also carry with you your wise but difficult knowledge that you now understand this condition better than others and know that tough -- but ultimately, kind -- decisions may lie ahead. We all hope that will be some time in the distance.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •