30th January 2014, 09:51 AM
At the moment she is on omaprozole alone and yesterday evening she started to experience something which she never experiences before. She started to doing a frequent air scratching usually she use to do it one a day but yesterday she started to do it like 7 times in a 2 hour span. I got really worried and I called the doctor and he asked me to try rimadyl with the omparozole as suggested on the algorithm treatment as a next step.
But with regards to gabapentin I went to search in bigger pharmacies and yes they do have. So if the vet asks me to give her the gabapentin it shouldn't be a problem.
Thanks a lot
30th January 2014, 12:07 PM
'to try rimadyl with the omparozole as suggested on the algorithm treatment as a next step.' But the first step suggested on the algorithm is gabapentin - and your vet seems to have jumped over that. Air scratching is a very common symptom of neurological pain caused by CM/SM and rimadyl won't touch it because it is an anti-inflammatory painkiller (my Oliver takes it for his mild osteo-arthritis), not a neurological pain reliever like Gabapentin. I know it's easier said than done to challenge your vet, but with this sort of scratching, you shouldn't be waiting for your vet to ask you to give Bliss gabapentin, you should be telling him to give it to her now! That's the first thing Dr Rusbridge prescribes - so print off the algorithm and ask your vet why he's missed out the first thing on the list!
Kate, Oliver and Aled
31st January 2014, 09:00 AM
I am following this it is on dr clare's rusbridge website and there is NSAIDs before gabapentin that is why he decided to do so.
31st January 2014, 11:50 AM
It is NSAIDS before gabapentin -- -- but this works for so few dogs (indeed have never known of one with SM managed on NSAIDS alone). Kate is right that air scratching is a pretty certain sign of SM (it isn't known with any other condition, according to Dr Rusbridge) and is definitely a sign to start on gabapentin, I think any neurologist would say. I'd definitely move to gabapentin at the starting dose but be aware that most of us find we do need to give it three times a day, not two, and generally have to increase dosage above the starting dose. 100mg 3x is typical but yours may do fine on the starting dose.
In memory: Lucy
Cavalier SM Infosite:www.smcavaliers.com
31st January 2014, 12:31 PM
Seconding what Karlin says, I think trying NSAIDS is actually on Dr Rusbridge's algorithm first as a way of testing whether CM/SM is present, in the absence of an MRI. If they work quickly in controlling pain, then it probably isn't CM/SM. If they don't work (and they won't work on neurological pain, of which air scratching is a very common sign), then you need to use gabapentin to get the pain under control, and if it works (and it often makes an immediate difference) then this is a strong sign of CM/SM being present. The important thing is to get Bliss's pain under control as quickly as possible, so don't let your vet leave her on NSAIDS for too long if they don't stop the scratching - go back to your vet and point this out and ask for gabapentin.
Kate, Oliver and Aled
31st January 2014, 07:43 PM
No my vet told me to give a trial of a week with NSAIDs and omaprozole. If this does not work we will switch to gabapentin.
To tell you the truth my mistake a couple of week ago the vet suggested to put her on rimadyl to give it a shot and I had seen improvement but the weather was fine during those days. She used to have one air scratch during the day and a normal scratch int he morning. Then we stopped it and started the omaprozole and they weren't quite working. So I called the vet two days ago when the air scratching got worse and worse I have never seen her like that. It happened to be the day when there was a drastic change in weather. Therefore I called him and told me to add rimadyl. If I wont see any improvement by monday I will definitely call him.
He is a very nice vet and always ready to listed my suggestion and to read information I give him about the condition.
Thanks a lot for your concerns!!
31st January 2014, 10:34 PM
I'm glad you've got a good vet that you trust and who is willing to work in partnership with you to help Bliss - it makes such a difference.
Kate, Oliver and Aled
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I am back. My baby was on 10mg omaprozole and 40mg rimadyl and I used to observe that she still had some yelping episodes out of the blues. I took her to the vet and he check her glands and they were full. From that they she did not have any yelping episodes (so I think it could have been related). He gave me a prescription of gabapetin however he suggested me not to start them unless she is uncomfortable. However she is still scratching, air scratching and biting her legs. The biting of her backs was increasing a lot therefore I decided to switch to gabapentin. She has been on gabapentin for a week now. However I haven't seen any major improvement. She still does scratch and does air scratch every now and the major symptom is biting at her feet especially when she is on the bed. However she does not seem to be in any pain and she is always willing to play and goes out for a walk twice daily.
What can you suggest? Cause sincerely I do not know what to do since we do not have an MRI over hear!