Vets that have knowledge on SM in the Solihull area?

What a lovely post to read on an otherwise horrible and rainsoaked Monday morning. I've been doing some studying over the weekend, which is also intensive, so I know exactly what you are going through

It's marvelous news that Ziggy's change of medication has helped him so much. It's the same with most of the affected dogs and quite true to say that once the right combination for that dog has been found, the difference is amazing and the condition becomes manageable. Rebel is doing well too and I am now starting to anticipate the times of stress and air pressure changes when I need to make adjustments to his meds.

I just lkove the new pictures of Ziggy - he looks a new dog doesn't he and of course he's gorgeous. He looks a lot like Rebel about the head. Maybe there's something to be learnt from all this talk about head shapes?

Hi James

That is such good news about Ziggy! Now you can just enjoy your dog instead of worrying about him all the time! cl*p

Aled is progressing slowly and doing pretty well. Oliver's legs are still bad but we're trying him on steroids at the moment - at 13, I don't think we need to worry too much about long-term side effects!

We are having our usual Cavalier Christmas party in Coventry on Sunday, 7 December. I hope you and Ziggy will be able to come. Let me know if you'd like a ticket ([email protected]) - more information on the Companion Cavalier Club website.

Kate, Oliver and Aled

Great news that he's so much better on his new meds

I just don't know how you do it Kate, but you've done it again by having your Christmas party the same day that I'm judging the Fun Classes of Cavaliers for N. Lincs Club at Newark. Otherwise I would have loved to come to the party. Maybe next year?

Seriously though, I'm so glad that Aled is now doing much better. I'm not surprised Oliver's legs are a bit of a problem, but hopefully the steroids will help. Holly P sends 'ferapy' hugs and lix to help him to feel better.

What a shame Flo, we'd love to have you. The original date was the Saturday, but the church wanted their hall for the Christmas Bazaar on that day (a conflict of interests here, as I'm chairman of the Companion Club and Secretary of the church council!). Hope your judging goes well. The Companion Club has organised a Health Seminar on 19 October, so I'm trying to work out how to get to Surrey by public transport on a Sunday! One of the speakers is Clare Rusbridge on, amongst other things, latest CM/SM research and developments in treatment.

Thank you to Holly P from Oliver :thnx: He's getting quite a lot of side effects - drinking a lot, always hungry, heart beat and breathing a bit faster from time to time - but nothing too drastic. I hope all your patients are doing well.

Kate, Oliver and Aled

Kate, Oliver and Aled

Indeed, Kate! Although having said that.... Lol

He just walked into the living room and began peeing, literally 5 minutes earlier we let him out side and he was out there for a while so I'd imagine he'd have done what he wanted in that time. I heard SM/CM has incontinance as a symptom?

He's perfectly fine in himself though! So maybe just a one off? Didn't seem to be any blood or anything weird in it so I don't think its anything.

re to the Xmas party I'm unsure if we can make it due to some family members that are coming down before their Xmas trip sadly .

Thanks all

Incontinence isn't an actual symptom of CM/SM, it's a side effect of the diuretic they are on to diminish the cerebral spinal fluid (Zitac or similar). If you get rid of bodily fluid it has to go somewhere! So it will happen from time to time, it almost dribbles out without them realising - I say this with feeling as I've got two of them on diuretics!

Kate, Oliver and Aled

Kate H said:

Incontinence isn't an actual symptom of CM/SM, it's a side effect of the diuretic they are on to diminish the cerebral spinal fluid (Zitac or similar). If you get rid of bodily fluid it has to go somewhere! So it will happen from time to time, it almost dribbles out without them realising - I say this with feeling as I've got two of them on diuretics!

Kate, Oliver and Aled

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Rebel sometimes has this problem too. I always know when to get the mop out because he has that hangdog look about him. Sometimes it's good not to have carpets in the dog hangout areas

And on the subject of diuretics like Zitac, your neurologist should tell you that Ziggy needs to have a blood test at least every 6 months. Diuretics remove fluid from all over the body, not just the spinal fluid, and this can impair the functioning of the kidneys and liver, so you need to keep a very watchful eye on them and check them regularly.

Kate, Oliver and Aled

Kate H said:

And on the subject of diuretics like Zitac, your neurologist should tell you that Ziggy needs to have a blood test at least every 6 months. Diuretics remove fluid from all over the body, not just the spinal fluid, and this can impair the functioning of the kidneys and liver, so you need to keep a very watchful eye on them and check them regularly.

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Zitac (cimetidine) is not a diuretic, it is a histamine H2 blocker.

http://www.petmd.com/pet-medication/cimetidine

It is a very safe medication with rare side effects, and it can be used for senior pets and those with kidney or liver disease. See the information about giving with certain other drugs and with food.

Thankfully, the up to date protocol does not recommend diuretic drugs anymore as an option for reduction of CSF. Lasix (furosemide or frusemide) was originally a treatment option, but the side effects were worrisome.

Yes, I know that Zitac is not marketed as a diuretic but something quite different, but for dogs with CM/SM, Zitac acts as an effective diuretic. When Aled went into heart failure and was put on frusamide, the cardiologist stopped his Zitac because he didn't need to be on two diuretics. Oliver is on Topiramate, which again reduces CSF as a way of dealing with inter-cranial pressure (for humans it's an epilepsy drug), and again stopped Zitac when he was put on the alternative. Clare Rusbridge's treatment algorithm describes cimetidine as 'a CSF pressure reducing drug'. Because there are virtually no drugs produced specifically for CM/SM, neurologists have had to be inventive in using drugs designed for other conditions (in both dogs and humans) that also have properties that can help with CM/SM. I'm surprised that Zitac is used for kidney and liver disease, since my two CM/SM dogs, when they have been on it, have had to have 3-6 monthly blood tests to make sure that its diuretic properties were not damaging the kidneys or liver. Both have now stopped Zitac, but still have regular blood tests for the alternatives they are taking (frusemide and topiramate), and for the same reason - potential damage to the kidneys and liver by prolonged use of a diuretic.

Kate, Oliver and Aled

Hi everyone!

So so sorry for not posting any updates recently! More studying (learning 2 different things at the moment and also learning a new language in my spare time) along with volunteering at my local RGT (which I'm really enjoying, great lot of people there ) has made things pretty chaotic!

Very unfortunately, although our new setup worked for a while in October, things have started to slowly decline very sadly. The one side of him (it seems to be in his patches of white fur) is very nearly bold, if he loses any more fur he will be bare skinned . His stomach took a turn for the worse at the beginning of November, only this time without colitis. His stomach was constantly churning and he just seemed a little under the weather. So we ended up deciding that we'd take him off his steroids completely with his new amitriptyline, which didn't have any ill effects, he was definitely feeling less sick and there was no change in him which was great!

While that helped a little bit, it still didn't do a lot so we rang Stephanie and she recommended some anti sickness tablets for him. This has calmed his stomach a lot which is great and that seems to have put itself to rights.

Other than his stomach, his SM/CM has definitely worsened. Where as before his legs would collapse every few weeks, it is now every day or so. His legs have lost quite a bit of strength, as we discovered the other day while trying to put his winter coat on for a walk, he fell over because we lifted one of his back legs... This is new, as we have been keeping a close eye on his legs.

Walking wise, he is (weirdly enough) fine! Although he can't go as far as he used to anymore.

In general, we aren't very happy with him, whenever he's awake he's licking his paws now. Only, just recently it's been more of a really violent chew rather than lick which is pretty concerning. His tremors have worsened a lot to the point where he can fall over depending on how bad they are.

We suspect he might have cussians? We have noticed that around his privates area, (he is castrated) that occasionally he swells on both sides.... Not sure what that's about but I have heard its as symptom? The reason we think it might be this is because of his fur lost too, along with a number of other factors.

We are ringing Stephanie after the weekend, will keep you posted . Hope you all have a good start to December

So sorry to hear that Ziggy isn't doing too well at the momentl

So sorry to hear about Ziggy's problems. Oliver too has very weak hind legs; he does better when walking outdoors and enjoys his gentle walks, but falls around quite a lot in the house, where he's having to change direction more to negotiate doors and furniture. I find a couple of short walks a day help - he is worse if allowed to rest all day. I also find that when he does collapse, it helps more to just gently move his hindquarters so that his spine is straight, and then he can usually haul himself up, and it's better for him to do it himself than to be over-helped. The instinctive response is to lift up his back legs to get him on his feet and that seldom works - he just collapses again; but a gentle poke to straighten him out usually works. We had a session with a physio, who gave us some simple exercises to do; too soon to know if they are really helping. The physio was impressed by how well he manages on the whole; he has very little muscle in his back legs and his nerves are pretty dead, but he uses other muscles in his abdomen to keep his back legs straight and usable.

The tremors could be Cushings, or could be myoclonus, which is quite common in Cavaliers - old dogs tend to get it (Oliver has mild twitches), but also younger dogs (Aled has it quite severely but is helped by medication - he's under Sebastien Behr at the Willows).

Aled is now in heart failure as well, so I sometimes feel I'm living in a veterinary hospital and pharmacy! I expect you feel the same! I do hope Stephanie can make Ziggy more comfortable, please keep the updates coming.

:hug:

Kate, Oliver and Aled

Oh gosh Kate! So sorry to hear about Aled! How is he doing now?

Thank you all for your support. Unfortunately it is not good news at all. We rang Stephanie to tell her about his discomfort, and she suggested to up his amitriptyline to 2 tablets. So we did, and literally the next day his stomach got upset. (we discontinued this dosage immediately after finding out) Diarrhea since 7am til around 12PM on Thursday, after around 12 it stopped and he seemed OK after that. So we just thought he ate something funny. Friday came and went and on Saturday morning, he was up since 1am with quite a lot of Diarrhea with blood and mucus so we rang the vets and booked an appointment. They have given us some stomach calming medication for him and have suggested we carry on with the bland diet of rice and little bits of chicken (which we have been doing since Thursday) and see how it goes. They were saying how uncomfortable his stomach would be for him and said that if this current set of antibiotics and stomach binding stuff doesnt work, theres limited options past this point. They were saying his stomach is struggling to cope with all the meds hes on and it might not be a good outcome.

We are keeping our fingers crossed and hope the stuff he is on does the trick. We are a bit sad about not being able to put his amitriptyline up to 2 tablets a day as his not very good at the moment. He is currently on (this is excluding his anti biotics and binding stuff):600mg of Gabapentin a day. (all together)40mg Amitriptyline a dayOmeprazole 1 capsule - 40mg (We have had him on this now for around a month for his paw licking which we thought might be sickness related)Yesterday he tried to go for a poo, but nothing came out. He hasnt tried today, although he keeps going in and out to sniff the air which is unusual for him as he usually only goes out just to empty himself. His temperature was taken at the vets, all checked out normal etc. Fingers and toes crossed!

So very sorry to read this. I am in bits just thinking about what poor Ziggy is going through.

Let's be realistic about this - I think there is only one thing that you can do for Ziggy at this point. I had to make the decision for my Rebel when he lost the ability to walk and all dignity disappeared. How I wish it was different for both these dogs.

Let's face it, we have much in common; both of us have gone through all the options to help our beloved dogs through all the various stages of this dreadful condition, but there is a time to say the suffering is greater than the quality of life we and the vets can give them. I am writing this with tears for your boy and you streaming down my face, because I know how much it is going to hurt you to make the decision that is lying before you, but it is one that we all know you must now take. My heart goes out to you both. Nobody could have tried harder for Ziggy than you or have done more. I will keep you in my thoughts and prayers.

Hi flo, thanks so much for your kind words, it's not looking like it will turn into a good outcome.

As far as things are going so far, he hasn't been to the loo for a few days yet, so we still don't know his situation just yet. although he has improved since, to the extent where he still has a quallity of life (to the point where it's worth keeping him) but​​ even after sorting his stomach we don't have anywhere else to go treatment wise for his SM/CM. Either way, I don't think we have much longer with him and we will definitely let him go when there's no longer a sustainable quality of life, as we definitely want to do right by him and make sure he doesn't suffer. The last thing I'd want is to delay the inevitable unnecessarily.

If we can get his stomach more solid, there is still a good enough quality of life for us to keep him. But as you say flo, we definitely don't want any unnecessary suffering and we will do the right thing when the time comes. (Which will be soon due to the meds not being able to put up)

As for right now, he's a lot more comfortable since his stomach meds, we are on his last day and hopefully he will empty out today, if he doesnt there could be a problem.... Although he has gone 3 days without emptying his bowels before, but if he doesn't go today we will ring the vets and see what's up.After his stomach meds tomorrow we'll keep a close eye on him and see what's what.

Thanks so much for following his story and providing support for us to treat him. It means a lot that everyone has stuck with us all this time.

Il let you all know what happens over the next few days

Hi James and family

How is Ziggy doing? Aled is deteriorating slowly but still enjoys gentle walks, food and fuss; both his heart valves are useless, so at some point his heart will just be too tired to keep going, but at the moment his medication is giving him enough support.

In spite of it all, do have a peaceful and happy Christmas.

:hug:

Kate, Oliver and Aled

Kate H said:

Hi James and family

How is Ziggy doing? Aled is deteriorating slowly but still enjoys gentle walks, food and fuss; both his heart valves are useless, so at some point his heart will just be too tired to keep going, but at the moment his medication is giving him enough support.

In spite of it all, do have a peaceful and happy Christmas.

:hug:

Kate, Oliver and Aled

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I've been wondering how Ziggy is doing too. It would be so nice if both Aled and Ziggy could spend one more happy Christmas with both their loving owners.

Hi everyone!

Sorry to hear about Aled, Kate .

Ziggys stomach has straightened out once again and he is fine in that respect. We have put his amatriptaline up by 1 tablet again (so hes now on 2 tablets of amatriptaline) and it hasnt had any affect on his stomach but sadly, it hasnt had any affect on his condition either. (which is so weird, when we first put him on it, it filled in for his steroid!) We are seeing symptoms creeping back in now that we havent seen since last Xmas which is a worrying sign. Trouble is, we are on so much now, Id imagine itl be rather difficult to find something else to keep him comfortable for the time being. We will be ringing Stephanie tomorrow to see if theres anything more that can be done and just hope for the best. Il keep you all updated
Hope you all have a good Xmas!