Bentley's Health

[CSutherland]

I'll just give a little update on how he's doing. He had the MRI 2 weeks ago and was prescribed gabapentin and prednisone after being diagnosed with CM/SM and PSOM. It seems that the PSOM may be the most severe of his issues. He has one small syrinx along with CM. Since then he has gradually been improving and at the moment seems norma, except for the excessive peeing! I'm aware that this is due to the prednisone. He loves taking his meds because I wrap them in a dab of peanut butter!

[Kate H]

So glad Bentley is responding well to the meds - the peeing settles down after a bit! Neither of my boys has PSOM, so I don't know much about it (they have plenty of other things!), but hope the vet will be able to help it.



Kate, Oliver and Aled

[CSutherland]

There is a surgery for PSOM but it's not without risk and the problem can return. For the time being, we're just keeping him happy & comfortable. They told us at Univ of Missouri where the MRI was done to just "let him be a dog." He's doing that!

[Kate H]

I entirely agree with letting SM dogs just 'be a dog'! The worst thing you can do is wrap them in cotton wool and over-fuss them. As long as they are physically able, a normal life with plenty of exercise, obedience classes if that's what they do, even agility - anything that keeps them happy, alert and sociable. Like Bentley, Oliver has CM and a small syrinx. He was diagnosed 6 years ago and is only slowing down now because he is nearly 13 - so hopefully Bentley too will have many more years with you.

Kate, Oliver and Aled

[Karlin]

Agree they should be allowed to do 'normal' things unless they cause distress through overexertion. And there's some evidence that activity can actually help decrease pain, too.

I'd question whether to keep Bentley permanently on prednisone though. This is recommended as a drug of last resort by Dr Rusbridge who like many experts feel vets and some specialists too often reach quickly for this potentially debilitating drug because owners like the fast results they see. But there are some very serious potential side effects from long term use of prednisone.

For CM/SM it really should only be used either for cases where a lot of pain needs to be brought under control (generally, before a longer-term meds regime is decided upon), or in cases where other meds cannot manage the pain or disagree with the dog.

Clare Rusbridge's treatment algorithm, which is available from her website, lists the meds to try. For CM, a CSF inhibitor has been seen to help a lot -- something like cimetidine or omeprazole. Hopefully that combo ( ie with gabapentin) might work and you can stop the prednisone. NB: it is very important never to just simply discontinue prednisone though-- this can make a dog very sick or be fatal. It has to be slowly reduced over time, under supervision of a vet, so that the dog's adrenal glands start to function again. Prednisone makes this essential gland stop producing the essential hormone cortisol.

[CSutherland]

Yes, he's supposed to wean down, starting this weekend, and ending in 2 more weeks, see how he does, and attempt to keep him off of it. Vet said we may need to do an on-again/off-again routine.

[Karlin]

That sounds like a good plan.

[CSutherland]

Well.....I don't know what to think. Bentley has been doing better & better each day. This morning he was perfectly fine until about noon when I heard him crying in another room. I knelt down beside him and he just climbed onto my lap while I held him close. He acted as if he had something in his throat and was smacking his lips. So weird. After a few minutes it passed but when he left the room he went into another room and sat on the floor against a couch, staying in the same position for several minutes. Later I picked him up and rocked him like a baby and he now seems OK. We've had this mouth/throat thing before. Is this a usual symptom of CM/SM & PSOM?

[Kate H]

One of the problems with CM/SM is that there are so many possible symptoms, almost as if every dog reacts differently. But I would guess that Bentley was in pain. If his meds generally seem to be working OK, it may have been related to a change in air pressure, which affects many dogs with CM/SM, especially when the pressure goes very high or very low in a short space of time. Keep an eye on the weather forecasts for a few weeks and see if Bentley's episodes of pain or discomfort are related to changes in air pressure. If the do seem to be, it would be worth talking to your vet about it and asking if it's OK on those days to give him an extra gabapentin, which seems to help. If you become obsessive about air pressure and check it regularly (a symptom of owners of CM/SM dogs!), and it seems to be affecting Bentley, you can begin to anticipate when he will have bad days and give him the extra gabapentin before the pain has a chance to surface.

Kate, Oliver and Aled

PS Some dogs are happier having gabapentin four times a day, instead of the more usual three times - Oliver seems to do better with four times. It always seems to be trial and error for a few months until you find the right doses of meds for your particular dog.