SM and prednisone update
I've been posting about my dog Sammy's health over the past 7 years quite a lot. He had serious SM symptoms from about 1 year old. He was treated with Gabapentin for a year and finally prednisone, which kept him very stable over the past 6 years. Last Autumn he had a bad neurological/vestibular episode (which my vet at the time said was definitely a central brain problem rather than inner ear problem), from which he recovered really well. However, he had to be put on a higher dose of prednisone to control these new symptoms (blinking eye, head tilt and facial paralysis, and eventually collapse and nystagmus).
Unfortunately 7 months later, it looks like he has developed cushings from the prednisone. He is losing his fur, especially on his tail, where the skin also looks pretty bad. I have tried now (as several times before) to reduce prednisone and increase Gabapentin and tramadol instead. We got through 2 weeks looking good, but now in the last few days he's been scratching a lot and rubbing his face so much that his eye is infected. He is on 450mg gabapentin per day, 5mg prednisone every third day, tramadol at night, and now an antibiotic. I don't know what to do - to keep giving prednisone everyday, causing cushings, or keep giving him this blend of medication that still leaves him with some level of sm related suffering. His scratching/rubbing episodes are not constant and otherwise he just gets on with things, but his eye looks pretty sad. Lyrica for some reason doesn't seem to make any difference. He is also on furosemide and furtekor for heart failure.
Compounding it all is the fact that Sammy has never been MRIed. He hasn't been insured, I've been a student and his symptoms seemed obvious and urgent enough to make their treatment also obvious (Gabapentin made a clear difference). However, I have been wondering for years whether some of this might be caused by PSOM or even an allergy. He has been seen by an ear specialist who didn't see PSOM pain reflexes but was happy to do an ear flushing operation nevertheless (he said it wouldn't harm Sammy whether they found a problem or not). I decided anyway not to put him through it.
I guess I'm trying to simply update Sammy's story for anyone who followed it, gather some similar experiences, and possibly decide on some questions. My questions now are:
- has anyone seen red eye with pus as a result of SM or PSOM? (Sammy actually had a similar eye infection at 1 year old when first diagnosed and started on gabapentin).
- has anyone had to keep on prednisone despite fur loss? I am giving him Denamarin for the liver and feeding him a hepatic and renal friendly diet, but the fur loss has developed despite this. Was it worth continuing the prednisone anyway or did worse problems develop?
- how much scratching and rubbing do you tolerate before you figure that the medication is not enough?
- would there be any benefit in doing the MRI now? I still can't afford it, but if i knew it would make a difference in his outcome, I would find a way to make it work.
- would it be worth flushing the ears (a lot cheaper than the MRI) just to see if PSOM is part of the problem? The ear specialist seemed very experienced in this surgery. If it is PSOM, it would probably needed repeating though. But I would be happy to do that, knowing that it is making him better.
In short, any similar experiences and advice would be welcome!
Last edited by laram; 11th June 2014 at 12:14 AM.
& Samwise (7 year old ruby male)