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Thread: SM and prednisone update

  1. #11
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    Laura I'm sorry to hear of the problems with steroids and your various concerns. You've done a good job in caring for Sammy.

    I wonder if you've tried trialing him on Lyrica instead of gabapentin? Many dogs do much better on it at a far lower dose and it is only needed twice daily. Leo was on 600mg gabapentin a day and is now on 50mg Lyrica 2x. He's a lot better on it -- his ears have grown out again for example.

    I wouldn't do PSOM surgery unless a dog was shown to have it on a scan and it seemed as if the surgery was the best option. Often it has to be repeated several times, something to keep in mind.

    On some other questions: I wouldn't bother with an MRI, and I think the eye issue is a separate one. Never heard of an eye problem related to SM or PSOM but the rubbing could have inflamed/infected it.

    I would tolerate very mild scratching or head rubbing. Anything more than that indicates meds need adjustment. There are a range that can be tried other than tramadol, too.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

  2. #12
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    Thanks for your reply! I know I stuff my posts full of info and questions, so they must be pretty confusing to read.

    I have tried Lyrica a few times, since I know it should be more potent. But for some reason, it just doesn't seem to have as obvious an effect as Gabapentin on Sammy, even at 50mg x 2 per day. I've wondered sometimes whether I should have tested it for longer (the most I've given it is a couple of weeks). I would prefer to use Lyrica, since Gabapentin is actually more expensive at the doses I'm using.

    Sammy started Vetmedin yesterday. Surprisingly today his breathing seems worse. He's panting a lot and restless. Is there any way this could be part of an adjustment period to the new medication? I'm starting to really worry now... He's on 20mg Furosemide, Fortekor 2.5mg x2, and now Vetmedin 2.5mg x 2. We were out for a walk a couple of hours ago, so he might still be recovering from that.
    Laura

    & Samwise (7 year old ruby male)

  3. #13
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    Sorry you're having so many problems with Sammy. My Oliver too has both SM and spondylosis and it's difficult to know which is causing what. He has never scratched very much but he has always squinted, and as headaches caused by dilated ventricles (and therefore by his CM rather than his syrinx) have been his major symptom, I have always felt that squinting was all part of the same problem (have you noticed that other breeds simply don't squint in strong light?). So I would think that there is some connection there between Sammy's squinting and his CM/SM. Cavaliers are amazing survivors - at death's door one minute and then asking for breakfast and tail wagging. Oliver has had some symptoms most of his adult life but has just turned 13, so battle on with Sammy - getting to 10 will still make him quite a youngster!



    Kate, Oliver and Aled

    PS His worsened breathing may be an indication that he's not actually ready yet for Vetmedin, which is causing his heart to overwork, but others will know far more about it.

  4. #14
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    Thanks Kate for your reply!

    Sammy is still worrying me. His breathing improved yesterday evening, but today he is again panting quite often. He is also often just sitting/standing and staring at me. I have no clue what he wants or what I can do for him, since he has already been walked, fed, and given his medication. I think the Vetmedin might really have made him worse at this point.

    I've also noticed now that his squinting eye really is on the right side where the thicker inner 'wall' was found in the ear. Moreover, I've now noticed that he keeps subtly lifting his right ear while he's squinting.

    I'm now almost convinced that his problems include PSOM at least on that one side. But I can't do that in-depth ear check (let alone ear flushing) anyway without having his heart stabilized, since it requires anesthetic.
    Last edited by laram; 17th July 2014 at 12:56 PM.
    Laura

    & Samwise (7 year old ruby male)

  5. #15
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    Sammy's thyroid results came back and they were pretty normal. So the fur loss is almost certainly due to prednisone. I'm going to continue trying to find a combination of medication where his fur will grow back but he isn't suffering.

    On the vet's advice, I'm keeping him on Vetmedin for a while longer and monitoring whether he is improving or continuing to pant more than usual. It's been warm weather here, so it could also cause the excessive panting. At least he isn't coughing at all or fainting, and he's still happy to go for evening walks up to 30min (on a cool evening, he's previously been trotting along happily for an hour). X-rays showed fluid in the lungs though and the heart isn't contracting fully, so I guess the Vetmedin is necessary.

    No real clue still on the anemia - so we're just monitoring it too.
    Laura

    & Samwise (7 year old ruby male)

  6. #16
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    Update: Sammy's head pain symptoms are doing pretty ok on 2.5mg prednisone every other day plus lyrica and tramadol. The lyrica has nowhere near the same immediate effect as gabapentin on his scratching and squinting, but after a week of 100mg per day, I'm beginning to think it is indeed part of what is keeping him stable. But unfortunately I know he couldn't survive without the prednisone. Even now, I'm having to remove mats from his ears and armpits, and it's a waiting game until he gets his prednisone dose.

    I'm starting him on Dermoscent spot-on treatment for his fur loss. Unfortunately I couldn't find Salmon oil after scouring the local stores, but this came highly recommended. So I'm giving it a go. It a treatment for skin problems that is applied in much the same way as Frontline. I'll keep posting on whether I actually see an improvement.

    The biggest and most worrying problem now is most definitely his heart. It has been hot weather here for a couple of weeks now (25-30oC). I think the Vetmedin has helped since I haven't heard him cough once in the last week, but his panting is really scaring me. My apartment heats up in the afternoon, so he pants most during the day time and gets a bit better at night. I've been looking into ways to cool him down. Any suggestions?

    I've been surprised though that he is still begging to go for walks; and still running around enthusiastically outside regardless. I've been trying to take lots of breaks to sit down in the shade, but he doesn't seem to want to rest. It's when we get home that the rapid breathing starts. Does that sound at all familiar to anyone? Should I be more strict about the exercise?
    Laura

    & Samwise (7 year old ruby male)

  7. #17
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    Dear Laura

    A few ideas for keeping Sammy cool in this horrible hot weather: keep curtains closed as soon as the sun moves round into the room, it really helps keep it cool. A fan will also help. Some people put a cool coat on their dogs when the nights are hot - might help Sammy during the day as well; if you can't get one locally, try the internet. And exercise early in the morning or late in the evening - in the UK the weather really hots up in the afternoon and stays warm until well into the night, so Oliver gets walked for 30 minutes at about 6am. Aled is in congestive heart failure and isn't being exercised at all at the moment. You may want to keep Sammy on lead - give him an interesting 'sniffing walk' rather than running around off-lead. The dogs don't know they're ill, and can't make the connection 'I ran around and now I'm panting', so we have to think for them.

    Kate, Oliver and Aled

  8. #18
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    Just to update, Sammy's fur is now growing back with gusto. Especially his tail, which was half bald with dry, black skin, is now covered with thick red fur that is growing pretty fast. Either this is due to the reduction in prednisone finally having an effect, or this is due to the dermoscent (which I've been using on him for 3 weeks now). Either way, I'm really pleased! For anyone who has had similar problems with fur-loss, dermoscent could be worth trying. I'll update again if it makes any difference at all to the condition and color of the fur on his sides. It's been blond since starting the prednisone 6 years ago, so if the color deepens, I'll know it's the dermoscent.

    He's still squinting and getting eye-problems from time to time, which is directly correlated to his prednisone dose. Sometimes one eye even gets blood-shot before his prednisone is due. He's also still scratching his ears and chewing his back paws quite a bit when his dose is due. Lyrica and tramadol are helping with that a bit at least. He's been on 2.5mg prednisone every other day. I may still try to increase that a little to see if I can really get him comfortable, while still avoiding cushings.

    Heart-wise he's doing pretty well too. The weather has cooled and he's not panting constantly anymore. I do think the Vetmedin has helped. Though he sleeps a lot at home, he isn't slowing during walks at all now. I think he might still have a bit of edema in his abdomen though. It seems a little full.

    But mostly things are looking up at the moment!
    Last edited by laram; 16th August 2014 at 06:47 PM.
    Laura

    & Samwise (7 year old ruby male)

  9. #19
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    Laura - I had never heard of dermoscent so I googled it. Are you using the using the dermoscent 6 spot-on that comes in the capsules that you put between the shoulder blades? If Riley's fur could grow back on her tail that would be a miracle!!
    Bev
    Oliver (blenheim, born 3/2001), Riley (black & tan, born 8/2002,), Madison (ruby, born 9/2003), and Oz (tri-color, born 7/2007)

  10. #20
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    Hi Bev, yes, exactly that. It was recommended by a vet nurse and I thought it would be worth a try. It may be a coincidence and the regrowth may be due to lowering his prednisone 2 months ago. But even one month ago his tail was still losing fur and the skin was grey/black. This new fur started growing two weeks after starting dermoscent and today I was amazed at how his tail is already fully covered. So maybe it is actually working! I'm going to keep using it for at least another couple of months to see if there is a change in his side fur color.
    Laura

    & Samwise (7 year old ruby male)

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