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How long does gabapentin take to address SM symptoms?

First of all, I apologize for so many recent posts. We've been lucky to be free of health problems with Nicky for the last 7 years but this last year has been a little rough.

As I said in my other thread, Nicky started really itching a few weeks ago. He does this every summer around this time but we're living in a new apartment this year, that is in a much more rural area, and the itching has been particularly bad. We finally took him to the vet a little over a week ago and she prescribed an anti-histamine three times per day. That worked until a few ays ago, when he started itching after 3-4 hours instead of his usual 7. But then that was also the day that I found a flea on him. So there's the possibility that the anti-histamine isn't strong enough to stop him from itching from the immediate bite.

I'm really struggling with what to do at this point. I've done quite a bit of research on SM and he has exhibited some of the symptoms but none of them are the tell-tale primary symptoms and all of them could be chalked up to something else. Once in a while he will itch his ears and bite his feet and sort of growl but it's always been when there's knots so I assumed it irritation so I would brush his ears and he'd be over it. I've been monitoring his itching and it does seem to be more on the right side but that's also only been in the last 24 hours and he has red spots on both sides so it's really not possible to say that it's always the right side. He does roll around on the floor on his back and sort of wiggle but it's always been more of a playful thing to me. After he eats each time he'll rub his face along the furniture. Since his itching episode he's been rubbing his side along the furniture but obviously he could just be itchy. The one that's a little more concerning is that he kicks his back legs when he's laying, maybe once or twice, but just knowing him at this point, I take it as him being tired of itching and trying not to itch. Maybe that's wishful thinking.

This morning I gave him his anti-histamine at 7am. He was fine for the most part, apart from the occassional scratch but then started itching at around 11. I've been worried enough about SM that I decided to go ahead and give him one of the gabapentin that I already have on hand (100 mg). I figured it may be good that he wasn't getting them both at the exact same time. He did stop itching more but he also was very drowsy so it's really hard to know if he stopped itching because it's neurological pain or if he just is so sleepy that he's sleeping through the itching. Then he started itching at about 3:30 PM so after about 4 hours of the gabapentin. So at this point I really don't know if I should stop the anti-histamine and do a true gabapentin trial or if I should just limp through the remainder of flea season and watch for symptoms of SM after that. I don't think it's a good idea to keep doing both the gabapentin and the anti-histamine since the combo is making him so drowsy, especially since it's preventing me from really telling anything.

For those of you who have much more experience with SM and gabapentin, after how many doses should I expect to see improvement in his symptoms, if it is SM as opposed to allergies? I really would appreciate any insight or advice. I've been very stressed about his MVD diagnosis in May so the addition of possible SM has really thrown me.
 
Nicky has seen improvement with his symptoms since starting the Gabapentin. I have very mixed feelings because I'm happy to see him have some relief but at the same time I'm devastated since I know this probably means he has SM. I feel awful that he has likely been suffering pain for quite some time without me helping him. I guess the next step is to make the trip to see the neurologist.
 
Update: I called and made an appointment with his regular vet to start the process. I figure then I can get a referral to either OSU or Cornell. OSU is much closer for us but I've read that Cornell offers reduced cost MRI's so I may go there if necessary.

But I am still very confused. From my research, it seemed that 100mg 3 times per day would be the best dose. He's big for a Cavalier, weighing 27 pounds. The meds were making him drowsy so it was a little hard to know if he wasn't itching just because he was sleepy. He got a dose at 11PM last night then today I gave him one at 7AM. He started to itch a little at 2:45 so I decided to go ahead and do 3 times a day and gave him a dose then. But now he seems to be back at scratching. I know I likely just have to wait until he goes to the vet but I'm not optimistic that she's going to know what to do with SM. I also don't know if I should give him an 11:00 dose of gabapentin or if the fact that they're making him drowsy should indicate me stopping them. I also don't want the gabapentin to interfere with the vet exam tomorrow.
 
also don't know if I should give him an 11:00 dose of gabapentin or if the fact that they're making him drowsy should indicate me stopping them. I also don't want the gabapentin to interfere with the vet exam tomorrow.

From what our dermatologist told us, gabapentin is a fairly safe drug. Lucky was on it for Chiari Malformation and PSOM and the dermatologist also gave it to my sister's dog for allergies so I wouldn't stop. Gabapentin can make them drowsy. Lucky used to get very unsettled, frantically wanting up and outside in the middle of the night (I now think this was related to his PSOM or CM) and our regular vet suggested I go with the Gabapentin 3x a day and the last one right before bed to help his be drowsy and settle down. I had only been giving it twice.

It seems to me that the tough thing for you is figuring out if a dermatologist or neurologist is the right specialist to go to first. But be aware that dermatologists are very well informed about PSOM (they are the vet you'd usually see for PSOM), SM, Chiari, and allergies so that might not be a bad place to start.
 
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Do you have any idea why your sisters dog was prescribed gabapentin for allergies? The fact they have provided him relief has made me think I'm dealing with more than just allergies but if it is prescribed for that then it would be a comfort that maybe I'm not actually dealing with SM.
 
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