I'm Dr. Jo and I'm here to help you with your question about Georgie. I'm so sorry he isn't doing well, but glad you're looking for the information you need.
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This sounds like an awful ordeal for both you and Georgie! I want to emphasize, however, that there are a lot of types of problems that can cause this sort of pain but show no abnormalities on x-rays or blood work. Muscle
spasms, and vertebral disc disease would be at the top of my list. Neck problems are very common with Pekes.
Unfortunately, the medications your vet has prescribed are targeted at general symptomatic relief and are not a real solution to the problem. Because your vet was unable to come up with a diagnosis, he had to make his best guess at what kind of treatment might help. Clearly prednisone and gabapentin aren't doing the trick.
That means you need to see a vet who will be able to make a diagnosis. An emergency vet, internal medicine specialist, orthopedist, or neurologist would all be excellent choices for which kind of vet to see.
Anything short of a seeing a vet capable of a more aggressive workup would result only in more guesswork, unfortunately.
I've worked a lot in emergency medicine and dogs who are painful like this are not uncommon. Sometimes we can find the problem, other times we can't. Regardless, rest assured a much more aggressive approach to pain management can be pursued. Sometimes we add more oral medications like tramadol, other times we need to use continuous IV injections of morphine combinations.
The bot***** *****ne is that if Georgie were mine, I'd be on the phone to my closest emergency center.