Hello and thanks for trusting me to help you and your pet today. I am a veterinarian with over 25 years experience and would be happy work with you.
Can I ask you how long Bandit was taking the Gabapentin?
It can vary a little based on the drug and the pet, but in general, most adverse effects will subside or at least decrease within 12-24 hours and be absent by 48 hours.
How long has Bandit been experiencing ataxia?
Let me see.....
Basically he was kind of slow and not really getting the bed, etc...so we took him in, had X-rays blood work, etc.
his liver was a 1663 so they put him on tramadol...this was a disaster because he vocalized really loudly and of course we thought he was getting worse and in a lot of pain, but it ended up being Dysphoria from he Tramadol
we took him off, took him to an veterinarian acupuncturist...and she prescribed a bunch of herbal things...he had major diarrhea that looked kind of black so we took him back to the holistic style vet and they took him off, prescribed gabapentin 100 mg 2 x day and an antibiotic for diarrhea
Yes, I have been reading some of your past questions.
Did the Gabapentin make him ataxic or was he slightly ataxic before and he seemed to get worse when the gabapentin was added?
we are trying to remember
I think it happened after the gabapentin
I am trying to get an idea of if the ataxia could be due to the addition of the gabapentin or if it may be a progression of whatever is going on with his spine.
the original low dose, because then we took him to a neurologist
the neurologist wanted to do an MRI and a spinal tap
we didn't do it because I wanted to see if the medication therapy worked first. we figired since we didn't really give anythign a chance, it was best to be on Rimadyl for a week and whatever else he prescribed us
If there was suspicion that it may have been worse after the gabapentin was introduced, I would stop it for 24-48 hours and if his signs are no better, likely it is not from the drug and more likely his disease.
(Gabapentin 200 mg 3x day)
denamarin 1 tab a day
rimadyl 50 mg 2 x day
clavamox 375 mg a day
Metronizadole 250 mg 2 x day
Gabapentin is often used in conjunction with other meds (NSAIDS) and can be very effective but doesn't work for everyone. In my hands, it is very weak when used alone, and when it does help, seems to take a week or two to see it's effects.
Actigall 300 mg 1 x day
well the weird thing is...Bandit was totally fine (except stiff) before we took him in to anyone at all
and a few days ago he was acting like himself again...
now he's falling
My husband seems to think he was fallingbefore Gabapentin (of course I was out of town for those 5 days)
the only other thing I can think is he has had some sort of reaction to the yearly shots they gave him
If you were not seeing a response after adding the gabapentin and if his signs seem worse, I would be very worried that this is his disease progressing. I think the MRI and spinal tap are needed to get a definitive diagnosis as to what is causing his pain and loss of function.
I do not think the vaccines are related.
the only different one I think we got is the 3 year rabies instead of the 1 year
he doesn't seem in pain
The 3yr versus the 1 year would not make a difference. It is not a different vaccine or a different dose.
I wonder why a few days ago he was like a whole new dog and now he falls
he even jumped on the bed
It is good that he does not seem to be in pain. Pain can be part of neurologic disease, but it doesn't have to be. SOmetimes it is just loss of function.
we skipped acupuncture last week
the only other thing we've done differently is we started him on Adequan
It can be rather acute in it's presentation,even if it is something that has been building up slowly. Cancer in the spine or nerves has to be on the list as well. Hopefully not, but has to be considered. :(
In my opinion, it is time to stop trying to trying to figure out what is wrong based on his response to meds because even when we know what is wrong, they can have variable response on any given day.
If you have access to MRI and it is within your budget, it is the best way to go.
but is it straneg he was hurting last week, them a few days ago felt great now he falls?
You will most likely get an answer there.
we have vet insurance
Are you working with a neurologist?
thank goodness...up to $7k per incedent
yes but I don't trust him
Oh, that is great that you have insurance. Then I would definitely go with the MRI.
because he gave me some big 10 minute speech about how I shouldn't give him Milk Thistle and that it was a last resort after all the other drugs they prescribed for his liver...then I get hom and read that Denamarin has milk thistle in it. I feel he was just trying to get $120 out of me
we are probably $4k in right now...I'm nervous about the MRI because they have to put him under.
and it seems he doesn't tolerate drugs well
I am sorry to hear that you don't trust your neurologist, but the MRI doesn't lie. Even if you don't believe his diagnosis, you can then have a second opinion with another specialist who can look at the facts form the test.
Are you near a veterinary University?
how much do they generally cost?
yes I am
they gave us the option of takign him to a REAL hospital or the Vet Hospital
I guess I am confused by your last few questions/statements? How much does what cost? What do you mean by a real hospital versus a vet hospital? Do you mean having the MRI done in a human facility? Is your current veterinary neurologist board certified?
What veterinary university are you near?
good question, I'll check
This is what it says on his profile: During this time he achieved board certification by the American College of Veterinary Surgeons. Following four successful years in private practice he returned to LSU to join the companion animal surgery faculty as assistant professor.
Use of a titanium mesh for cranioplasty following radical rostrotentorial craniectomy to remove an ossifying fibroma in a dog.
Application of evidence-based medicine to recurrence of Hansen’s Type I intervertebral disc disease in dogs: A justification for continuation of study into percutaneous laser disc ablation. Journal of Photonics and Lasers in Medicine. In publication, 2012
the last 2 looked to be publications
Give me a second to look something up.....
by the way, they seem to think he may have a slipped disc in his neck
my husband just said Bandit 's neck looks low again
he's alert, tail wagging, just ate a bowl of food
There are various specialties under which a vet can become board certified. It is a statement in and of itself that he went through the extra training to accomplish that in any specialty. Many "board certified" neurologists will earn their certification through a branch of Internal medicine. It sounds as if his is through veterinary surgery, but that is not a bad thing necessarily.
It sounds as if he is working closely with the University and I would think that because of that, he would have access to many resources, if needed, to consult with in regards XXXXX XXXXX case.
That being said, if you do not trust him, you should seek a second opinion. I would still recommend the MRI, but before or after, if you pull another specialist in to give their opinion, I can't see where it would hurt. Most vets that are confident in their recommendations would welcome a second opinion.
I just don't like that he lied to me about the Milk Thistle
Did he prescribe the Denmarin?
Anyways, I will definitely see if taking him off Gabapentin helps. They said to do it immediately...although the internet says gradually or he could have seizures (any thoughts there?)
If you think it possibly made the ataxia worse, I would not wean off. I think the seizure thing is more in the case of dogs who are already having seizures before the gabapentin.
ok...thanks for all of your help
I saw 2 docs at the same clinic...I think he said it was the other doc
it is a specialty clinic
Well, it would be nice if all of the docs were on the same page, but I have to say that I prefer the combination of denmarin over milk thistle alone, but I would never tell anyone not to give it and I do think that it has some positive effect for some.
yeah, I think they like it because it's regulated
Thanks for all of your help...
Yes, there is something to be said for nutriceuticals (supplements) that we can trust have what we think they have.
You are welcome.
Please keep me updated as far as how things progress.