August 14, 2011 - I started both on gabapentin 25mg strength last night. Oliver's dose is .75ml and Shadoe's is .5ml. Dr. Mitelman said we can start low and see how it goes, and we can make adjustments as needed.
A bit of history needs to be recorded to understand how we arrived where we are now. I'll start with Oliver as he has less history, cover to the present, then cover Shadoe's history.
In October 2010, Oliver was sick, so the vet put him on Tylosin 100mg from Oct30/10 to Nov08/10. I had some Tramadol for him for pain so vet said to give him 25mg on the first 2 days, and he seemed to act relieved.
He became quite dehydrated, so I started 100ml fluids with small amounts of buprenex, and he perked right up. That bout was his first since being adopted Mar17/10.
In February 2011, he seemed a bit sluggish, and 1/4tab pepcid along with .1ml bupe am and pm on Feb04/11 seemed to fix whatever was bothering him until Feb17/11, so we tried the pepcid am and pm for a few days and bupe a couple times if the pepcid did not do the job. At this time, he had very good BG and there were several skipped shots here and there through the month. Because pepcid seemed to help in most cases, whenever he seemed a bit off, 1/4tab pepcid was given.
On April 04/11, I decided to try giving Oliver 1/4tab Tramadol to see if it would perk him up. He has never been very active, did not play, and moved slowly. Sleeping and eating were his main activities, yet if you looked at him, you would see his hooded eyes, as if he was drowsy.
Within 2 doses, he was a different cat. On April 20/11, I gave him the first 1/4tab at 2pm, and started am and pm dosing with his shots. Here are my notes from his spreadsheet:
Tram is definitely helping him. After just 2 doses, he is brighter eyed, moving around more, and more relaxed and purring. Will watch for lower BG and adjust dose if needed.
Needless to say, I continued to give him Tram, same dose until my supply from Lorna was depleted. I had already decided to request more from Dr. Mitelman for Oliver, but first I wanted to try him on a maintenance dose of Buprenex, just to be sure the Tram was what he liked. In the past, when I ever gave him any bupe, he would comically zonk right out to the point of just laying around with his tongue out, and I bet if he would talk, he'd slur his words - bupe for pain in Oliver was just too much for him. Ironically, if Shadoe gets the same dose or even more, she is perfectly fine and bounces around like a kitten.
Anyway, I had 3 strengths on hand: .3, .4, and .6. I tried the different strengths and even doses as small as .03 of the .3 strength, but still, Oliver found the bupe to be too much for him. I had also started giving Shadoe a low dose to see if maybe she had some pain or discomforts, and it could be possible that she may perk up like Oliver did on the Tram. I was shocked to find that Shadoe was much more out in the open, purring, and even bouncy and eating more when the bupe was given BID to her. Trial ended - no good for Oliver, but good for Shadoe, indicating that she could use something.
I had to stop by the vet office to pick up copies of the testing for PLI of both and also Shadoe's b/w, so I decided to see if I could give Dr. Mitelman some info on on various pain meds and maybe get fitted in to ask for an rx for more Tramadol or maybe, ask what he thought about trying Gabapentin for Oliver. Other acros were doing quite well on it, so I thought let's give it a try if he thought it might be good for Oliver. I told him how Shadoe improved as well with the bupe, but I was hesitant to give any opioid long term.
We decided to go with the gabapentin at 25mg strength, giving a .75ml dose to Oliver and also try it on Shadoe with a dose of .5ml.
I should mention here that on our last visit with both Oliver and Shadoe, we got B12 to give Shadoe shots and I again decided that if it's good for her for her pancreas, then it should be good for Oliver as well!
The results so far is that Oliver is good, better, on 12.5mg Tramadol, loopy on any strength/dose of Buprenex, and the jury is still out, but leaning towards the B12 and gabapentin are doing some good because he is more alert since stopping the bupe. Hopefully, in time and a few more doses of each, he'll continue to improve.
Here is Shadoe's history of medications - it's a bit longer as she was diagnosed with diabetes October 04, 2009.
On August 26, 2010, Shadoe was not well, so vet sent us home with bupe and Flagyl (Metronidazole). She was still not good on .1ml bupe and 50mg Flagyl by August29, 2010, and tests showed pancreatitis, so we started 100ml fluids for4 days. Treatment with bupe, Flagyl, and also 1/4tab pepcid continued each morning until September 09, 2010, with 100ml fluids given if her BG was high enough - Shadoe's BG drops low from fluids, so they were given if her BG was higher or on the rise.
In January 2011, Shadoe was given pepcid and the odd time some fluids if it seemed she was not feeling well
- Shadoe has a tendency to be 'gassy' and the pepcid seems to settle her well enough to eat better. In mid-February, I tried giving Shadoe pepcid at each shot time, and her numbers did get better. When I stopped giving pepcid, she seemed worse and had higher numbers, so I started giving her pepcid on a regular basis with each shot. Sure enugh, her numbers seemed to improve.
Shadoe was good with the odd need for pepcid, bupe or fluids until June 2011 when she seemed to have a good CP flare, I suspect,. but since I had kept a stock handy of pepcid, bupe, and fluids, I just started the 3 up from June 22 to July 01, 2011. Her pains seemed passed but I continued with the pepcid for awhile.
Again, on July 11/11, she had more problems, the same growling when her belly was touched and also needed to be put into the litter box as maybe it bothered her stomach to climb into the boxes. At certain times, I could tell she was ready to use the box, so I just picked her up and put her in the box and she was OK. If I was not around, she would be in front of the box. Bowel movements were fine, always in the box but urine was right in front of the box.
Again on July 01/11, Shadoe started her lip licking, so she got pepcid BID for a week and was better again.
In August, I got the B12 for her, and decided to also start her on a low dose of bupe BID to see if it helped her feel better, like the tram had helped Oliver months ago. I don't know what it was but I have to say that I think the bupe really did help her feel better as she changed dramatically.
Shadoe was always shunning light. She slept in dark places, under the sofa or bed, in dark corners, or she would just face the wall or corner, or cover her eyes with her paw. After starting the bupe BID, she now sits out in the open, does not face the walls or corners, and is much more relaxed and purring all the time.
Now we are current, up-to-date here.
I am giving both their B12 injections each Thursday night for a month then bi-weekly, and finally, monthly, .25ml for Shadoe and .5ml for Olier, and the gabapentin daily, .5ml for Shadoe and .75ml for Oliver.
As of today, August 14, 2011, they are both much happier campers, so something is working well!
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