Purpose and Brief Explanation of Study:
Syringomyelia (SM) is a painful neurological problem which causes neuropathic pain (NP) behaviors such as scratching, face rubbing, and intermittent vocalizations in affected dogs. Pain management of SM-NP is currently limited by the lack of objective ways to assess severity of pain in dogs with the condition. The long-term goal of our group is to improve the diagnosis and management of neuropathic pain in dogs.
Objective of the trial:
We will explore the utility of a technique for mechanical quantitative sensory testing developed by our laboratory to provide an objective measure of neuropathic pain in dogs with SM and to monitor response to therapy. We will also evaluate the efficacy of a novel medication used for treatment of neuropathic pain in humans, amitriptyline, and will compare its efficacy to that of the standard therapy gabapentin.
What qualifies my dog for enrollment in this in this trial?
To participate in this clinical trial your dog must have:
- Clinical signs consistent with SM
- General good health that permits anesthesia
- No exposure to any medications 7 days prior to enrollment
- An owner that can administer medication 2-3 times daily
- Be able to attend follow-up appointments 4 weeks following MRI
What does enrolling my dog in this clinical trial involve?
Dogs will undergo sensory testing and an MRI under general anesthesia on initial exam, and a second sensory test at the four week follow up. Dogs with SM-NP will be assigned to one of two treatment groups: gabapentin (standard of care treatment) or amitriptyline, a tricyclic antidepressant (TCA) with well documented efficacy to treat neuropathic pain in humans. Amitriptyline is an attractive candidate for management of SM-NP in dogs because it has known pharmacokinetic and safety data in dogs, and is inexpensive. Dogs will be re-evaluated after 4 weeks and ST will be measured again to assess treatment effects.
We will also obtain a stool sample from your dog during their initial and follow up visits to save for future research.
You will be responsible for the initial examination fee associated with deciding whether your dog is eligible for the study as well as any pre-anesthetic bloodwork required based on the age and health status of your dog. If your dog is determined to be eligible and generally healthy, the study will pay for the sensory testing procedure as well as an MRI and associated general anesthesia costs to determine your dog’s SM status. The study will also cover costs associated with 30 days of medication to treat syringomyelia (either gabapentin or amitriptyline depending on the group to which your dog is randomized).