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View Full Version : Just back from London/SM forum update



Karlin
12th November 2006, 02:17 AM
And the major SM forum which brought together many of the global researchers on SM in cavaliers. Heard about 10 papers and sat in on the neuro/researcher roundtable closed-door session where they adopted Clare Rusbridge's MRI letter grading scale for cavaliers as well as her system for scoring pain displayed from SM.

Much of enormous interest, much that was distressing (more confirmation of the high incidence across the breed), a general concensus that this is a very, very serious problem for the breed, and some promise too -- Dutch breeders working to MRI for clear dogs and breeding for clear dogs have already considerably increased the number of clears coming up in scans. Mathematical predictions are that once you start following a careful breeding programme with clear or mostly clear dogs you can significantly reduce incidence and severity within 5 generations. There is work underway to get some funding in the UK for a similar project perhaps.

Also the genome research has isolated down the likely location of implicated genes to 6 chromosomes; still lots of work to be done but basically there is promise that the esponsible genes will be located (though a genetic test from that info is much harder to create).

I will spend tomorrow trying to get some shape on my notes and post them here and to the SM site and the CKCS-SM-Support list. Very tired after a long day of consecutive research papers, Q&A then the researche round table.

Overall it was fantastic to listen to all these deeply intelligent people that are dedicated to understanding this condition better and finding ways of treating it.

judy
12th November 2006, 02:44 AM
i've been thinking of you all day, and eager to hear from you. The dutch study sounds hopeful. looking forward to reading your future posts on the conference. i can imagine it was awesome to be among those people listening to their thoughts and ideas.

Karlin
12th November 2006, 07:55 PM
Slowly working on these... so much info.

Main conclusions from the closed session at the end:

1) Reseachers/neurologists/neurosurgeons to use the Rusbridge letter scale for
MRI
grading. They have removed the B and A star grades for a number of reasoons that
I'll go
into in a fuller report.

2) Ditto for Rusbridge pain scoring on a scale of 0-4 for evaluation of dogs
with CM/SM
and for evaluating response to treatment.

3) Formal support from same for the Rusbridge breeding recommendations -- which means these are now the recommended approach from neurologists as a way for breeders to proceed to have the best chance of minimising the continued spread and growing severity of CM/SM.

4) all of the above to be discussed annually for fine-tuning as more is
understood of this
condition.

5) proposal to meet annually for similar discuissions of research

6) Formal decision to drop term COMS and Chiari malformation (because the former
is not
accurate and the latter is not correct as it is a human SM term). Instead
researchers etc will
use terms Chiari-like malformation (CM) and syringomyelia (SM) to refer to the
two key
aspects of this condition, either of which may be present and cause symptoms. SM
is
secondary to CM but not always present in symptomatic dogs. Dr Marino in
particular
believes the CM is the aspect to treat thru cranioplasty as resolution of the
syrinxes often
follows. Also Dr Rusrbridge noted dogs post surgery using the more traditional
surgery
(cranioiplasty involves the use of the titanium mesh) also usually improve even
though
syrinxes do not seem to resolve. hence the malformation/herniation of the
cerebellum is
likely the chief cause of pain with syrinxes adding an additional level of pain.

All of the above resolutions were strongly supported by (and indeed mostly
proposed by)
Dr Marino who works with Dr Dewey -- they are the most prominent and experienced
of
centres doing the surgery in the US, at Long Island Vet Services ( www.livs.org ). There was cross table support generally
amongst the
group of neurologists/researchers/surgeons with reservations limited to
fine-tuning the
definitions over time.

Dr Marino and a colleague gave extremely interesting presentations on the
cranioplasty
surgery they use, and potential use of thermography. The latter looks especially
promising.

A real disappointment for many people was that Mr Geoff Skerritt could not
attend due to
ill health ( he had a stroke a few months ago and remains frail) and also was
unable to
finish his paper to have it presented by someone else, but a colleague who gave
a
presentation on his own work noted that it was hoped this could be presented at
the next
meeting. It was to be a report on 310 cavaliers they have scanned at
Chestergates so very
furstrating to many not to have this input on the day.

Karlin
12th November 2006, 08:01 PM
Current breeding guidelines/grading scale prior to changes that will be added after yesterday's event:


The current breeding guidelines
A* - no CM/SM – extremely rare
A – > 2.5y CM no SM (may have dilated central canal)
(B - < 2.5y ”mild” CM no SM (difficult to define “mild” essentially young dogs which look A* but not brave enough to call)
C - < 2.5y CM no SM
D – > 2.5y CM/SM no clinical signs
E - < 2.5 y CM/SM no clinical signs
F – CM/SM with clinical signs

Cut off 2.5y because same as MVD program


Current info from DNA research:


6 statistically significant regions on 6 associated chromosomes

Possible candidate genes are in the Pax and Hox families, for anyone who knows genetics.

Claire
13th November 2006, 01:02 PM
Thanks for this Karlin, I have printed it out and will let my Vet have a copy.