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Spencer'sMom
20th February 2007, 02:43 AM
Spencer was diagnosed with COMS or CM (Chiari-like malformation) today. :cry: He had his MRI on Feb. 5 and we met with the neurologist, Dr. McDonnell, this morning. After viewing the images and doing the neuro exam he said that Spencer shows early COMS but doesn’t have any evidence of syringomyelia at this time (I guess that’s good news). He said there is herniation of the cerebellum, a kink at the cerebellomedullary junction and mild hydrocephalous. Dr. McDonnell didn’t see any syrnixes on his spinal cord. He said the clinical signs are classic for COMS as well. I also brought two videos of Spencer’s scratching that I recently took. We talked about how sometimes the MRI and clinical signs do not correlate, which is what I think is going on given the intensity and frequency of his scratching.

We’re starting gabapentin tonight and I’m to call him in one month to let him know how he’s doing. He also wants us to come in for rechecks every three months unless we see any worsening of hic clinical signs- even more scratching, weakness in his back legs and/or a head tilt.

Like many others have said I’m relieved to know what’s going on but at the same time I’m heartbroken. :cry: He’s my little man and I just hate what’s going in his perfect little body. I really hope the gabapentin works. I do have a question on the dosage we were prescribed. Spencer’s to take 200mg twice a day. I searched the message board and it looks most pups who are on this take 100mg twice a day and on occasion three times a day. Does 200mg twice a day sound like too much?

Here is the scratching video (turn the sound down- it's really fuzzy) and two of the MRI images in case anyone is interested. I have 100+ more images- if you'd like to see any of them just let me know.

http://i14.photobucket.com/albums/a350/wawalton/th_MVI_0353.jpg (http://s14.photobucket.com/albums/a350/wawalton/?action=view&current=MVI_0353.flv)

http://i14.photobucket.com/albums/a350/wawalton/BrainMRI1.jpg

http://i14.photobucket.com/albums/a350/wawalton/BrainMRI2.jpg

Cathy T
20th February 2007, 03:57 AM
Whitney - I am so sorry to hear this. But it sounds like you are really on top of it. Hopefully the medication will soothe him and ease his discomfort. What I seem to notice on the videos is that when they are doing the scratching they almost look like they are zoned out. Is that true? I definitely see the difference between sm scratching and regular scratching. Thank you so much for sharing that with us. It's a good tool for all of us.

Hoping everything settles down for you and Spencer. Hugs and love from us!

Caraline
20th February 2007, 04:20 AM
Oh how sad you must be feeling. I am so sorry to hear this. I hope things settle down with treatment.

Shay
20th February 2007, 04:32 AM
Whitney...I am so sorry to hear this. I know you must feel better knowing what's wrong with Spencer, and now being able to treat it. Thanks so much for sharing the video. :hug:

Zippy
20th February 2007, 06:14 AM
Whitney, I am so sorry to hear that Spencer has CM. :flwr: :flwr:

merlinsmum
20th February 2007, 02:03 PM
So sorry to hear this :( Hope the medication helps!

BarbMazz
20th February 2007, 02:34 PM
I'm so sorry to hear Spencer has COMS. :( It sounds as though mom is right on top of things, though, and that can only be a good thing.

I'll be watching to hear how he is doing... good luck and hugs to all of you. :flwr: :hug: :xfngr:

Lindsay
20th February 2007, 04:30 PM
I am so sorry to hear this Whitney. :( Hopefully now that you know what is going on he can get to feeling much better. :flwr:

TN Spencer sends VA Spencer a big lick and a hug :hug:

Nicki
20th February 2007, 09:41 PM
So very sorry to hear this news Whitney :flwr: :flwr: :flwr:

Sending healing thoughts for you and Spencer.

Have you tried him without his collar? TedBear can't tolerate a collar at all, it makes him scratch too much. He has a harness but only when we're out...it was trial and error to find one that suited him.


It might be worth mentioning this to your neuro - it's really helped my affected dogs.

a mixture of Tagamet and water, given daily, has helped a moderately to severely affected SM dog become a typical happy, cuddly Cavalier. In contrast, she had been screaming, preferred to be huddled in the back of a crate, went out of her mind if her ears were brushed and did not want to be touched.

200mg tablet Tagamet dissolved with 1 1/2 oz (3 Tablespoons) water, keep in dark bottle in the refrigerator and give 0.9cc {0.9ML} per day.
{I make this up about every 5 days…I'm actually give 1ml daily to Rupert and TedBear as they are bigger dogs - 23 and 21lb. I find it works best in the morning, about 1 hour after food.}


Dr. Mayo said that a research project was done on Tagamet. To their surprise it caused a reduction of spinal fluid.

Jen
20th February 2007, 10:58 PM
Hi Whitney,
I'm so sorry you got the results you did, but I'm really glad you're on top of things. Abbey has COSM as well w/ no sign of syrinxes as of yet. We've had very good luck on Gabopentin, I hope Spencer does as well. Our neuro was saying the same thing, that sometimes the MRI and clinical signs do not correlate; it's frustrating.
I would advise contacting your breeder with your results, it's important for them to know especially considering so many breeders are in denial about COSM and SM.
Keep me posted on how he does on Gabopentin. I wish him well! :flwr:

Karlin
20th February 2007, 11:20 PM
Hi Whitney:

So sorry for your diagnosis. The good news IS no syrinx. Spencer's spinal cord looks totally clear. The spur (malformation) though does press in on the back of the brain quite a bit. It could be that this is enough to cuse some of the scratcing; or it could be that the way in which the brain herniates out at the bottom obstructs CSF flow; most likely a combination. Researchers think some dogs are more affected than others simply by the dynamics of the CSF flow.

I think 200 mg twice daily is high, myself. How big is Spencer? Leo had similar scratching and 100mg twice daily is more than enough. I had him on half that for a while; he only weighs 14.5 lbs though. Ypou could try him on half that dose and see if it has any affect. Or try the 200mg 2X for two weeks and see if it helps. Different dogs are helped by different amounts. You might see if frusemide would help too as that theoretically effectively lowers the pressure of the CSF squirting through that herniated area.

I am sure you have probably viewed Clare's treatment diagram.

If Spencer is really groggy on that level of gabapentin I'd try cutting it but do talk to your neuro about doing any of that. Most seem to feel finding the right dose is a case of fine-tuning the level to the lowest dose that brings relief.

Cathy: yeah Leo always looked kind of zoned out when he did his SM scratch.