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Kelly
23rd March 2007, 09:31 AM
Well Chester has his MRI yesterday and thankfully is clear of SM. The Vet said there was a very slight malformation but that was very normal in the breed and that it wouldnt be causing his symptoms.

I was so relieved I could have kissed the Vet.

They have also taken blood tests and some fluid off his spine to see if he has any inflammation. We should know the results on Monday. They have put him on a weeks worth of Gabatin (??) in case he has some kind of pins & needles sensation. They said it may work but if not it is likely to be a behavioural trait.

When we picked him up yesterday he looked all sad & the Vet said he was a little sleepy still and would probably sleep all the way home & most of the evening. He didnt sleep a wink in the car & then as soon as we got home all he wanted to do was play.... perhaps it will catch up with him today!

I know he obviously still has something not quite right but I am so pleased he hasnt got SM I could cry!

Kelly

Caraline
23rd March 2007, 09:52 AM
Ah Kelly, you must be delighted with that news. That is certainly something worth celebrating. :pi*no:

coconut
23rd March 2007, 10:15 AM
i am so happy it's not SM!

Karlin
23rd March 2007, 11:10 AM
That's great news for you. What were his symptoms that led you and a neurologist to opt for an MRI? Why didn't they do the spine work first, out of curiousity? Normally that would be investigated before sending a dog for something like an MRI. There is some concern amongst neurologists that vets do not do a full workup before sending a dog for an MRI which is a far more invasive and costly procedure -- the term one neurologist used was that he feared SM was becoming a 'bucket diagnosis' for vets who don't eliminate other likely causes, so this is truly a growing concern that dogs are having costly procedures when they are not warranted.

A couple of things to think about if there's no evidence of a spine problem and symptoms continue and you continue to be baffled by this: your vet is actually wrong; the malformation alone, no matter how small, CAN produce the same symptoms as SM (that is why it is now called CM/SM, not just SM). There's also some debate about what is normal' in the breed and how to classify malformations of a certain size -- eg there is a difference between a small malformation, which is still a malformation and not normal and capable of causing problems, and hind brain crowding due to the smaller skull, which is different from the malformation and common in toy breeds (indeed this may over time be causing a range of problems for small breeds anyway -- remember a small size is NOT a normal size for a dog; it is a redesign of their shapes, as if we tried to breed for tiny humans! We already know how the smaller mre flattened skull affects breathing for example). I'd ask your neuro to clarify which s/he thinks s/he sees.

The way they can determine if CM causing symptoms is possibly the case, is to try the dog on two weeks of frusemide. If symptoms are relieved then there are almost definitely CSF problems related to CM and gabapentin will likely help long term. Taking this approach is well documented in Clare Rusbridge's papers. The researchers at the London SM event in London made it quite clear that the size of the malformation does not correspond to severity of symptoms and even a very slight malformation may be causing the same problems for a dog -- obstruction to CSF flow that in turn creates symptoms.

The other thing people need to keep in mind is that an MRI for SM is no different from a cardiac test for MVD. SM may not be present at the time of an MRI but like MVD it is a progressive disease, and just as a murmur may appear at a later point, so may SM. In MRIs of older dogs, far more in the research samples have syrinxes.

That isn't cheerful perspective I know, but it is very important for people to understand what a scan means and what it doesn't mean.

If your neurologist is not familiar with the problems CM (the malformation) alone may cause and how to treat, they should consider contacting Clare Rusbridge's surgery in Wimbledon (Stone Lion Vet Hospital).

Clare suggests two weeks on frusemide as one way of checking whether the malformation is the cause of problems. If it is, the treatment and prognosis is generally the same as with SM, and syrinxes may or may not develop over time.

If Chester continues to have problems I'd consider taking your MRI to Clare Rusbridge to get a second opinion or I can recommend some other neurologists very familiar with this condition in the UK.

Alison_Leighfield
23rd March 2007, 11:38 AM
JUST FANTASTIC NEWS!!!! ;)

I think I would have kissed the vet as well LOL. :lol: :lol: :lol: (if he was a dishy one)!

Alison.

Kelly
23rd March 2007, 11:43 AM
Hi Karlin,

Thanks for your response.

For the last 3 - 4 weeks Chester has been fighting with his back foot. He gets quite aggressive with it. It's always at night when he is getting a little restless and sometimes first thing in the morning. He is easily distracted from it but will continue if you leave him to it.

He also scoots quite a lot - always has done.

I had video'd an episode on my phone so the Specialist could see exactly what he does. He felt him all over & said he couldnt see what else it could be other than CM/SM so suggested we did the MRI scan to determine that first off. He did explain that Chester could still get SM at a later date.

Would a week on the gabapentin give the same results as a couple of weeks on frusemide? I was told to go back to my own Vets if there is no change so I will mention the frusemide to her then.

Thanks for all your help, Kelly

Kelly
23rd March 2007, 12:01 PM
Sorry, didnt mean to ignore everyone else's lovely comments.

Thank you x

Mabel's Mom
23rd March 2007, 12:20 PM
That is terrific news, Kelly. Enjoy your little Chester and give him lots of love.
Karin

Karlin
23rd March 2007, 01:01 PM
Thank for the additional info, Kelly. I remember you describing him grabbing at his foot. Did the neurologist do anything else -- do a neurological exam for example to see if there is any sign of limb weakness or other pain, or did they only do an MRI?

Gabapentin can have the same effect as frusemide so I would think it would be better to try frusemide first to see if it could possibly be CM causing the symptoms. A spinal problem will not respond to frusemide. But it might rtespond to gabapentin, so then you wouldn;t know if the CM might be the cause of the problem. Gabapentin will almost surely help if it is CM -- if you look on Spencer's thread, you'll see that Jen has Abbey on gabapentin as Abbey (who has CM) responded well to frusemide but was having incontinence problems with it so they moved her to gabapentin.

I'll see if I can find the reference in Clare's thesis (which is basically her published papers) to checking for CM.

Kelly
23rd March 2007, 01:08 PM
He checked him all over. Checked his reflexes, along his spine & all his limbs. Is that a neurological exam?

I will leave it till next week, once I have heard back re: the blood tests & spinal fluid and once he has finished this course of pills & then I will go and see our Vet again and tell her what you've just told me.

inca
23rd March 2007, 01:09 PM
thats fab news..........................

Shay
23rd March 2007, 01:37 PM
Great news Kelly! cl*p

Molly's mom
24th March 2007, 02:53 AM
What a relief for you :jump:

Jen
24th March 2007, 04:01 PM
Hi Karlin,

Thanks for your response.

For the last 3 - 4 weeks Chester has been fighting with his back foot. He gets quite aggressive with it. It's always at night when he is getting a little restless and sometimes first thing in the morning. He is easily distracted from it but will continue if you leave him to it.

He also scoots quite a lot - always has done.

I had video'd an episode on my phone so the Specialist could see exactly what he does. He felt him all over & said he couldnt see what else it could be other than CM/SM so suggested we did the MRI scan to determine that first off. He did explain that Chester could still get SM at a later date.

Would a week on the gabapentin give the same results as a couple of weeks on frusemide? I was told to go back to my own Vets if there is no change so I will mention the frusemide to her then.

Thanks for all your help, Kelly

I have to agree with Karlin on this, as I have a dog who doesn't have the syrinxes but she does has the malformation (CM)--which is enough to cause the spinal fluid to flow just off enough to cause the symptoms. I would take your films/results to another vet to get a second opinion. Print off all the information you can in the health section here and bring that as well.

Kelly
26th March 2007, 09:22 AM
The Specialist is phoning back today with the blood results so I will ask him then.

He has been on the Gabapentin since Thursday night but is still fighting with his foot. Do you know how long the drugs should take to work if these were symptoms of CM? I know they are in his system as he so dopey at the moment, last night he could hardly move he was so lethargic.

I phoned the emergency vet as he was so lifeless I was quite scared. They just said to give him 1 pill instead of the 2 and see how he reacts to that. He seems fine today.... thankfully.