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View Full Version : Could Vet be wrong about this? does this sound like SM?



dogsaregodsgift
6th August 2008, 12:05 PM
Hi
My 20 Month (nearly 2) old cavvie Kizzy has started (about 5 weeks ago) to show signs of pain, we have taken her to the vet several times now and the vet has been unable to determine the cause of her pain or give us a diagnosis for anything. She said it could be a 'neck problem' because she has neck pain. She has just been giving us Rimadyl, which kizzy is normally much better on.

After researching hours on the internet i realised kizzy had many symptoms of syringomyelia. So when we went back to the vet I asked her if she thought it could be SM - she said no because she isn't scratching or showing signs of neurological damage. She prescribed rimadyl again.

Basically when Kizzys on the meds (rimadyl) she's much better but when she isn't -or sometimes even when she is, she is oviously in a lot of pain, which is heartbreaking to see. She walks around with her tail inbetween her legs, goes off her food, has difficuilty jumping onto beds and laps and can't bend down her neck for food (she lies her whole body down instead to eat). She has had two major pain episodes now which where painful to watch. Also when she is in a bad way she will hide away from me when she thinks i'm going to pick her up,(to put her on the bed) I believe this is because she is afraid i'll make it more painful. She also will not play at all when she's like this, she does'nt even bark at the cats! (very unusual). She has had a scratch occasionally lateley but nothing to significant. Basically when she's like this she is like a completley different dog, more like a 10-12 year old dog would act like.(normally and before she was ill she bounced around like a mad thing playing and constantly tail wagging)

Do these symptoms sound like any experience any of you have had with an SM dog? I know all the symptoms i have read through nearly every article regarding Sm on the internet but i would like to know if anyone has experienced this with any of their dogs? Are there other things it might be? I've heard of ear disease and Disk disease(uncommon in young dogs). Also do the symptoms of SM usually come on this quickley and serverly?

Also how is the best way to convince my vet we need an MRI? and does anyone know how long a dog can live on painkillers with syringomyelia?

If anyone could give any advice or support that would be great!

Thankyou :)
Hannah xx

Karlin
6th August 2008, 12:13 PM
Yes, they sound potentially like SM. Your vet should read up a bit more on SM, as many dogs do not scratch -- only about half do -- and many will not show neurological signs that a vet can pick up. vets however are GPs, not specialists, and would not be expected to know a lot about SM. It is a good idea for them to learn about it in detail though as especially in the UK and Ireland, vets see a LOT of cavaliers.

I would ask for a referral to a neurologist for an exam and to decide if an MRI is the right next step, given that the vet cannot find any other reason for Kizzy's neck pain. And yes, rimadyl will help if it is SM.

Have you read my site> www.smcavalier.com?

You'll note that it states that SM is highly variable, it more often comes on slowly and progressively with the dog adjusting to increased levels of pain until the condition is often quite severe without the owner having seen any symptoms. Also when signs are there in dogs under 4 it is a more serious form, generally and should be investigated. Only rarely do the signs come on fast and in severe form.

Karlin
6th August 2008, 12:15 PM
PS I have a list of the low cost UK neurologists/clinics that will do scans on my website; you can contact any of them directly to ask for an appointment. That is what I did with my two dogs. You can also ask your vet for a referral. However a low cost scan is probably not what you need as if the neuro suspects SM you really need a full scan and aftercare, which is not included on the low cost scheme -- it is more for breeders to get MRI certs for their breeding dogs.

Cleo's Person
6th August 2008, 12:19 PM
Oh gosh Hannah. I'm sorry as I have no personal experience to share. I just wanted to say how sorry I am to hear your precious Kizzy is unwell. :hug: :hug: to you at the moment as I'm sure you need them.

As always Karlin's advice is very sound. Try to get a referral for a nureologist, it really does seem to be the only way to definitively diagnose the awful illness. Once you know exactly what this is, you can hopefully start to make Kizzy's life much more comfortable.

Thinking about you at this difficult time.

dogsaregodsgift
6th August 2008, 12:23 PM
thank you very much for replying so quickly:)

Do you know of any other diseases the symptoms could be?

Also you mention Sm rarley comes on so quickly - this has come on with in three weeks of first symptoms, and so severley (already having pain episodes and poor quality of life). Is this a good sign that it's unlikley to be SM or still a possibility?

Do you know or have any idea (if it is syringomyelia) how long she would be able to live healthily on gapatin (or whatever other medications there are) ? Is there a chance she could still have a normalish (8-10years) happy life?

Sorry for all the questions! I'm just really worried

Karlin
6th August 2008, 01:21 PM
It can come on quickly and when it does it is very, very urgent that you see a specialist. These are the most severe cases. If the vet cannot find anything on xray, it doesn't seem to be disk problems, and the pain is in the neck area, really you are advised to see a neurologist. I would not delay if you are seeing a dog in severe pain. You need to figure out what is going on and once a vet exhausts possibilities you would be best seeing a specialist.

I would raise her food dishes and prevent her jumping on sofas and block off stairs.

Really she is showing textbook SM symptoms so I think this simply must be top of the list now to investigate ASAP since your vet has not found any other likely cause. I would be on the phone today to one of the listed neurologists close to you in the UK. I'd also see if the vet will give you a prescription for frusemide and gabapentin to see if those help. Gabapentin will help pain caused by disk problems too and may help Kizzy enormously.

Download the info from my website for your vet -- this includes the symtpoms list, Clare Rusbridge's intro to SM (which you will notice lists many of the problems you are seeing), and Clare Rusbridge's treatment diagram. If rimadyl isn't fully helping her I'd try to get her more comfortable on Clare's recommended medications.

The reason I am stressing you see a neurologist is precisely that your vet has tried to find a cause and cannot (a vet should always try to find other likely causes first). I know you will want to get Kizzy out of this state of pain and the only way to do that is to find the cause of her discomfort and then take decisions based on that. :flwr:

Evelyn
6th August 2008, 01:40 PM
Kizzy may have a disc problem or other kind of back injury that will sort itself in time. On the other hand it could be SM , it is a difficult one to call. Either way Kizzy is in pain and a diagnosis is needed asap.
If you are insured there isn't really a problem of cost.As has been said I would get a referral and go for a scan. It would then eliminate SM or not and I'm not sure ( maybe someone else would know) it may show disc problems if they are there.
If you are considering cost (and we all have to) the low cost scan will only tell you if its SM but it is a one off set price. If you can't think of a reason or injury that may have brought this on ,and have tried several bouts of cage rest (essential) and pain killers,this may be the way to go.
I have had several low cost scans ,and on one occasion felt I my girl would definately have SM ,as she had bouts of neck pain . She didn't have SM and it was concluded that it was damage done by her "athletic jumping acrobatics" , Though this girl began he pain bouts at 5 years old.

Hope this helps

Cathy Moon
7th August 2008, 12:14 AM
If you are considering cost (and we all have to) the low cost scan will only tell you if its SM but it is a one off set price.

I have had several low cost scans ,and on one occasion felt I my girl would definately have SM ,as she had bouts of neck pain . She didn't have SM and it was concluded that it was damage done by her "athletic jumping acrobatics" , Though this girl began he pain bouts at 5 years old.

Hope this helps

I think the low cost scans only scan the neck and head. If there is a syrinx further down the spine, the low cost scan won't catch it. Karlin, please correct me if I'm wrong about this.

Karlin
7th August 2008, 12:46 AM
Yes that is the case, though evidence is that this will catch most cases of SM as most syrinxes start in the neck area. But the low cost scans are definitely not advised for diagnosis of a dog suspected of having SM but really are for breeders to get the status of their breeding dogs. Still that low cost scans will give a basic diagnosis too.

Claire L
7th August 2008, 01:37 AM
My Rudee had the same problem when she was about two yrs old. Back then I didn't know anything about SM but I had her thoroughly examined ,x-rays etc and the Vet couldn't find anything wrong with her. I raised her food and water bowls and I didn't allow her to jump up or climb stairs. She was prescribed Metacalm and painkillers at that time and after a few days she appeared OK again. I always kept her food and water bowls elevated from then on. She lived to be almost 13 yrs old and eventually succumbed to spondylosis. I hope you can get a referral to a neuro and take it from there.

Alison_Leighfield
7th August 2008, 07:52 AM
It does sound like SM related problems, get to a neurologist and get an MRI done, at least that way you will know whats gong on.

The only problem though with a mini scan is the area being covered is only the head and top neck.

Although unusual 1 Cavalier has gone through an MRI scan in Swindon (on M4 junction 15, at the Great Western Referrals, the scanner calls in evey Monday, neurologist on site but scans can also be sent to Geoff or Clare for written report, although one given with results) with a very low syrinx only. This would have been missed with a mini scan.

The dog went for a disc problem and SM was picked up then.
Although uncommon, it's worth noting. If you can get a full scan then it's preferable.

Alison.

Cathy Moon
7th August 2008, 10:40 AM
Although unusual 1 Cavalier has gone through an MRI scan in Swindon (on M4 junction 15, at the Great Western Referrals, the scanner calls in evey Monday, neurologist on site but scans can also be sent to Geoff or Clare for written report, although one given with results) with a very low syrinx only. This would have been missed with a mini scan.
I know of a cavalier in the US who has only one syrinx low on the spine. This cavalier has no SM symptoms.

Karlin
7th August 2008, 11:20 AM
Yes I know of some cases too, though they seem to be very rare. You have to keep in mind the purpose of the low cost scans is to balance cost of a service against giving breeders some tools to work with for their breeding programmes -- very few dogs would be scanned and graded if breeders had to pay €1200 per dog. A symptomatic dog should probably have a full scan (depending on what is desired from the scan); for grading, neurologists say they almost never see lower spine-only syrinxes in any dogs with symptomatic SM, having seen hundreds of MRIs. So neck area MRIs for the low cost scans are a good balance I think.

For that matter Leo was diagnosed with a mini scan and that has been perfectly fine for the way in which I decided to approach treating him. If you don't wish to do surgery (and in many cases, even if you do) there may not be any reason to get a full body scan. Seeing whether there are syrinxes in the spine doesn't alter the way the decompression surgery is done either. But it is useful for a whole picture view of what is going on and to see whether syrinxes reduce (but with the normal decompression surgery they do not tend to reduce at all).

The problem with assuming pain has gone away simply because the dog stops showing pain is that with SM dogs do tend to start to adapt and *tolerate* vicious amounts of pain without showing it, after time passes. Neurologists regularly remark upon this. Vets do not have the training to spot the neurological deficits and signs of neurological pain that a neurologist can pick up even without an MRI. So for any dog that seems to suffer recurring or ongoing bouts of pain in this breed, and when an orthopedic problem cannot be identified, I think an owner should always see a neurologist even if you know you will not opt for an MRI. A lot can be determined from a basic exam by a neurologist.

Or to put it another way: I just had my vets check leo, my SM dog, for outward signs of pain. He showed none on a routine exam. Yet I know Leo regularly has bouts of SM pain when I can hardly touch him on his right side without him yelping. He showed none of this when at the vet. And as my vet noted, Leo has always showed a very high pain threshold and is also a very gentle sweet natured dog who does not react to people even when they cause him pain (seen during his anal gland problem). This makes it very easy for vets to miss an SM diagnosis. As is noted in the current thread in the main discussion section, cavaliers because of their gentle nature can hide considerable levels of pain.

My vets now are very aware of SM and if treatment for disk pain doesn't work and nothing can be seen on xrays or basic scans they always refer a dog to the university now to neurology because of the high chance of SM. Numerous cavaliers have been identified as SM dogs because of this, which other vets would likely continuously miss.

Claire L
7th August 2008, 12:03 PM
Yesterday I noticed a huge truck outside the local Vet practice; it read Burgess Diagnostics MRI mobile scanner. Anybody dealt with them ???
I had a look at their website (http://www.burgessdiagnostics.com/) and they do low cost scans. I would be very interested in having both my girls scanned, for peace of mind.

Alison_Leighfield
7th August 2008, 05:09 PM
They are the same company that supply the scanner in our town and various other places.

Claire try to find out if a neurologist visits with the scanner or ask where the scans go and to whom for the write up/report afterwards.
How often does it come to that area? keep a note incase anyone else on here needs a scanner for an MRI in your area. The vet should have contact numbers and information. :)

Alison.