View Full Version : surgery ???
13th November 2008, 03:28 PM
I took Anne to the vet and she was checked over very carefully - no signs of allergies, fleas, mites, dry skin, or anything that would cause the scratching. I have read everything I could find on SM. Because Annie is only 7 months old it indicates the onset would be severe and rapid. I plan to see a neurologist next week. But in all the readings about surgery I can only find statistics, has anyone out there done surgery and if so how were the results? From what I read it alleviates pain but does not stop it from coming back. Is there any threads I can read about people's personal exerience with surgery? I know I will have more answers after an MRI, like whether she really has it, but I am trying to gain as much information as I can before that appointment.
Thanks, I am so glad you are all out here - support means everything.
Love my Cavaliers
13th November 2008, 07:42 PM
Riley (6 years old) had decompression surgery in June of this year. I had never heard of SM before I took her to the neurologist for what I thought were seizures. He recommended an MRI that day, but felt pretty sure that she had SM based on her symptoms. Her symptoms have been so different from most of the other dogs with SM on this board. Riley never scratched, never seemed to be in pain, never seemed spooked for no reason, never nibbled at herself anywhere, never even whimpered. She was amazing. I knew she had some type of neurologic deficit from the day we got her when she was 11 months old, but the breeder said she had a very difficult birth and we attributed her quirks to oxygen deprivation at birth. She had the head tilt, weakness in her rear legs, couldn't jump as well as my others, just seemed a little floppier, and then started having what I thought were 10-15 second seizures. When they increased in frequency I took her to the neurologist, who said she had a severe and advanced case of SM and recommended decompression surgery to halt any further progress. A second opinion with a different neurologist resulted in the exact same diagnosis and treatment plan.
Her surgery was June 10 and it definitely took 3-4 months until she was back to being "normal" for herself. Her problems with balance and seizure like activities remain - although not as severe as before the surgery. But she still has the head tilt, the circling and/or continuous rolling behavior that can precipitate a seizure like event (it's really a problem with her vestibular system that was damaged when her brainstem and cerebellum were being herniated through her skull), still has the weakness in her hind legs, and nystagmus (rapid eye movements).
So, getting to your question - am I happy that I did the surgery? During the first 3-4 months, I questioned my decision every single day. I always wondered if I had shortened her life. And I cried a lot! But I'll never know the answer to that question, so I've decided that it's not worth thinking about it anymore. Like I said, she is pretty much back to the dog she was before. The only difference is fewer seizure like activities (she's on Keppra, a human anti-epileptic drug but still has some of these events). Since she never seemed to be in pain, or even scratched before her surgery, I can't answer that question about whether the pain /scratching comes back - and if it does, when does it come back. There are medications like Gabapentin that help with that. Riley's issues were so different that Gabapentin had no effect on her.
I hope this has been helpful to you. I found this board on the day she had surgery. It helped ease the passage of time while I was waiting to hear how Riley's surgery went to know there were other people who were going through similar trials with their cavaliers. Good luck to you. Let us know the results of Annie's neuro visit. Waiting is agony!!
13th November 2008, 08:02 PM
Thank you for the repsonse. I can't imagine the agony of the three months post surgery. Riley has a very special mom and I will keep him in our prayers as the others that suffer from SM. I will let you know what the neurologist says next week.
13th November 2008, 09:35 PM
Here is a thread:
14th November 2008, 12:20 AM
Click on 'Search' in the brown bar, then key in 'decompression surgery' without the apostrophes, click on the radio button for 'Show Threads' and click 'Go'.
There are several of us who have had cavaliers undergo decompression surgery in the search results - pages of threads.
14th November 2008, 12:38 AM
I forgot to say that I hope you and Annie have a good appointment with the neurologist. I'm sorry you're going through this, but glad you're taking her to a neuro. :flwr:
18th November 2008, 06:00 AM
After a lot of research and consulting 4 neurologists, 2 of whom have done multiple decompression surgeries, we opted for medical management (combination of a very low dosage of prednisone, gabapentin and omeprisol). The 2 "experinced" neurloigsts felt that long term the dogs all fared about the same, so best not to put them thorugh the surgery as some come out for the worse.
Jack does extremely well and most days is a normal dog. He has roughly one screaming "attack" every six to eight weeks, but itches daily. Before we got him on meds, we has screamed all of the time, did not want to walk, bunny hopped, etc. I contribute this largely to acupuncture (he goes every 3 weeks) and a raw diet. He was diagnosed at 20 weeks and is 1.5 years now. The problem is it seems like every dog is different, so you just have to watch for progression and if it is rapid, surgery may be the best option. I keep a journal as I find it very helpful to determine patterns.
20th November 2008, 04:23 AM
Annie and I want to thank all of you for the kinds words and responses. Our first attempt to address the itching, Benadryl badly failed. In fact, it appears her scratching is now more often, and more intense and now she is chasing and chewing on her tail. She had a "coughing" fit, but it really sounds strange, more like snorting than coughing and her neck gets stiff and she backs up while it is happening. So tomorrow we start introducing different medications. Her appointment with the neurologist is Wednesday in Carrolton - Dr. Ducote. She is listed on one of the links.
I am still praying it is anything but SM but the more I read and watch her the less hopeful I feel. I do intend to rule out PSOM as well.
Tomorrow night she graduates from Beginning Obedience class and has done well - she is a great obedience dog. Whatever happens it is my goal to keep her as comfortable as possible. It has been hard on my kids to lose Lacy from autoimmune disease at 6 months and now this.
20th November 2008, 05:54 AM
I wish you all the luck @ the neurologist appt. I will say a prayer for you and your sweet baby! My Bella is 11 months old and I am constantly watching her for signs and symptoms! I hate to say that, but it seems that it happens more often than not! I am just hoping I can find a qualified neurologist in my area if we ever need one!:xfngr: Hope all goes well. Keep us posted!
20th November 2008, 11:22 AM
She had a "coughing" fit, but it really sounds strange, more like snorting than coughing and her neck gets stiff and she backs up while it is happening. So tomorrow we start introducing different medications.
Martha, what you're describing sounds like 'backwards sneezing', which is common in cavaliers and doesn't require medication. When the cavalier starts snorting, gently tilt her muzzle towards her chest so that her nose points to the ground, and the snorting should stop, as this action lifts her soft palate away from her trachea.
20th November 2008, 02:09 PM
Thank you for the advice on the backward sneezing - I will tilt her head next time that happens. The medication I mentioned is prednisone for itching - the vet is trying to rule out allergies before my appointment next week with the neurologist. I certainly am willing to try everything even though I suspect SM.
21st November 2008, 04:47 AM
Sometimes Prednisone is used to relieve SM symptoms. Charlie was on Prednisone a few times both before and after surgery.
24th November 2008, 04:14 PM
The vet put Annie on Temaril (which has some prednisone in it) allergy medicine since last week and her scratching has been reduced almost 95% She has not air scratched at all since two days into the medicine. I am going to continue this for a couple of weeks and see how things go. I am torn whether or not to do the MRI at this time, unfortunately right now I am cash poor and could use a couple of weeks to get money together for an MRI. There are no low cost clinics anywhere in Texas that I could find.
Annie attended obedience class with a harness and didn't scratch one time the entire hour long class of healing and sitting. I know that ultimately I must do an MRI.
27th November 2008, 03:54 AM
Hi, Annie went to Dr. Ducote today, and based on the symptoms as I described them and her exam she is certain that Annie has SM. They could not do an MRI today due to the holiday and based on symptoms and her age, Dr. Ducote put Annie on Gabapentin 50mg/ml 0.7ml 2x daily. We are to continue until symptoms change, become worse, or she starts showing signs of pain. If she worsens we need to do an MRI to see what exactly we are dealing with.
She did warn me that with the onset of sypmtoms before the age of 1 year usually those dogs deteriorate rapidly and can develop severe pain. We are not going to look down the road, but take it a day at a time. I really liked her, felt she would be a partner, rather than just a vet. I told her my main concern was that Annie had quality of life and if that was not possible I would let her go.
She also said now the mediciation is available in generic form so I will talk to my vet about getting that. It was very pricy !
I am feeling a little better after seeing the neurologist, and I am glad some of the things I was seeing in Annie was not nuerological. She truely is just clumsy ! Annie was a champ and asleep at my side. One thing Dr. Ducote and I agree on is that these wonderful, happy, caring dogs don't deserve this illness. I pray that something can be done to future generations to eliminate this diesease as much as possible.
Thanks for the kind words and prayers. Annie is my baby, and this has been so hard on my kids and I. We love her just as you all love yours. But Annie is a trooper and we will pull together !
27th November 2008, 05:09 AM
I'm glad you had a consult and feel you now a bit more about where you stand right now tough I am sorry you have had the diagnosis you didn't want to hear :flwr:. As Cathy noted, the allergy meds with prednisalone would almost definitely have helped SM symptoms.
I'd consider whether you feel you will ever need to go with an MRI. What would you be doing it for? If you are not considering surgery and wish to stick with medications, an MRI really is not going to give much helpful information except reveal the extent of a syrinx etc. But seeing what is there isn't going to change your treatment approach. If your neurologist is pretty sure of the diagnosis, ad the meds are helping, then you can be pretty sure she has SM. It is a very expensive way of finding out information you will not be using, in other words. There are no other approaches that could be changed simply from knowing the result of an MRI -- the medications are pretty straightforward as there's only so many variations you might use and they really would not depend at all on an MRI.
My second dog with SM was being treated for SM without ever having an MRI -- the symptoms were pretty indicative of what was going on. I eventually had her MRId through one of the low cost programs in the UK but that was really only because I was doing three other dogs for research.
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