View Full Version : My fears have been confirmed
17th November 2008, 06:27 PM
We're back and it's not good news.. she has SM. It is very mild though. A very thin line hows along her spine where the CSF is. I'm not very good at getting my head round it, sorry. The neurologist was a very nice (quite young) lady, she did all the tests which my little Star didn't like very much, she did a lot of drooling through stress, but she was such a good little girl.
She pressed along her spine and neck, no yelping thankfully. They took her off for an MRI and also said they may do a spinal tap. In the end they didn't do the spinal tap though coz the MRI showed what they were probs expecting to see after describing her symptoms. I asked about surgery but she said she wouldn't even consider it with how mild it is at the moment. I have to give her 1 tablet (Gabapentin) every 8 hrs for the rest of her life or until there are any changes and I have to keep a daily diary and let them know if she gets worse in the next 3 wks or if the medication seems to work. She couldn't tell me about Star's outcome though as she said every dog is different but she did says she's seen other young pups who have yelped just at being touched along the spine so that gave me a bit of hope.
I'm so upset but I just knew she had it. I'm relieved in one way that i know now and we can get it treated but it scares me that she is so young to have this horrible thing. We just have to take it a day at a time now. My husband is gonna phone the lady we got her from just to make her aware. She did say she was getting Stars mum spayed as she was only having the one litter but how do we know she was telling the truth... plus the owners of Stars brothers and sisters should be made aware.
Keep crying on and off at the moment..
Just want to say thanks to everyone for your warm wishes and just wish I had better news to tell you.
17th November 2008, 06:31 PM
I'm so sorry your fears have been confirmed. Sending you loads of :hug:
17th November 2008, 06:39 PM
I am so sorry to hear your sad news about star. i really hopethat the tablets take effect and help her. I can't even imagine how you are feeling at the moment, bu just wanted to say i'm thinking of you and star. :hug:
17th November 2008, 06:40 PM
Oh no I'm so sorry. :(
17th November 2008, 06:42 PM
I'm really, really sorry to hear the tests were positive. Will be thinking about you with Andy!
17th November 2008, 06:47 PM
the bright side is you know for definate now and you can treat her and make sure she is as comfortable as can be.
give her a gentle kiss from me and licks from Peaches
17th November 2008, 06:51 PM
I'm so sorry to hear this! I hope the medicine helps her to live a normal, happy life and I am heartened to hear that it is mild, at least.
It makes you wonder how many of our little Cavalier angels have this horrible disease? And they wonder why we all got so up in arms about the documentary?
17th November 2008, 06:52 PM
I am so sorry :hug::hug::hug:
---Aileen and the gang (Barney---Jazzie---Jake)
17th November 2008, 07:03 PM
I am so sorry about Star. You will have a better opportunity to prevent it from worsening by knowing early like you do. If surgery becomes neccessary, you can get it done before the SM causes permanent damage.
Hugs to you both.
17th November 2008, 07:15 PM
So sorry to learn of this... your instincts were correct. With such a loving & intuitive mom, Star is sure lucky to be in your hands!
17th November 2008, 07:22 PM
I am so sorry to hear about Star, it is just so very sad to hear another one of our cavaliers has been diagnosed with SM, sending you and Star :luv: :hug: :flwr: Thanks to your instincts Star is now receiving the best treatment sooner rather then later.
17th November 2008, 07:24 PM
I'm very sorry :flwr: It's wonderful that you caught it early and can treat it somewhat, or at least manage any pain. I'm sure many a pet owner has spent years wondering about the symptoms you noticed.
17th November 2008, 07:25 PM
I'm sorry to hear Star's diagnosis, beautiful sweet girl. You were quick to see her troubles and you've spared her some difficulties by getting physician direction now. She is and always will be your Star-she didn't change because of the diagnosis-and she'll always be happy one day at a time.:hug::hug::hug:
17th November 2008, 07:31 PM
I'm so sorry that it has turned out this way:hug:, but at least now you know for sure. You followed your instincts, and now Star is on medication which should combat any pain she has been feeling:flwr:
17th November 2008, 07:37 PM
Big :hug::hug: to you and Star.....It must be devastating to get news like that with such a young pup:(
17th November 2008, 07:57 PM
Such horrible news to receive but at least you now know,you can concentrate on giving her the best help she needs,she's still your little Star and she is beautiful.Thinking of you and Little Star :lotsaluv::lotsaluv:
17th November 2008, 07:58 PM
i am so sorry that star has SM, thank god it is mild and lets hope it will stay that way!
17th November 2008, 08:28 PM
Thinking of you all - you are a fab cavi owner to get this sorted so quickly :lotsaluv:. I know you feel devastated at the moment, Tilly was diagnosed at just over a year - she was showing symptoms from just 6 months! Theres no getting away from it SM is the pits - however with early diagnosis and gabapentin every 8 hours you can still have a pretty active little dog - with a great quality of life. Tilly was 2 on Friday - she is a complete delight, the gabapentin seems to be working and like you we are determined to give our girl the best possible life and enjoy her to the full.
Keep going - sending you a big hug :luv:
17th November 2008, 08:34 PM
We're so sorry to hear this news, just wanted to pass on some :hug::hug::hug:from all of us
17th November 2008, 08:57 PM
You are a lovely mum to Star, you quickly acted on your instincts, and now she's already on the right medication.
Sending gentle cuddles to Star and here is a big bunch of flowers for you to :flwr::flwr::flwr::flwr:.
17th November 2008, 09:04 PM
I am so sorry to hear that your fears were confirmed. I was thinking about you this morning and hoping you were wrong. It makes me scared how many Cavaliers really got SM. It makes me scared for my three. It’s good you found out now so her medication gets sorted and she can live a pain free live. Please keep us updated. Sending you and Star lots of love :lotsaluv:and :hug:.
17th November 2008, 10:09 PM
Thank you everybody.. it's very heartening to hear you're all thinking about us.
She's started her medication tonight so hope that helps her with any discomfort or pain she may have been feeling. Just breaks my heart coz she's such a sweet little thing and hate thinking of this horrible thing happening to her.
Thank you again from both of us. :lotsaluv:
17th November 2008, 10:56 PM
I'm sorry you got this result back on your MRI. :flwr:
To give some context, many dogs would MRI with SM and have no symptoms. At least a third of every research sample so far has MRI'd with SM, for example, even though the majority of those dogs showed no clinical signs on a neurological exam. So it actually is not too unusual that an MRId cavalier would show a syrinx. But a tiny syrinx of the type you are describing also usually isn't symptomatic according to several neurologists, and may never even be a concern for the dog, who may well lead a totally normal life.
Did your neurologist confirm she is showing enough actual signs of discomfort from this condition to have been put straight on to a high-level painkiller like gabapentin? Especially if she couldn't initiate any discomfort in her spine for example? To me, this would all be quite important -- I wouldn't want to start a dog on a drug that generally tends to lose effectiveness over time due to a build up of tolerance to it unless there's a real and very clear reason she should be on gabapentin. Most neurologists start with just a CSF inhibitor and if a painkiller is needed, move to NSAIDS. Gabapentin only comes much further down the line unless the dog is really showing signs of discomfort at the time it gets examined. Even then many neurologists just start them first for a trial on a CSF drug. So jumping straight to gabapentin 3 times a day just seems very excessive. It took ages before I moved Leo to 3x adn he had very, very clear symptoms and a medium sized syrinx already.
If a dog is not symptomatic generally you'd really only use something like frusemide or cimetidine, as per Dr Rusbridge's treatment document. That's all I use with Lily. Her neurologist did not even feel any of the signs she does show were due to her syrinx as it is tiny. He thought it more likely to be something a CSF inhibitor would manage quite well.
17th November 2008, 11:12 PM
It may take 2 or 3 of weeks before you see the gabapenin working fully. Dylan is on the same but 200mg divided into 3 doses, I make up the capsules myself. My neurologist didn't want to used CSF steroids straight away.
The dose depends on weight of course.
18th November 2008, 06:00 AM
I am sorry about your SM diagnosis.:hug: Hopefully you will be on the right track for future care now.
Other than the scratching, did she seem to be in alot of pain? I was just wondering if in a mild case where a small syrinx is confirmed but the dog just has several scratching sessions a day, but otherwise seems happy and okay, do Vets always prescribe pain medication right away?
18th November 2008, 09:33 AM
i'm so sorry about this news.
just wanted to say star is really lucky to have you looking out for her.
sending you good thoughts from los angeles. :hug:
18th November 2008, 09:51 AM
I think I'm going to have to either speak to the neurologist or my vet and ask about the drugs Star has been put on then. I didn't realise it was such a big painkiller.
I'll also have to ask about how much discomfort they think she is in. To me, it just seems to be the scratching, in herself she's still the mad little thing we bought home, running about the place etc. She did mention though that she has stiffness in one of her back legs and had I noticed but I haven't noticed this at all coz like I said she runs around like a mad thing and I've never seen any problems in her legs.
She did say she didn't want to put her on steroids yet.. are steroids to do with reducing the CSF flow? I should have asked all this there and then but all I wanted to do was get her home.
She was going to write up her report and send me and my vet a copy so will wait for that then start making some calls.
18th November 2008, 12:03 PM
So sorry you're going through this.
Drugs that reduce CSF flow are diuretics like Lasix, or proton pump inhibitors like Omeprazole (Prilosec) and Cimetidine (Tagamet).
Steroids are much stronger and wouldn't be used long term in many cases.
18th November 2008, 12:19 PM
I am sorry to hear the result, however fingers crossed it's a problem that does not cause any major concerns in the future.
18th November 2008, 04:30 PM
Sorry to hear that Star has SM, but at least you know what you are dealing with. :flwr:
18th November 2008, 06:58 PM
The neurologist is of course the expert but this treatment approach just seems excessive to me. Unless the neurologist actually saw the scratching and assessed it as actually being a reaction to having a syrinx and thinks the stiffness is painful and definitely caused by the syrinx (both of which seem unlikely with a tiny syrinx, from all the conversations I've had in the last couple of years with researchers) I don't understand why she is even on a painkiller. Really, if all of us on the board MRId tomorrow probably a third or more might MRI with what you are seeing and most of those would have no symptoms at all. That is why I wouldn't recommend MRIing without understanding the broader context of what is being seen by researchers -- eg a high rate of affectedness but a lower rate of symptoms -- and understanding the various approaches to treatment, IF NEEDED.
If the neurologist truly believes Star is scratching from SM and has seen this for herself to separate out what is normal scratching, then perhaps she needs medications. Yet most dogs would simply be put on one of the CSF drugs and might never, ever need something like gabapentin. It also sounds like you are giving 100mg three times a day -- it took 4 years before Leo was on that high a dose, just to give some context, and he is showing a lot of definite symtpoms. A dog that just scratches a few times a day for 5 seconds or under is not scatching due to SM. SM dogs scratch for long, long periods and cannot be distracted from scratching.
If you go to www.smcavalier.com, all the treatment approaches are explained, all the medications are explained, and you can see videos of typical SM scratching, which does very much stand out from normal dog scratching. My clear dogs would scratch many times a day for a few seconds at a time, just for context.
I just do not believe a valuable painkiller that is known to lose effectiveness over time should be wasted by being used too early for a dog that isn't having any problems.
Keep in mind that dogs with the scan you received (and if the scratching is not SM scratching) would still be considered fine for breeding under the researcher recommendations -- this is not a bad scan at all from what you have described, and is a very minor syrinx. I just think you really need to clarify whether you re seeing SM scratching so as not to give medications that are not necessary.
18th November 2008, 08:17 PM
I'm very worried about this now as have seen the diagram on meds and it says further down about Gabapentin 2 x daily for dogs between 8-12 kg.. Star is only 6 kg at the moment.
Is it worth me getting a 2nd opinion or just phoning the neurologist that dealt with Star and asking why she's put her on this drug to start off?
I need to keep an eye on the scratching (she also scratches at her side by her ribs) but she has yelped a couple of times for no apparant reason and she does bite at her hind quarters a fair bit.
18th November 2008, 09:05 PM
If the neurologist did a full assessment they will be able to tell you why they opted for this treatment approach. You should talk to the neurologist.
Puppies in particular often will seem to yelp for no reason and you'd want to have eliminated all possible reasons for her biting at her hindquarters before assuming this is SM.
The dosage is what is significant -- gabapentin comes in everything from 100mg on up. A 6kg dog would usually be trialed on 50-75 mg 2x. You will see Clare has a recommendation based on the weight of the dog AND the amount of drug per kilo. But that is only a starting point. Leo weighs 6kg and gets 100mg 3x. Many are on far higher.
I'm only going on what you have described; and it is hard to guess whether what you have seen is significant because board posts are not very useful in this regard. But what you have described just makes me doubt you are really seeing symptoms for Sm that are significant. But it is your neurologist who did the tests and has made a decision based on that. I would just be concerned if they are only recommending medications based on a description of possible symptoms they didn't see the dog exhibit, and that actually could be due to many other reasons; and so many dogs would likely MRI with a small syrinx that I'd really want to be sure the dog needs gabapentin. That is all I am saying and it is simply my opinion; and also wondering if there are not really clear reasons to give gabapentin why other things weren't tried first. Usually gabapentin isn't started until there are very clear signs of chronic symptoms. But all neurologists will have their own approach.
The place to start is with your own neurologist. If you want a second opinion you can book that with a different neurologist and bring your scans.
19th November 2008, 03:05 PM
Welll I phoned the AHT at lunchtime to speak to the neurologist but she wasnt about so am hoping she will call me back at some point today.
I'm very concerned now about Star's med and want to get my head round it and find out the reason, if any, why she has been started on such a high dose of painkillers when noone else seems to have the same treatment early on.
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