PDA

View Full Version : spondylosis



laram
23rd January 2009, 01:43 PM
My 2 year old cavalier Sammy has been showing signs of pain lately - e.g. yelping when he lies in the wrong position, gets up after lying down or jumps onto the sofa. I took him to the vet today, who took x-rays and diagnosed him with spondylosis. He apparently had 4 places of bone bridge formations on his spine. The vet said she'd never seen it in a dog as young as Sam. She gave me pain medication and said the problem would get progressively worse over years.

Since that I've been reading about the disease online and finding some pretty conflicting information. Some sites call it a 'non-diagnosis', stating that most dogs get these bone formations without any symptoms, and the cause of pain is most likely something else. Other sites sound quite dramatic about it, saying that it will progressively cause paralysis.

So... I wanted to ask here if anyone's cav has been diagnosed with this, how the disease progressed, and how it was treated? I would really appreciate any practical advice, as of course I want to do the best I can for Sammy to have a long, comfortable life!

brotymo
23rd January 2009, 02:03 PM
I am so sorry to hear you are having to go thru this with your Sam.
Has anyone considered the possibility of syringomyelia?

Karlin
23rd January 2009, 02:24 PM
I'm sorry to hear Sam is having some pain and tha you have this diagnosis.

If your vet is not familiar with syringomyelia (http://smcavalier.com) in the breed, I would make sure that she is. This is also a common symptoms pattern for SM as well and there ARE things that can be done to address pain if the problem is actually rooted in SM, not spondylosis. Given that the latter is often a 'non-diagnosis' I'd definitely be looking at SM as an option and perhaps ask for a referral to a neurologist to at least (hopefully) eliminate the possibility by clinical exam or to consider what to do next. Perhaps try with a neurologist's advise, some of the SM medications to see if those help (eg gabapentin, the CSF-reducers etc).

laram
23rd January 2009, 03:36 PM
Thanks for your replies. I did mention SM to the vet, and she said it is a possibility but that she didn't think so. He had clear signs of pain on his mid-lower back, exactly where the x-rays showed bone growths. She said one of the growths was large enough it might be touching his spinal cord, causing him pain when he makes sudden movements (like jumping).

She also said that if it is SM, it would have a similar treatment and prognosis (i.e. painkillers such as rimadyl and monitoring whether the pain progresses). I will ask her though about the other treatments you mentioned and where I could find a canine neurologist.

frecklesmom
23rd January 2009, 03:49 PM
Think, if nothing else, you would have more peace of mind by consulting with a neurologist and they definitely would have a treatment plan and be up to date with knowledge. :) It appears that this diagnosis is a long haul for you and your Cavalier and :xfngr: for the best answers. :flwr:

Karlin
23rd January 2009, 03:56 PM
That's excellent that she's aware and considering all options. :thmbsup: She sounds like she has a good sense that it is the growths. On rimadyl -- that seems only rarely to be a long term treatment for SM except in the milder cases -- most dogs would need to go onto neurological painkillers to effectively deal with pain. In the other hand, gabapentin sometimes helps with nerve pain from back problems too so maybe the treatment would be similar even with that.

drphilzeltzman
25th January 2009, 06:27 AM
As a vet surgeon, I would say that spondylosis is either there or not there. Age doesn't really matter. It's simple to diagnose with an X-ray. So there should be no question here.

Assuming it's truly a spinal problem, your Sammy still could hurt from something else, like a slipped disc or SM. That is harder to prove. Typically, a myelogram, or better a CT scan, or better an MRI, would be recommended.

You also made me realize that I don't have info on spondylosis on my web site. I will fix this in the next few days!

Dr Zeltzman
www.DrPhilZeltzman.com (http://www.drphilzeltzman.com/)

drphilzeltzman
26th January 2009, 05:05 AM
I am happy to report that I have added a link about spondylosis on my web site. There really isn't much good stuff on the Internet, but I think the info provided is good.
Please do let us know about the final diagnosis!

Dr Zeltzman
www.DrPhilZeltzman.com (http://www.DrPhilZeltzman.com)

laram
31st January 2009, 03:04 PM
:cry*ing::cry*ing::cry*ing:

This has been such a horrible week. I'm really sorry to say I was probably in denial about Sammy having Syringomyelia. He definitely was shown to have spondylosis, but it can't be the main problem. His condition has worsened a lot over the past week and he's now showing severe SM pain signs.

Rimadyl didn't agree with Sammy's stomach, so he was given Metacam (for the spondylosis). That seemed to help a lot with the back pain he was showing - he stopped yelping and was able to jump onto furniture again. But over the past week, he's been scratching his head more and more, and started rubbing his head and rolling around on the ground. Yesterday was the worst. He scratched so much he ended up with a bloodly wound all down his neck. Every time I bandaged it up, he would just get more crazy. He was frantic all last night and the only way I could calm him down was to massage his head. So I stayed up all night sitting beside his bed on the floor and rubbing his head. Every time I stopped, he ran around frantically. He finally calmed down and went to sleep at about 7am. He's a lot calmer so far today.

Needless to say I spent a lot of the night crying and wondering if I'm going to lose him.

I called my vet's office yesterday to ask for stronger pain med, such as gabapentin. Unfortunately I wasn't able to talk to my previous vet, but talked to another vet. She had never heard of gabapentin, and she precribed a drug called 'Stronghold'. I later discovered this is a medicine for fleas (?! :mad:). It could be that we just had a miscommunication because of my Finnish, but I specifically explained that he needed stronger pain meds.

I also wrote to the only animal neurologist I could find in Finland - who is a long way away from where I live. He explained that in order to confirm sm as a diagnosis, it would cost me over a 1000e. That would be just to say he has sm, and then it would be another several thousand for surgery. I'm devastated to say that my insurance won't cover it (it's a long story, so I won't go into that) and I recently became a student again. I simply can't afford it, not even if I save for a year.

I've made an appointment to see my previous vet on Monday, as they're closed over the weekend. I'm going to try again to get stronger meds. The vets we've seen have already ruled out allergies, mites, ear problems and teeth/jaw problems. So I'm pretty sure it must be SM. The only symptoms that don't match up are:

- he doesn't like to have his head held high. In fact he tries to bury his head under blankets, in snow, on my lap etc.

- he doesn't air scratch. In a way, I wish he would, it would save his poor skin.

- he doesn't show pain on the top of his neck/shoulders. He doesn't react at all to being touched there or wearing a collar.

- although he's been scratching somewhat for a year, which I thought/wanted to believe was due to allergies, these clear pain signs have developed and gotten much worse over just two weeks. I thought SM is more of a gradual decline?

The documentary "Pedigree dogs exposed" was just shown on Finnish TV this morning (talk about coincidences). It made me SO angry and upset. I naively believed that if you get a puppy from a kennel that has been registered with the kennel club, the puppy has been bred for health as well as looks (and with health as the priority!). I thought that's the whole point of registered breeding. What an eye-opener. :( My childhood dog who was a mongrel from the pound (and also much loved) was a lot healthier than my poor Sammy.

annie121
31st January 2009, 06:13 PM
Laura,

I'm sorry you and Sammy are going through this. :hug:

I don't have any advice since I don't have any experience with this. Just wanted to let you know that I'm thinking of you guys and hoping for the best!

RodRussell
31st January 2009, 09:06 PM
The documentary "Pedigree dogs exposed" was just shown on Finnish TV this morning (talk about coincidences). It made me SO angry and upset. I naively believed that if you get a puppy from a kennel that has been registered with the kennel club, the puppy has been bred for health as well as looks (and with health as the priority!). I thought that's the whole point of registered breeding. What an eye-opener. :( My childhood dog who was a mongrel from the pound (and also much loved) was a lot healthier than my poor Sammy.

As controversial as PDE has become, hopefully your vets watched the part with the video of the Cavalier affected with SM and listened to what Dr. Clare Rusbridge had to say about it. Education of vets is key to dealing with this disease.

I don't know a thing about Finland's breeding practices. I know a little bit about Sweden's and the power that kennel club has over registrations and requirements that purebred breeding stock be tested for genetic disorders before litters may be registered. The fact seems to be, however, that as with mitral valve disease in our breed, SM can crop up regardless of whether the breeding stock is tested (in the case of SM, having an MRI scan) and found to be clear. No amount of genetic health testing will assure a genetically healthy puppy. It is best to accept that fact before getting a Cavalier.

ilsamom
31st January 2009, 09:13 PM
How terrible for you and Sammy. I sympathize, it's agonizing to watch the SM symptoms. I'd be concerned about his scratching himself bloody. Ilsa often makes contact as well when she scratches, but I've never seen it so severe.

If you can't afford the surgery now, I'd get the MRI done and get him on proper medications for SM, they can make him so much more comfortable. 1000 euro is a lot, the bills do add up! But if the medications work, you could wait a bit and save for the surgery if you decide to have it.

I've also tried Karlin's idea about applying ice to the neck when she yelps, it works!

Take care,

Jen and Ilsa

Cathy T
31st January 2009, 11:44 PM
I'm so sorry you are going through such troubles with Sammy. I, too, have no advice but your posting really tugged at my heart. I hope you find some relief.

brotymo
1st February 2009, 03:38 AM
I am so sorry about all this you are facing.

Perhaps you could locate a veterinary teaching hospital that would treat Sammy for a much lower fee. These facilities offer some of the most pioneering procedures and care, top notch experienced vets (they are teaching the next generation of vets!) and they need the patients to be able to do their job.
You might ask your vet about this.

I will be thinking of you.

drphilzeltzman
1st February 2009, 06:06 AM
Laram,

If you can't afford the MRI, why don't you just try gabapentin and see if it helps?

Your Sammy would need blood work to rule out kidney disease before starting it.

There are few side effects, so you might want to discuss this option with your vet.

Good luck.

Dr Zeltzman (a surgeon in the US)
www.drphilzeltzman.com (http://www.drphilzeltzman.com)

Cathy Moon
1st February 2009, 01:30 PM
Dr. Zeltzman,
I'm really glad you brought this up. I think many of us are under the impression that the dog must have an MRI diagnosis in order to be treated for the pain and symptoms of suspected SM. But pain relief is important regardless of whether or not an MRI is performed.

laram
1st February 2009, 02:06 PM
Thanks for your replies and messages of support. My plan is definitely to get him on to gabapentin as soon as possible. It's horrible to see him suffer, and getting him relief is obviously my immediate concern before thinking of what to do next. We had another bad night last night.

I did feel helpless though when the vet I talked to on the phone on Friday had never heard of gabapentin, and I ended up with flea medication. I'm hopeful they'll have a better suggestion when I take him in tomorrow. If they don't, I will make the trip to the neurologist as soon as possible at least to get more suitable pain medication.

At the moment, Sammy is quite ok when he's outside, when he's eating, and when he's sleeping. It's when he's just trying to rest or get to sleep that's the problem. He keeps jumping up with pain and scratching. Like I said, massaging his head helps a lot (I tried an ice-pack, but he didn't really like it). He also sometimes calms down a bit when I wrap his head.

Cathy Moon
1st February 2009, 02:14 PM
Try asking for the generic form of the drug Neurontin, which is Gabapentin. Maybe your vet will recognize Neurontin. Although it's a drug prescribed more often by neurologists, so your vet might not be familiar with it.

laram
3rd February 2009, 12:53 AM
Just to update: I took Sammy to the vet again today. She thought his scratching wasn't the type she's observed with SM. She's hoping that it's actually an infection in the middle/inner ear which can't be seen, so she gave me antibiotics to see if they help. He would anyway have needed antibiotics for the wound on his neck.

She had never heard of treating SM with gabapentin before and said she would need confirmation from the neurologist in Helsinki that it's ok to give it without having an MRI confirmed diagnosis. So if the antibiotics don't work, I'll be back in touch with the neurologist and possibly have Sammy examined without the MRI. Of course, I hope I'll eventually be able to afford the MRI. I did do some searching for vet training schools, but didn't find any that were offering services (and I forgot to ask the vet... arghh!).

On a positive note, I uped Sam's Metacam dosage (still a safe amount), and it does seem to be making a difference now. He was actually almost himself for nearly 12 hours after taking it. He started yelping and scratching again this evening though :( He keeps scratching regardless of the wound on his neck - which just shows how painful his head must be.

Sammy :( ( (with my tights on his head to protect his neck)

http://farm4.static.flickr.com/3408/3249193354_f771cb8515.jpg?v=0

frecklesmom
3rd February 2009, 02:34 AM
I'm glad Sammy had some relief and that must have made you feel better,too. I'm wondering if you printed some information out for your Vets if that would help with their understanding and knowing about drugs for SM. This is a good site for information for them:

http://www.cavalierhealth.org/syringomyelia.htm

drphilzeltzman
3rd February 2009, 01:09 PM
To answer the question above, I would think it's OK to use gabapentin on a trial basis, ie to see if it makes a difference. It's a pain killer after all. That said, I'm just a surgeon, not a neurologist!

Dr Zeltzman
www.drphilzeltzman.com (http://www.drphilzeltzman.com)

Cathy Moon
3rd February 2009, 01:39 PM
I took Sammy to the vet again today. She thought his scratching wasn't the type she's observed with SM.

When I compare the SM-related scratching of two of my cavaliers, there is no similarity between the two. Please share this with your vet, as she may not realize the wide range of symptoms that are possible with SM.

My Charlie (at the bridge) did the air scratching and also hit his head with his hind leg during pain episodes. He had an MRI diagnosis of SM. He was cared for by both a neurologist and a neurosurgeon.

My Geordie scratches at his neck below his ear and at his shoulder region and licks his front legs. He always makes contact with his skin, and I've never seen him air scratch. He had a CT-scan diagnosis of SM while in the PSOM study. He was seen by a neurologist at the time he was diagnosed.

laram
3rd February 2009, 02:11 PM
Thanks Dr Zeltzman, it's been really great to get the opinion of a vet surgeon here!! The vet I saw was really interested and receptive about the information I've had here, and hopefully this will mean more pain relief in other other sm dogs she's treating. Apparently all the vets in Finland pretty much refer all difficult cases to this specialist centre in Helsinki (which includes a neurologist etc). I think that's why she was so eager to have their cooperation.

The reason the vet suspected the scratching wasn't sm-like, was because he doesn't seem to be triggered by exercise/excitment etc. The other dogs she's seen have been scratching on the way to the office, while being examined etc. Sammy on the other hand has never scratched in front of them because he seems to be distracted by exercise and excitment. He also shakes his head a lot, as though there's something he wants to get out.

laram
5th February 2009, 12:58 PM
Update: Sammy's been doing much better the past couple of days. He's nearly back to himself in fact, and I was so so happy yesterday evening when he picked up his favourite toy and started zooming up and down the living room with it and wagging his tail. He was grinning from ear to ear :D. I can only hope that the vet was right and he had an inner ear infection, which is being cured by the antibiotics :xfngr: He is still scratching though from time to time, so I don't want to speak too soon. I also started giving him omeprazole on Monday, so that may also have made the difference. But it's just wonderful that he's out of that pain at the moment.

Am absolutely exhausted after all of this - I feel like I'm the one who's been sick, not my dog :o