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sophie
3rd June 2009, 07:12 PM
Hi,

I have a 6 yr. old tricolor cavalier who is scratching her ears terribly. She has gone to a dermatologist , been put on presciption food (Z/D) for a food trial, and Temaril P. After following the Temaril P protocol for 2 months she is now off it and the scratching has returned. It's always bad first thing in the morning after getting off the bed for a couple of minutes. You cannot distract her from scratching. Then a little scratching during the day and evening with some episodes being worse than others. (But it's extreme enough that it's not just scratching a little itch) Her dermatologist has informed me that the next step is allergy testing and shots. I am not totally convinced this is the way to go and I would appreciate some advice from some of you who have maybe been in a similar situation. I asked if she thinks it's PSOM or SM and she does not think it's either, she is convinced it's airborne allergies especially since she responds to the Temaril P so well.

I just want to do what is right for her, but again I'm not convinced allergy shots are the correct thing to do for her situation.

Could the Temaril P mask PSOM or SM symptoms? Her dermatologist says it wouldn't.

She is a small cavalier at about 11 lbs. She used to eat Orijen (before the Z/D she is now on). She has had limited vaccinations. I am very uncomfortable with the thought of allergy shots. I wonder if she should have a CT scan or MRI before we go that route.

Thank you in advance for any help you can offer. I am not sure what direction to go in as of right now.

Fran

harleyfarley
3rd June 2009, 07:20 PM
I doubt she would have just ear scratching, have you looked at all the other symptoms of SM, head shaking, pain when touched around the shoulders or front legs, rear leg weekness, yelping for no reason, licking paws or constantly grooming one area, scooting when anal glands are empty, symptoms come and go if she is itching just her ears all the time, it might be glue ear. di

sophie
3rd June 2009, 07:37 PM
Thanks, yes she has always been sensitive around her head, neck area. I have had her to a chiropractor quite often and that always seems to help. She is cautious when greeting us and she likes it when you put your hands down and she comes to you, rather than you reaching for her. Although that all stopped when she was on the Temaril P. Years ago she had an episode when she got off the bed (we have steps for the dogs) and went in a crate and just shook. I took her to the vet and she said it was her back and put her on medicine for a bit and that seemed to do the trick. I didn't know about SM then, and like I say it was years ago. I don't think she's had an episode like that since though.

Fran

Karlin
3rd June 2009, 07:44 PM
The dermatologist is mistaken -- Temaril P has exactly the same ingredients which would ease SM symptoms (prednisalone is actually one of the things that often eases symptoms) and the fact that symptoms ease when she is on them then return when off, would be consistent with what many with SM cavaliers have seen. Her scratching pattern also is I'm afraid, pretty consistent with SM scratching. With allergies you'd usually get more round the clock scratching I would think. People with airborne allergies certainly have more problems when out and about in the daytime or stuirring up dustmites etc (I used to have such allergies before undergoing desensitising). Also I would not want to give ANY injections into the neck on a cavalier, just in case you do go that route. :thmbsup:

Given that you've had no luck and that she is very uncomfortable, and especially given the other things your describe which would really point towards needing to see a neurologist, I'd ask your vet for a referral to a neurologist, ideally someone familiar with SM in cavaliers. I'd go for a clinical exam before considering an MRI as a clinical exam may well reveal other deficits or pain issues that won't be obvious to a vet. In your place, I'd probably go that route before allergy shots. There are listings of neurologist at www.cavalierhealth.org (http://www.cavalierhealth.org). If your vet wants to see if s'he can help ease some of your girl's symptoms, there is a downloadable treatment diagram from neurologist Clare Rusbridge at www.smcavalier.com (http://www.smcavalier.com) as well as more info on this condition. I've also pinned the links to Dr Rusbridge's new website and her intro podcast on SM at the top of the Health Library section. Most neurologists would not advise having an affected cavalier have their neck manipulated at all so I would not continue any visits to a chiropractor until you definitely can eliminate SM as a problem.

It would be helpful to the dermatologist probably to have a look at Dr Rusbridge's site and perhaps email her with any questions. As most dogs get a very delayed SM diagnosis due to vets treating mistakenly for allergies, during which time the condition may worsen and cause permanent neurological damage, it would be a good idea for a dermatologist to be aware of this issue in this breed (and other small breeds).

Let us know if you find out more.

sophie
3rd June 2009, 08:01 PM
Thank you Karlin for your response. That is exactly what I was afraid of. I knew one of the ingredients in Temaril P is prednisolone and wondered if it could be relieving symptoms. I will definitely ask my vet for a referral to a neurologist. I think that is the correct way to proceed. Thanks again for your advice! And also all the helpful info on your this board and your sm site.

Oh as a side note, I tried to buy "Primary secretory otitis media in the Cavalier King Charles spaniel: a review of 61 cases" for $12.95 from your site, but the link doesn't work for me.

I will let her dermatologist know of Dr. Rusbridge's site.

I will also keep you informed with our progress in helping our Lucy.

Fran

Karlin
3rd June 2009, 08:26 PM
Oh I see they no longer offer that article -- that's a shame. I think now it is only on the subscription sites.

sophie
16th September 2009, 09:07 PM
Lucy just had an MRI and CT scan last Thursday. She had PSOM which they immediately took care of and severe SM. We chose to go the surgery route since her case is so severe, this disease is progressive and medicine would probably only work for her for a while. Fortunately the surgeon could perform the surgery the next day. Friday they performed the decompression surgery with cranioplasty. She is recovering well although she is still in the hospital. We miss her so much.

I am just sick when I think of all the time I've wasted thinking it was yeasty ears, allergies, etc., etc.

We had even tried gabapentin before she was diagnosed and it did not help her at all. But remember the Temaril P took away all of her symptoms.

Again her main symptom was scratching her ears (yes, making contact with both of them). She did have neck sensitivity and back sensitivity but she didn't show it often.

We love this little girl so much and while we were devastated by her diagnosis we are now looking forward to her future and we are hopeful she will recover great.

Fran

Nicki
16th September 2009, 09:12 PM
I'm so sorry to hear about poor Lucy - please don't blame yourself, many of us had a long delay to get our dogs diagnosed.

I hope she has a good recovery from the surgery and will keep well for as long as possible.

Look after yourself too.

Love my Cavaliers
16th September 2009, 09:27 PM
I also had years of delay in getting Riley diagnosed. She was one month shy of 6 years old when she had her surgery last year for severe and advanced SM. The recovery is long, but she tolerated it beautifully. This is actually a good time to have it done since Lucy will need to go outside on a leash for a few weeks, meaning you have to go out with her and the weather is not terrible yet. Riley has recovered well and is maintained really well on prednisone every day. I hope Lucy recovers well. PM me if you'd like details on recovery or any other info related to the surgery. Good luck. Like Riley and me, you feel like you should have done something sooner, but at least now Lucy has a better chance of having a good quality of life.

Karlin
16th September 2009, 09:38 PM
Even though this was not the diagnosis any of us ever wants, I am glad that you finally got some definite information and were able to take the steps you chose to address Sophie's discomfort. I hope she recovers well and that she leads a pain-free life from now on. :flwr:

Don't be hard on yourself -- many of us get set in the wrong direction because vets and even specialists are just not familiar enough with SM -- normally in most breeds it would be very rare though researchers are finding it is present in several toy breeds now (still the incidence in cavaliers seems to be the highest). The misinformation that circulates, some through people or clubs who are well-meaning but ill-informed or very far behind in posting up and circulating up to date information on incidence and symptoms, really does not help the breed at all. :) Major breed club sites and breeder sites state that terrible error about contact scratching -- it absolutely isn't true and never has been true that contact scratching means some other problem -- so many of us have cavaliers who contact scratch with SM (and some who never scratch at all, and others who do a mix of air and contact scratching -- but I've never heard of an SM dog who *only* air scratches myself (I am sure some exist but of all the people and dogs I have come across dealing with this, none have a dog that only air scratches that I know of).

It would be a positive step you can make for cavaliers to go back to your dermatologist and vet, and explain Sophie's diagnosis, and let them know that current information on SM -- which would be very helpful to a dermatolgist and vet as they would see similar symptoms for skin problems -- is here:

For more information on SM in cavaliers:

* Visit the CKCS SM InfoSite:
www.smcavalier.com

* Read Dr Clare Rusbridge's SM FAQs:
www.veterinary-neurologist.co.uk/faq.htm

* Listen to Dr Rusbridge's 'Introduction to SM' podcast:
www.cavaliertalk.com/rusbridge.mp3

* Order CDs from October '08 CKCS SM seminar:
www.cafepress.com/cavaliertalk/4311456

sophie
16th September 2009, 10:16 PM
Thanks for the well wishes Nicki, Bev and Karlin. I do feel some relief now that she has a diagnosis, although you're correct, it's not one anyone ever wants to hear.

I am going to be putting together a packet of information for my vet and all the vets in her office and our dermatologist.

I can't urge anyone enough that if your dog is scratching their ears, neck, chin, shoulders it would probably be a wise idea to get them MRI'd. By the time some of the symptoms get extreme, the disease is advanced. With Lucy the disease progressed so slowly she was able to tolerate higher levels of pain more and more. Although her scratching was definitely getting worse.

I was so lucky to read on Karlin's SM website about a study going on in Long Island conducted by Dr. Marino. Fortunately it's close to us and that is where we decided to take Lucy. They offer many helpful tests for a very reasonable price and it is a first class facility with much experience.

Fran

tupup
16th September 2009, 11:09 PM
Fran im so sorry youve had this diagnosis:hug:Please look after yourself & i hope after recovery Lucy has a much better pain free life. Plse keep us updated with her progress

chloe92us
17th September 2009, 09:24 PM
Fran, I am so sorry you had this diagnosis. So many people go through the guilt game and it will tear you up inside. I hope she starts feeling better soon and you're able to move forward. Bless you for sticking to your guns and listening to your gut. You're a good mom.

Tania
17th September 2009, 10:12 PM
Please let us know how Lucy recovers. We wish you well and feel sorry
you have gone through this emotional trauma.