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Nicki and Elvis
9th June 2009, 11:49 PM
Hey all

I am new to the site and have been having a good look around for advice on SM.

I have a 10 month old blenheim male called Elvis who was diagnosed with SM today :cry*ing:

I am totally confused as to my next step. We have decided for him to go ahead and have the surgery and we are hoping this can be done as soon as possible. I am worried however as a lot of people seem to be talking about pain medication and I'm wondering if the vet may have forgotten to prescribe this for Elvis or is it too early?

He has been showing symptoms since he was 8 weeks old and it breaks my heart to see him in such discomfort.

Any advice is much appreciated :confused:

Thanks

Nicki :)

Karlin
10th June 2009, 02:21 PM
Glad you found the board and sorry you have this diagnosis with Elvis.

If he has symptoms and isn't on any medication at all I'd talk to your neurologist about whether medication would give some relief right away, rather than waiting until whenever the surgery is planned.

SM generally tends to be more severe and have faster progression in younger dogs that show symptoms, especially as young as you were seeing. Medications are always an option but for dogs with fast progression and more severe SM they would probably only serve to relieve pain short term for a much shorter life. Surgery is not a cure but can offer the best prospect of relieving pain and giving a longer to normal lifespan, though there are no guarantees.

Clare Rusbridge's website, which is linked to from a post pinned at the top of this section, gives the most comprehensive information on the options.

Where are you based? is your neurologist familiar with the condition and has s/he done surgeries for it before? That's what I would be looking for -- but in specific answer, I'd suspect that surgery is the best option for Elvis if you wish the longest and best outcome for him. However people make decisions regarding surgery based on many different factors and there's no right or wrong approach.

I have two dogs with SM, one with medium and one of a slow rate of onset. The slow dog gets minimal medications and the casual observer would never guess she has SM but there are and always have been subtle signs since she was about 1 (she is now 4). My other dog is treated with painkillers -- gabapentin -- and a CSF inhibitor -- cimetidine. He has been MRId twice and has progressed quite a bit though not compromised in any significant way -- he is 5.5 and I will need to revisit treatment approaches to consider whether surgery is his better option now before he may worsen.

Karlin
10th June 2009, 02:23 PM
PS If you'd like, PM me your phone number and I'll give you a call -- there are places I would not recommend in Ireland for surgery, and I can talk to you about the options.

*Pauline*
10th June 2009, 02:42 PM
Karlin has given good advice there so it only leaves me to send a :hug:. I'm so sorry you are going through this. My dog is nearly 3 and has SM so anytime you need to chat, I am on here everyday. You can PM me.

tupup
10th June 2009, 03:26 PM
Im so sorry to hear Elvis has SM & at his age:flwr::flwr: You'll find lots of help & support on here, my girl (5yrs) has SM & this site & the people on it have been invaluable

Nicki and Elvis
10th June 2009, 11:51 PM
Thanks all for your kind wishes and thanks Karlin for the advice, I have spoken to the neurologist today and booked the surgery for next week, its all happening so quickly but we are hoping that with the surgery we will see sme improvements in Elvis :xfngr:

I feel so guilty as both myself and my husband have thought that some of the symptoms Elvis has been showing we thought they were just him being quirky and its only now we are realising that they are signs of discomfort :o

Karlin, I am based in Meath but am seeing a neurologist in Baldoyle, Dublin, and would really appreciate having a chat with you about it as I seem to be finding more answers on this site than from the vet!:bang: Ill pm you my number, thanks.

meljoy
11th June 2009, 09:24 PM
Just wanted to say good lucky Nicki......I really hope little Elvis does well.:thmbsup:

Mel

team bella
12th June 2009, 06:29 PM
Good luck for next week.:hug:

Love my Cavaliers
12th June 2009, 09:14 PM
We'll all be thinking about you next week. If you have questions about the recovery, please ask. My girl Riley went through the surgery exatly one year ago and is doing really well right now. Good luck.

tupup
16th June 2009, 04:55 PM
Hi how is Elvis doing & how are you doing? I hope you are coping ok x

Nicki and Elvis
16th June 2009, 09:41 PM
Hey everyone

Elvis and I have just arrived home from his surgery, he is totally wrecked and I feel so sorry for him, he just looks awful.....I havent stopped crying since I went to pick him up.... But it was very successful with no complications and the neurologist is confident he has every chance of a successful recovery

has anyone got any tips on how best to help him recover, is it best to keep him confined to a playpen? I am searching the internet for one right now!!! I understand that he needs to rest and not be jumping around but I really dont want to keep him cooped up in such a small space all day and night.

I have pain relief for him for the next month and an also wondering if there is anything that I can do to help him... he's breaking my heart :(

Thank you all for such kind messages of support it really is so helpful to be able to talk to people that have been through this before :rah:

Thanks

tupup
16th June 2009, 09:49 PM
Im glad to hear that he's back from his surgery, im not surprised youve been in tears it must have been traumatic for you both.
I cant help with advice, im sure many others will jump in to help but im thinking about you & sending you :hug:

Karlin
16th June 2009, 10:05 PM
The person who performed this surgery is not a neurologist. It is important to realise you are not getting the advice of someone who has this specialty and its specific training.

IMHO Elvis should be under intensive care at your vets. He should not be home right after this surgery; dogs normally remain for at least several days under careful watch, in confinement, in hospital. This is the norm for neurologists and neurosurgeons who do this surgery.

This is the second time I have heard of this man doing this with dogs after this serious surgery.

I think this is absolutely APPALLING.

Your vets might wish to contact Stone Lion in Wimbledon or Chestergates Hospital in Chester, UK to get proper guidance on how to give correct surgical aftercare.

Elvis really needs to be in a crate right now and probably for at least this week (this is how he would be cared for at a proper surgery, until his pain levels drop); many neurologists advise crating or penning for a month or two; others allow for controlled activity. His recovery is going to depend on this critical post surgical period when normally he should have remained in hospital and confined, so please try to get your vets to get adequate advice asap.

Karlin
16th June 2009, 10:54 PM
You can download Clare's general info document here (http://www.veterinary-neurologist.co.uk/syringomyelia/docs/cmsmeng.pdf) which includes treatment info.

This is her post surgery info:


Should my dog have surgery or not?
The cases where surgery is clearly indicated and most likely to be considered successful are dogs that are painful and responding incompletely or not at all to medical management.

How long does it take a dog to recover from surgery for syringomyelia?
At Stone Lion Veterinary Centre postoperative dogs are hospitalised until the dog is comfortable enough for injectable painkillers to be discontinued. After discharge it typically takes 1-4 weeks before the dog returns to normal activity levels.

Will I need to confine my dog after surgery?
At Stone Lion Veterinary Centre postoperative dogs are not crate/cage restricted after discharge. Exercise is limited to short 5-10 minutes walks 2-4 times daily over the first 2 weeks postoperatively and then, depending on the dog’s progress, gradually increased over the next 4 – 8 weeks.

What is the recurrence rate after surgery?
In some cases scaring and fibrous tissue adhesions over the foramen magnum seem to result in re-obstruction and 25% to as many as 50% of cases can eventually deteriorate (Dewey et al 2005, Rusbridge 2007). This can be as early as 2 months postoperatively.

Will my dog need medication after surgery?
Even after successful surgery it is possible that your neurologist may recommend continuing some medication for example cimetidine or omeprazole to reduce cerebrospinal fluid production or painkillers because the damage to the spinal cord has resulted in a neuropathic pain syndrome.

It is typically one to two weeks caged and supervised in the hospital before dogs are off injectable painkillers and considered able to be released to owners to go home. That is why I think Elvis really should at least be under close care at your vets or a hospital facility in the days following this serious surgery. Most dogs that I know of continue on gabapentin permanently and often some additional medication like omeprazole or frusemide.

Louise1823
17th June 2009, 01:25 PM
Hi Nikki, just wanted to say Im so sorry to hear your having to go through this with Elvis especially at such a young age (I think we met you and Elvis recently at a DTI class - he's adorable from what I remember :luv:)

I hope you're able to get the help you need for him and that he's feeling more comfortable soon. How is he today?

TKC
17th June 2009, 01:42 PM
Hi Nicki,
Here if you need anything at all from us. Believe me we see many Cavaliers that give us cause for concern at classes. He is a lucky dog to have you and such a lovely little cavalier.

Nicki and Elvis
17th June 2009, 01:44 PM
Hi Louise1823

Thanks for your message, Elvis is thankfully doing really well today, Ive been over to my vet following Karlin's comments and he has been checked over, so far so good! :D

Thanks x

Love my Cavaliers
21st June 2009, 04:06 PM
After Riley had her surgery last year, her neurologist wanted her crated or in our arms for the first 6 weeks. She really didn't mind being in her crate and even seemed to like her sanctuary from my other dogs. She was allowed 5 minute leash walks for elimination and just to get moving a little. Mostly, he just wanted her kept quiet - absolutely no running or jumping. Hope Elvis continues to do well.

Nicki and Elvis
23rd June 2009, 10:13 PM
:updte:

Hey guys

Just wanted to let you all know how Elvis is doing, he is recovering from the surgery very well, although he does look a bit silly as he has baby socks on his paws so he cant scratch himself! But we are just back from the vets this evening for another check up (I feel like I live in the vets these days!) and all is going great.

He has even managed to put on weight! for the first time in his little life! :*nana:
back to the vets for another check up on friday and to get his little socks changed!

:xfngr:

Jake
27th June 2009, 01:07 PM
Thats great news Nic! Jake is missing is little brother.. ''he told me honestly'' see he is doing fine at home with you..