View Full Version : Confused!!
19th September 2009, 09:18 PM
Heidi has started to show symptoms of SM (she turned 3 today) she is having several scrathcing episodes a day, rubbing her face on the floor and air scratching now both on and off lead. I dont want to sound over dramatic but i am convinced she has it. We have a vet appointment tuesday morning - however she has never once yelped or cried in pain. when she is having an episode you can see it in her eyes as they glaze over and go bloodshot for a few minutes. I really like our vet however am a bit worried about how to approach this with him - im going to print off all the info on here but dont want to be fobed off - is there any advice anyone can give on how they approached their vet. I dont want to sound like i've already made the diagonsis but i would bet my last penny on it - I of course want to get it diagonised and her on treatment asap its just so confusing as there is so much info to understand. Thanks xx
19th September 2009, 09:40 PM
The most important issue here is Heidi not your vet. Karlin has given out a link to a list several times of neurologists which specialise in sm. I would choose one, go to your vet and simply tell him (nicely) you want to be referred its not up for discussion. It is important Heidi is diagnosed and treated as quickly as possible as this disease is nasty and painful. My Molly has SM, I can tell by her expression in her eyes how she is feeling, I would follow your gut instinct which is probably right, if you don't you will regret it.
Please let us know how you get on and I wish you all the best.
19th September 2009, 09:42 PM
I'm sorry to hear this. :flwr: Leo almost never yelps nor does Lily and both have SM -- once in a while Leo is sensitive on his sides. But the scratching IS a sign of discomfort and potentially also of pain -- they scratch to try and relieve the discomfort. Clare Rusbridge and other neurologists believe the scratching is often a sign of neuropathic pain. Such pain can be extreme but not make you cry out (I know several people with neuropathic pain). Likewise it would not necessarily cause a specific area to be sensitive to the touch. This is a multi-symptom condition and with neuropathic pain, all sorts of add sensations, nausea, headaches and actual pain sensations can occur. Also keep in mind that human Chiari/SM patients say the single most common symptom is severe headaches -- not something that would necessarily make a dog cry out.
If you are seeing a range of symptoms and your vet doesn't take them seriously then I'd contact a neurologist yourself -- not sure where you are based but you can ring the neurologists in the UK listed on www.smcavalier.com or the US/Canadian neurologists there or the more detailed list on www.cavalierhealth.org. Hopefully you will be able to get to the bottom of what is going on and see whether this is SM or not. :thmbsup: It is very frustrating and challenging for owners (and vets!) that it is such a complex and confusing condition but as I note on the list of common symptoms on www.smcavalier.com, a dog can exhibit one or several symptoms. Many do not yelp.
19th September 2009, 09:49 PM
Thanks Karlin, we are in west midlands uk so will see what the vet says next week, and then ring the neuroligists direclty if needed. obviously getting a diagnosis and the correct treatment for her is vital - just glad we've got insurance
Karen and Ruby
19th September 2009, 11:07 PM
I reffered myself to a neurologist. It was well worth it!
Love my Cavaliers
20th September 2009, 12:21 AM
I told my vet I wanted Riley to see a neurologist. She complied without a problem and has still been very gracious to me whenever I go in with any of the dogs. She is also very aware of Riley's diagnosis and is cautious when recommending any treatments. She wants to get the o.k. from the neurologist first. So, I had no problems asking to be referred. By the way, Riley never yelped or appeared to be in pain either.
20th September 2009, 06:28 PM
So sorry to hear about your concerns :(
I'm afraid that over the years my attitude to vets changed - Your vet is your PARTNER in the care of your dogs - they are also providing a service which YOU pay for.
I would go in and say that you would like a referral for an MRI scan as you are seeing symptoms, present them with the information, including where you would like to go and contact details and ask them to make an appt.
Normally you won't be able to make an appointment directly, it needs to be a referral from your vet
20th September 2009, 07:19 PM
I agree with Nicki, if you can work with your vet it will make life a lot easier in the future as you will still need his help. :) Good luck.
22nd September 2009, 09:47 PM
took Heidi to the vet today - she was great and totally agreed with me. She advised that Heidi should see a neurologist and that there is a new animal hospital opened about 10 minutes away from me, however when I called them they advised they have an MRI scanner but no neurologist until after christmas! what use is that?? :confused:
tonight i've emailed a couple in London (thanks for the links Karlin) it will mean travelling about 3 1/2 hours each way but will be worth it to see someone who knows their stuff.
22nd September 2009, 10:05 PM
The leading authority would be Clare Rusbridge at Stone Lion in Wimbledon. There may be some others in the area too but I just am not familiar with them or who has a practice. That's great that there will be another MRi scanner nearby as right now they are rare. We only have one or two in all of Ireland! It probably takes some time to get a qualified neurologist as well; there are very few in the UK or even the US.
23rd September 2009, 11:39 AM
It would be worth trying Chester Gates Referral Hospital, just north of Chester - it's only about an hour and a half by car from where I live in Coventry. Geoff Skerritt is another leading SM researcher, and he has a good team of neurologists there, one of them looks after my Oliver, who has SM. Tel. 01244 853823.
Kate, Oliver and Aled
28th September 2009, 08:37 PM
Heidi had her MRI scan today and the neurologist has advised that the scan is clear and shows no sign of SM which is obviously great news.
The insurance are going to pay the vet direct so I only had to cover the excess, as the scan was £1511.34 :eek:
Heidi is rather sleepy now bless her but am sure she'll be back to normal by morning.
Thanks for all the advice & support!
29th September 2009, 02:33 PM
I am so pleased for you and Heidi. Itís so nice to hear of some good news for a change.
29th September 2009, 03:32 PM
:rah: Wonderful news. I am so pleased for you.:rah:
Did they find anything in her ears that would explain the symptoms?
Please would you think about sending the certificate/report to Sarah Blott at the Animal Health Trust, to help with her research.
The address is..................
Dr Sarah Blott
CKCS Health Breeding Programme
Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU
This can also be done electronically: email@example.com
It would also be good to let Heidi's breeder know the good news. People need to know both good and bad results when cavaliers they have bred are scanned.
29th September 2009, 03:39 PM
That is excellent news. :jump:
Did they say anything about the Chiari-like malformation? I some dogs this alone causes facial pain and scratching at ears and head and face -- often treatment with a CSF-inhibitor drug helps. Also any sign of PSOM -- as Margaret says -- can also cause these symptoms.
29th September 2009, 05:47 PM
they did mention that Karlin- but advised that they really couldnt find anything wrong with her. Im now wondering if it was me starting to be too cautious and misreading her behaviour. They have still got all copies of her scans as they apparently send the copies off to be studied again - for their own research purposes. I will ask for these back next week and will definatley send them on Margaret.
Unfortunatley as Heidi was a rescue we cant contact her breeder and sadly they wouldnt care less :mad:
Thanks again for all the support!
29th September 2009, 06:53 PM
just had a call back from the neurologist and am completley stumped...
she has now advised that Heidi's scans have been looked at again by someone else (even after advising she didnt definatley didnt have it) and advised that she does in fact have SM. she was quite vague and said it is only very mild etc etc and suddenly seemed to know very little about SM. I have requested the report sent to me asap as am no longer convinced that they know as much as they claim to. She said she'd check if their allowed to do this - the invoice yesterday was £1511.34 surely im entitled to this by law??
When I get the report/scans back is it possibleto take them to a specialist in SM to getter a better diagnosis
Im just so annoyed at the vet for been so sure then changing her mind???
29th September 2009, 08:19 PM
I am so sorry to hear this has happened. Such a disappointment after being told that your little girl was unaffected.
I cannot understand how you could have been given such wrong information. It sounds like you were seen by someone who has no experience in reading a scan for syringomyelia.
Clare Rusbridge does sometimes review scans if there is a CD of the dicom images ( don't ask me what that means ) not just a sheet of film. There is a charge of about £35 + VAT
Love my Cavaliers
29th September 2009, 08:29 PM
I was advised to have decompression surgery for Riley when she was diagnosed with SM. Since it is such an invasive surgery, I wanted a second opinion. Her neurologist made a CD of the entire MRI (I believe this is what Margaret was referring to) and I was able to take that CD with me to another neurologist. The second neurologist was then able to load the CD into a computer and look at the images. I even asked them to make another copy for me because her breeder wanted a copy also. I don't know if it's different in Europe, but I got my two CDs of the MRI for free. And I do believe you are entitled to them by law.
I would absolutely ask for a CD and send it off to Clare Rusbridge. I'm so sorry you are having to endure this nightmare. Although I did wonder what they were going to attribute Heidi's symptoms to if she didn't have SM. Hopefully you'll be able to get a copy of her scan (not just a medical report) so you can get someone more qualified to look at it and give you some definitive answers.
29th September 2009, 09:06 PM
thanks very much :) have just emailed them asking how to get a CD. Im not upset or suprised that Heidi has it as I knew she did,but the woman so definate she didnt - she even made me question myself for over reacting. Will definatley contact Claire to see if she can read it - as am not convinced by anything they have told me. Its just amazing as yesterday the vet seemed so confident and had an answer for all my questions- today she couldnt care less, just advised that we monitor her and if symptoms persist toget her scanned again!!
Karen and Ruby
30th September 2009, 01:39 AM
Oh my goodness- what a rollercoaster of emotions you muct be going through.
I do know that Claire would analyse your scan results for you and I do beleive there is a charge although im not sure how much
It certainly wont be the price of a re scan though!! It may be that you have to book a consultation with her which is just over £120
I cant imagine being told that my dog is fine just to find out the next day that they are wrong. id be so angry!!
Good luck with your path from here- its all alot to cope with at first and I must say even a few months on I still get very upset even now!!
Karen, Ruby and Charlie!
30th September 2009, 02:52 AM
Oh my gosh you poor thing. What a roller coaster. You are entitled to that cd. I got one of Abbey and like Bev said she has one too. I think most would give them. I'm so sorry you are going through this.
21st October 2009, 06:48 PM
:updte: finally managed to get a copy of Heidi's MRI scan on CD and it was sent of to chestergates to be looked at.They have today advised that Heidi does not have SM. So 3 long weeks after the scan we finally have an answer which is good news!
21st October 2009, 07:47 PM
What a horrible time you have had but superb news at the end ,who did your first scan.:)
21st October 2009, 07:49 PM
Sorry I haven't read of your problems with Heidi before Gem. Sadly I don't often have much time to pop in here! I am sad to see that such a mistake has been made at Chestergates as my own experience has been totally different.
I took two Cavaliers up to Chestergates on one of Mark Marshall's runs to Chestergates resulting in one of my dogs having asymptomatic SM and the other only a slight herniation. My lovely boy is still without symptoms, but I now know to watch him carefully because of what is shown on the scan pictures which I have. I was also able to advise my vet of the results and show him the scans, so that anything arising in the future can be dealt with appropriate to his results.
The staff at Chestergates were absolutely wonderful throughout the day we were there, with our dogs treated with care and respect throughout. They even cardio checked both dogs for MVD for only £10 extra and to my delight both were clear.
The only slight criticism I had was having to wait 3 long weeks for the scan results, due to Geoff Skerritt being on holiday and therefore not available to check out the scans and authenticate and sign the certificates.
I was so pleased that I am taking my Blenheim boy up there on Mark's next trip in December.
21st October 2009, 07:56 PM
That's very good news Gem,I'm pleased to hear that all is well.
Flo,I plan on being there in December and it'll be nice to put faces to the names.I'll be the green person,not necessarily beause I'm Irish and patriotic, but because I'm the worst sailor in the world and will be green from the crossing.:p It'll be nice to meet you and one of your gang.
21st October 2009, 11:37 PM
:updte: finally managed to get a copy of Heidi's MRI scan on CD and it was sent of to chestergates to be looked at.They have today advised that Heidi does not have SM.
22nd October 2009, 05:58 PM
Sorry -just wanted to clear one thing up - the mistake was NOT made by Chestergates. I contacted them directly for a second opinion and they were brilliant :)
We have also booked to take our other girl Chloe on the low cost MRI scan in December with Mark
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