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kimy27
6th November 2009, 12:49 AM
I have been worried for a while now that my Bailey has SM. She has the symptoms like scratching, rubbing her face against the floor, rubbing her body against the sofa when I put her harness on and she hates being rolled over onto her back as it seems to hurt her back legs.

Anyway I would like to get an MRI scan to find out one way or another but don't really know how to go about it. My vet doesn't seem very knowledgeable about SM. I was wondering if anyone knew of a place near Glasgow that I could take her?

*Pauline*
6th November 2009, 01:06 AM
I don't know but I'm sure someone else can help you out with that info soon. I just wanted to send a :hug: while you wait. Oh, thinking about it, you need a referral from your vet so I would go there first. The vet should know the nearest Neuro to you.

Ruth
6th November 2009, 02:55 AM
Don't know how helpful this link is .......

http://www.gla.ac.uk/faculties/vet/smallanimalhospital/ourstaff/neurologyteam/

but if it is not too far to travel I can definitely recommend ....
http://www.wear-referrals.co.uk/ the set up is extremely good and very up to date and the Neurologist Gerard te Lintelo couldn't have been kinder and more helpful. He has done subsidised scanning for the Clubs and forwards results to Claire Rusbridge for interpretation.

barneysmum
6th November 2009, 10:13 AM
I would recommend asking your vet for a referral to Glasgow Vet School.

kimy27
6th November 2009, 11:10 AM
Thanks guys, I will make an appointment with the vet and try to get a referral. Do you have an idea of what it might cost for the MRI? I am assuming I won't be able to claim it on her insurance.

Nicki
6th November 2009, 11:20 AM
You should be able to claim for it as long as your dog wasn't showing symptoms before your insurance started.

Last time I went, an MRI plus consult was about 1600.

Glasgow are excellent, very up to date on treatments etc, and they ave wonderful with the dogs.

They have a mobile scanner visit, it was on a Tuesday, so usually book the consult for a Monday and keep the dog overnight.


Your vet has to refer you - look at http://sm.cavaliertalk.com/ for information to print off for them.


I hope that it isn't SM, but please keep us posted.

Murphy
6th November 2009, 01:24 PM
Nicki,
I have not been to Glasgow Vet School for an MRI (and I live 17 miles from Glasgow). My reasons for same would be that a mobile scanner, although perfectly adequate for most things, would not satisfy me so far as required detail is concerned for an MRI for SM.
Also, I would be pleased to hear who the Resident neurologist is there.
Could/would this person be able to discuss MRI findings with a client, as I feel this is imperative when considering an appointment of such importance?

Taking these things into account, I have always preferred to go to a Centre where I can have access to required info, on the spot, as it were, and in the knowledge that the scanner used was right for the job in hand.

Elspeth

Nicki
6th November 2009, 05:00 PM
I have been told that the scans I've had done are some of the clearest people have seen. Clare Rusbridge was very impressed with the quality of the images.

You pay for a consultation and diagnostic testing - this is an extensive consultation; you then have a further consult following the MRI with the neurologist, where things are fully explained.

This is NOT part of the low cost breeder scheme, you are getting a full body scan, a full consult and examination.

Quote from their website:

The Neurology / Neurosurgery Service of the Faculty of Veterinary Medicine, University of Glasgow, is one of the busiest clinics in the Small Animal Hospital and one of the largest neurology clinics in Europe. We accept referral cases from and provide telephone advice to veterinary surgeons over the entire UK and abroad. The staff of the Neurology / Neurosurgery clinic include Diplomates and Residents of the European College of Veterinary Neurology (ECVN).

Neurology team



Jacques Penderis (http://www.gla.ac.uk/faculties/vet/smallanimalhospital/ourstaff/neurologyteam/jacquespenderis/)
T. James Anderson (http://www.gla.ac.uk/faculties/vet/smallanimalhospital/ourstaff/neurologyteam/tjamesanderson/)
Annette Wessmann (http://www.gla.ac.uk/faculties/vet/smallanimalhospital/ourstaff/neurologyteam/annettewessmann/)
Mark Lowrie (http://www.gla.ac.uk/faculties/vet/smallanimalhospital/ourstaff/neurologyteam/marklowrie/)
Gillian Connelly (http://www.gla.ac.uk/faculties/vet/smallanimalhospital/ourstaff/neurologyteam/gillianconnelly/)



The low cost breeder scheme is NOT for diagnostic purposes - you do not normally receive a consult on the cheap days.

Murphy
6th November 2009, 06:04 PM
Right Nicki,
I am impressed with the qualifications of the team Leader, even tho' he is 'only a boy'.LOL!
I am glad that the quality of scans is good. This is not always the case when using a mobile unit. Also , it always seems strange to me that Glasgow has never had its own scanner? Last time I asked my Vet, it did not even have a Neuro - that was 5 years ago.
I guess with the new buildings going up as we speak, things are in for a change?
Hopefully a scanner of their own will be part of that. Hard to envisage how a Neuro team could operate successfully without one?
I suppose we, in the West have got so used to using the Royal Dick in Edinburgh for most things, while Glasgow waited for its new school.
Good to know that could be about to change!
Anyway, 1600 is a lot of money to pay for a scan/consult when there are Low Cost centres within reach of Glasgow (by car).
Chestergates is 4 hoursfrom Glasgow and the one at Bishop Auckland perhaps 3 hours?
At Chestergates you get a consult, not sure about the other one.
GS will charge around 275(my last one) - a big difference if you are not insured.
Elspeth

Karlin
6th November 2009, 08:15 PM
I understand Glasgow now has (I am told by another researcher) a state of the art scanner and Neurology department. I am sure anyone can feel full confidence in using this facility. :)

Also am told mobile units can themselves be far better than what some practices might have in a 'proper' neurology unit. The technology is always improving! :biggrin:

Ruth
6th November 2009, 08:33 PM
I had my boy entered for a low cost scan at Bishop Auckland recently but was told by the Neuro himself that it did not involve a consult. The situation then changed into an emergency and we had a full body scan and consult which came to 1500.

kimy27
6th November 2009, 08:36 PM
I definately cannot afford to pay 1600 for the scan. I could probably afford about 300. I think my best bet would be to get refered to one of the low cost MRI centres and take her down on the train.

Nicki
6th November 2009, 10:36 PM
The low cost scan services are for breeders - they are NOT for diagnostic purposes.

Will your insurance not cover this?


Glad to hear that Glasgow have their own scanner now - that's a very recent deveopment, I was down there earlier this year...

Karen and Ruby
7th November 2009, 01:59 AM
I borrowed the money for our diagnosis- it was just under 1300 at Stone Lion with Clare. Full body scan with consultation and feedback after. I sent the claim form in the next day and had it paid in full with in 2 weeks.
So I paid back what I borrowed no problem. as long as you are insured you will be fine they will pay out but get yourself on life cover right away or come next year they wont cover any re scans or medication for the SM if it is that!!

Problem with going on train- the dog needs to be sedated or aneathetised (spelling??) and im not sure train is practical in this situation.

Murphy
7th November 2009, 09:36 AM
[QUOTE=Nicki;341838]The low cost scan services are for breeders - they are NOT for diagnostic purposes.

GS will scan for diagnosis at Chestergates. Cost around 300.My vet asked me to check as she wanted to refer a client. He was happy to do it.
Elspeth

*Pauline*
7th November 2009, 10:36 AM
A 300 scan would only be head and neck, it's might diagnose SM but it wouldn't show up a syrinx further down the spine. You really need the full scan in this case. I think all of us with insurance have had this paid, as long as the vet referred us.

kimy27
7th November 2009, 10:53 AM
A 300 scan would only be head and neck, it's might diagnose SM but it wouldn't show up a syrinx further down the spine. You really need the full scan in this case. I think all of us with insurance have had this paid, as long as the vet referred us.

Bailey has pretty good insurance (M&S) so I should be able to claim. Out of interest do you think if I claim on her insurance the premiums will go up next year? I only ask because I'm already paying 20 a month.

Nicki
7th November 2009, 12:06 PM
Does Geoff Skerritt do a full consultation with neurological examination for 300? This wasn't the case when I last contacted him...he was more expensive than Clare Rusbridge...

I'm sorry but I am dubious about this - a full neurological work up {I was in for the best part of an hour} and full body scan is necessary in these cases, not just a mini scan and a quick chat.


M&S will cover the scan as long as there is nothing on the vets records to show evidence of symptoms prior to commencement of the insurance. Glasgow ask you to provide evidence of insurance, you have to pay for the consultation at the time - about 150 - 170, but they claim for the cost of the scan direct from the insurance.

Nicki
7th November 2009, 12:06 PM
I had my boy entered for a low cost scan at Bishop Auckland recently but was told by the Neuro himself that it did not involve a consult. The situation then changed into an emergency and we had a full body scan and consult which came to 1500.


So sorry to hear this Ruth - is he ok now?

Murphy
7th November 2009, 12:55 PM
Not sure what you mean by a 'full consult'. Can't see it taking an hour for that?
There is no full body scan done for the 300, but, if a dog is symptomatic, it is odds on that any syrinx in the lumbar region(not visible in a mini-scan) will be replicated in the Caudal area - Clare's opinion, not mine. I have only known of 2 symptomatic dogs whose syrinxes began in the lumbar region.
Any of mine who came up with a syrinx were easily diagnosed by the Mini-scan.
If a mini-scan came up with no syrinxes, and there were syrinxes further down, and so not detected, then a full body scan would be on the cards.
I have never had to have a full scan done on a symptomatic dog.
Not trying to be argumentative Nicki - just more financially practical when you are only looking for an initial diagnosis.
Don't need a sledge-hammer to crack a nut.
Elspeth

Karlin
7th November 2009, 01:06 PM
I have had low cost scans from Geoff that were for diagnosis and he made very clear that they are VERY basic -- this is what I had done for my first two 5 years ago. He also made clear that a diagnostic 'mini' scan is not the same as a scan for actual ongoing care. It is a minimal scan giving minimal information and with a short consultation and actual treatment, especially if surgery is to be considered, would require a full scan. So if one wants a proper diagnostic scan with a full commitment to care, then a full scan is really what is needed.

I have great respect for Geoff Skerritt and the team at Chestergates have been very kind and generous with me through two different scanning sessions but I am sure he would be the first to state that a mini scan for diagnosis is not the same as scanning for care. I discussed the option of surgery last time I was there (a year ago) and it was quite clear that for more involved diagnosis ad care, we'd be talking about a full scan and workup. So t really depends on what people want for themselves and their dog. I would say for some, a mini scan and mini consult is better than nothing if a full scan is too prohibitive. I did very much value the information I received but in no way would I have considered it a full consult and there is NO aftercare or ongoing advice -- you'd need to make separate arrangements so in that sense it is not at all like a full consult/full scan where the client is given a full detailed CD of scan images that can be used by other practices and where the neurologist will work with one's local vet to adjust meds etc. Such a scan might especially be useful to continue tracking development in a dog already diagnosed, too. But someone may well find that they end up paying for a full scan anyway after a mini diagnostic scan and that they really do not get the big picture f support and engagement that one definitely gets with a full consult. I also am not sure that Chestergates offers these mini diagnostic scans as a matter of course -- this may simply have been a kind gesture for a friend of an existing client.

Murphy
7th November 2009, 02:58 PM
Karlin,
I think you have covered pretty well all the possible requirements of the Companion Dog Owner going for a first time consult for SM. I would not dream of contradicting you.
But, I sometimes wonder if, in the scheme of things, the owners of companion animals are not tempted to spend more money than is actually required to find the answer to a question.
What I was trying to point out was: if you or your vet have determined that there could be a problem, all you really need to know is whether a problem indeed exists.
GS always writes a very polite reply to my vet saying,that, if they are at all concerned about the dog, just give him a call.
Treatment paths are easily accessible to your vet, via Clare's website

I have had a few dogs over the years with SM. None has needed more than a daily diuretic. Nothing more.
Perhaps I have been lucky?
But I think it is fair to remind owners of companion animals, that, even if your dog is diagnosed with SM, there is every hope that, with minimal treatment, that dog can live a normal life.

Just a comment from someone who has been down the SM road more than a few times, for what it is worth.
Elspeth

Ruth
7th November 2009, 03:37 PM
So sorry to hear this Ruth - is he ok now?

Sadly Nicki no, it was a brain tumour and the scan tipped him over the edge and we had him pts the following day. He was only five bless him.
Thanks for your concern though.

Karlin
7th November 2009, 05:18 PM
What I was trying to point out was: if you or your vet have determined that there could be a problem, all you really need to know is whether a problem indeed exists.

This may definitely be a consideration for many, as are finances. :thmbsup: I think it is better to have some information from a scan rather than no scan at all. But at the same time this is like saying you only need a xray to see if there's a tumour so that you know there's a tumour -- many people want and need more than that from a specialist consultation and want a more exact diagnosis. Most people that I know who are treating SM dogs have found CSF drugs only help for a short while and unfortunately, then need gabapentin, other painkillers, a different CSF drug, steroids, or to consider surgery. At that point further consultation is needed. There are also situations where a dog on a mini scan may appear to be less serious that it is -- for example may have only a small syrinx in the brief scan area of the mini scans, but have syrinxes down its spine, in which case an earlier intervention by surgery may mean the difference between a long life and euthenising.

In my own case, Mr Skerritt will not continue to advise on the care of my dogs after the scans and will not release the scans on disk for me to take to anyone else, as that is the policy of his surgery for the mini scans. The film images are not adequate for another neurologist to work from as they are far lower resolution; most will want the actual digital images; I'd need to re-MRI.

So, many owners opting for such a choice will find themselves spending more rather than less if they go for a mini scan then need a regular scan too. And they will need further neurology consults to manage care.

the other issue from an owner's perspective is that most owners getting this diagnosis are not reading the research, following the discussions, attending the SM conferences etc which allow a very informed owner to feel more confidence in weighing up choices and taking decisions. Most rely entirely on their neurologist, and then their vet working in consultation with the neurologist, but this relationship will not be there with mini discount scans as Mr Skerritt makes it clear they are diagnostic, not the basis for care of the condition.

It is another set of variables to weigh up, but for most that expect an SM diagnosis, I would advise to see what their neurologist feels is needed for a proper diagnosis and then ongoing care and the best care decisions.

Nicki
7th November 2009, 05:36 PM
Sadly Nicki no, it was a brain tumour and the scan tipped him over the edge and we had him pts the following day. He was only five bless him.
Thanks for your concern though.

Oh that is so sad :(

Thinking of you

Karen and Ruby
7th November 2009, 07:02 PM
Nikki- thats fantastic that they claim direct for the scan so no need to pay up front- I think this would be the best option for her in that case :p
A consultation is usually between 125 and 180 so to have to pay that after paying anywhere near to 300 for a mini scan anyway probably isnt the best option.
I now on my few consults with Clare she has mentioned that we could now do mini scans to see how the syrinx is progressing but certainly wouldnt be very useful in the first instance.
And yes at the time I didnt have much info to go on and my consult in total for before an after the scan was close to 1.5 hrs.
Bless clare had to wait for me to calm down before she could even recommend what treatment we could try.

kimy27
9th November 2009, 09:06 PM
I took Bailey to the vet today and explained why I thought she may have SM. She was very helpful and has agreed to refer her to Glasgow.

She asked if I have insurance which I do so she said I should be ok to claim the cost of the MRI.

Do you think I should call the insurance company to make sure they will cover it? I am with Marks and Spencer and have the premium insurance. There is no way I would be able to afford to pay 1600 on my own.

Karen and Ruby
10th November 2009, 12:12 AM
You can do what is called a pre authorisation claim which is arranged when you call them up

kimy27
10th November 2009, 11:11 AM
You can do what is called a pre authorisation claim which is arranged when you call them up

Thanks! I'll give them a call today.

kimy27
10th November 2009, 02:12 PM
Well I called the insurance but they're not commiting to anything :rolleyes:.

I have to get the vet to call them and confirm that there is no pre-existing conditions. This is worrying me a bit because Bailey wasn't insured untill she was five months old :oops:I think she may have been treated for dry skin round about that time so fingers crossed they don't try to say that could have been a symptom of SM.

Margaret C
10th November 2009, 02:34 PM
I think they would find it impossible to prove that a dry skin problem over two years ago was a symptom of SM

kimy27
10th November 2009, 02:40 PM
Well she was scratching a lot which was diagnosed as dry skin. She was treated for it and the scratching stopped so hopefully you are right.

I just hope they don't say that the scratching was a symtom of SM and not dry skin. Sorry I didn't make that clear :lol:

kimy27
13th November 2009, 10:50 AM
Bailey has an appointment to go to Glasgow on Monday. My vet refered her yesterday and I got a call last night! They had a cancellation so we are taking her in. I am assuming it will just be a consultation on Monday.

The vet also called my insurance but they will not make a decision until after I put the claim in :swear:

Oh well if worst comes to worst I'll just have to take out a bank loan :-).

kimy27
16th November 2009, 09:07 PM
Deleted.