View Full Version : SM Surgery
11th December 2009, 09:22 PM
I have to post in regards to Kloey's post that she wouldn't do surgery again and thats her right. I don't agree or disagree with her statement BUT personally I would do surgery again in a heartbeat. I don't think recovery is bad at all. Its common sense and I don't believe the dogs are in any more pain that a human is after surgery is either. They are on pain meds just like humans. Abbey never looked at me like I wasn't trying to help her. I truly believe she knows we/I were. In regards to surgery taking the symptoms away--nope don't bother with the surgery then. There is NO cure for this disease and the surgery does not cure it. What it hopefully does and even then there are no guarantees is that it stops the progression. So far so good with Abbey. She is better and thats more than we had hoped for. After looking at her video today which by the way I had not looked at it in a VERY long time I don't think I could stand to see her like than now knowing what I know now and probably would put her down like Kloey did with Olley. I pray to God everyday that it never comes to that but we don't know what God has in store for us. I think alot of people believe the surgery is a cure and it is not.
This post will be opening up a can of worms believe me and I probably shouldn't post it but I have to make known that there are some that have done surgery that would do it again also.
Karen and Ruby
11th December 2009, 09:37 PM
I think what you have said speaks alot of sense and i think it is one of the hardest desisions owners will have to make
To/or not to....
I think alot of people think it will cure the dog and it simply isnt the case. Surgery is a hope to slow down progression but so are diuretics. We cant see whether it works untill we re scan after a certain time period.
It certainly isnt a desision to be taken lightly but either desision is faced with its own problems.
Either way there is only one person (or 2 in some households) that can make that desision for the dog. Ruby kinda made the desision for me as she is soooo active that I wouldnt take a portion of her life away on a 'maybe' But that was my desision and I am sure I will regret it when the time comes for her. As all I will have is a 'What if' but I think that 'what if' wouldve been there either way.
11th December 2009, 11:15 PM
You both are so right. Surgery is very much a personal decision. It was has to be measured as to the age of the dog, progression of disease, likeliness of success. To flat out say one would never do the surgery isn't acceptable to me. We had a speaker at a meeting who made this statement and I completely disagree. I do think there are cases where the surgery can be successful and the only option. I know of two Cavaliers who were diagnosed at very young ages, the owners chose the surgery route...and both dogs are doing fabulously. There are so many factors to be weighed. It cannot be a blanket statement.
Love my Cavaliers
11th December 2009, 11:48 PM
If I had to do it all over again with Riley, I would and she was almost 6 years old when she had surgery. Faced with a dog with SM with different symptoms and a different course of the disorder, I can't say. Riley did not respond to any medication before surgery and with two different neurosurgeons saying surgery was in her best interest, I opted for that route. And I have been happy with my choice. Riley is an active dog, enjoys being alive and truly seems happy. Even her neurologist said she looks happy. Like Linda said, the recovery can be long but is so manageable and is a distant memory for me now (one and a half years post-op). Riley's quality of life has improved so dramatically. Unlike Karen, I don't feel like I took away a portion of her life by doing surgery. Rather, I gave her back a better quality of life by doing the surgery. Since surgery is not a "cure" for SM, Riley will always have deficits that my other dogs don't have, but she runs, she plays, she jumps, etc. And I hope I have stopped the progression of SM - in her case it sure seems like it because she has fewer manifestations of the disorder now than before surgery. I am not left with the question "what if". But, if I had a dog who presented with different symptons from Riley's and the recommendation for surgery was not as clear-cut, I honestly don't know how I would respond.
Love my Cavaliers
12th December 2009, 12:00 AM
Forgot to add to my last post that Riley is not coddled or kept away from activity. With a multi-dog household, that would be nearly impossible!! She is right in the middle of everything. I'm sorry that Kloey's outcome was not as good as Riley's. You just don't know. That was the big "what if" for me. "What if" she's not better after surgery - but luckily she was. Riley was diagnosed with advanced and severe SM with wide syrinxes covering the majority of her spinal cord and it was also complicated by a large cerebellar cyst. She was showing symptoms as early as 6-8 months, but was misdiagnosed for years. Guess that just goes to show that some dogs are more symptomatic than others and it often does not correlate with what is seen on the MRI.
Again, it is a personal decision and nobody else can tell you what is right or wrong. Actually what is right is ultimately about what is right for your dog, your household, your living situation, including all the factors Cathy T mentioned also. So many factors weigh into this decision. For Riley it was right, that's all I can say.
12th December 2009, 12:51 AM
I had a feeling that my message would have many responses but I only wanted to say what I felt. I did not in any way tell people not to have it. I did want people to know that it is not a cure. Ollie was never started on medications before the MRI. I wish I had tried that. And, the drs in NY, Dr Marino at the LIVS, did want Ollie on inactivity of any kind for at least 6 months. Kept away from any walks, jumping, anything that was stressful. He was my only dog so that seemed to be easy. Two months ago my daughter found a tiny yorkie puppy that she wanted me to train before she went back to Canada. Ollie wanted to play with the puppy and at first I kept him seperated but then decided he would know what was best for him. So he played and I'm so glad that I video tapped it so I can watch the happy times he had. He would always have a seizuer into play as stimulation caused the spinal fluid to run in rapids and he would quit. But, he did play like a normal dog at least for his 6 and 7th month post op. But I know his symptoms were symptoms of pain. People with SM.Chiari malformations etc will tell you that it is one of the most painful illness a human can experience. I hope Ollie did not feel half of what these people feel. But I still feel that what's right for some is not right for all. I feel one way but respect those who feel another. I will try again with another Cavalier and hope that it is not effected by SM. I feel the 90% numbers being floated out there are skewed as they can only report on those who have been scanned while hundreds of thousands of cavaliers are happily living out their life to 10 years or more without problems. We don't hear about them. I've done my research, gotten all the certificates on parental health I could and from here it will be a crap shoot. I'm betting on the good health of my next cav. Nothing can erase the memory of Ollie nor replace him but I need to smile again and I need a fur child to help me smile. I live alone and I don't think there is much worse than a home that is empty when you come home. I'm looking forward to the patter of four feet again and my choice is another cavalier. Hopefully I did not offend anyone. I will still work digilently in the new year to hopefully get some reduced MRI scanning available at least four days a year in some of the universities for breeders and owners and the breeders can post their results on thier site when selling puppies. It's baby steps but at least it will be a step in the right direction.
Karen and Ruby
12th December 2009, 12:57 AM
Kloey I truely dont beleive you offended anyone in what you said. You have every right to tell of your experiences as we all do and as we have all said at one time or another its all down to our personal choices and reasons behind them.
Ollie was a very special boy and I cant even imagine what you have gone though but one day I will and that is a very scary prospect.
These little dogs teach us alot about life and death and If I can live through my life with half the grace and dignity of my Ruby then I will be a very lucky lady and Im sure you feel the same way of your little Ollie.
12th December 2009, 01:37 AM
I don't think you offended anyone either...I certainly wasn't offended. You had a personal experience and are welcome to share your personal feelings. Only you know what was right for Ollie.
It's baby steps but at least it will be a step in the right direction.
You keep up those baby steps!! One day they will lead to giant leaps!
12th December 2009, 04:27 AM
I don't think you offended anybody either and certainly not me. My heart aches for you that your outcome was not good and you had to put Ollie down. That is a fear that all of us that have gone through surgery fears. I thank god that I have not had to face that. I'm so sorry that you did and I know how you love these 4 legged guys. They are our children. I'm going to post what a person that has sm wrote in my guestbook in another post.
Love my Cavaliers
12th December 2009, 05:23 AM
To put the shoe on the other foot, I hope I didn't offend you by suggesting that it was your choice to keep Ollie quiet and inactive. I certainly favored Riley for quite a while post-op and carefully monitored her every movement, looking for signs of relapse or signs that her health was deteriorating. However, after her 12 week confinement period ended she showed me how tough she really is. All of the responses engendered by Linda's original post demonstrate how personal a decision it is about how we treat our dogs, whether it be medical or surgical management. I do not fault you for saying you would not recommend surgery - you had a brutal experience with a very heartbreaking ending, and it's an experience I would not wish on anyone. Thankfully there have been some very good success stories with surgery and I thank my lucky stars that I can include Riley in that category.
I wish you the best of luck with your next cavalier. They just become a part of your soul from the first day they come to live with you. I cannot imagine living without at least two of them. I also appreciate the work you are doing getting the word out about SM and working for low-cost scans.
12th December 2009, 12:03 PM
I have no idea either way, all is can say is the neurologist at the animal health trust in newmarket, said surgery was next to useless, is about 20 dogs he had operated on abut 4 were improved and the rest were the same or worse after surgery. Those were his exact words, if a simple proceedure could be found to correct the cm in the brain hense stopping the fluid from entering the spinal cord i would have it done in a second. di
13th December 2009, 03:14 AM
I'm so glad I found this board as, believe it or not, it has been the biggest help to me since Ollie's death. I've gotten to listen, learn and start to heal. I have a new nine month old Ruby coming December 30. I've done as much research as possible and think I've chosen wisely for health screening etc. I know I'm taking a chance but it's something I really want to do and I know Ollie is approving of me getting another little fur sister for him. He will watch us from above and hopefully teach her to be as kind, loving and obedient as he was. I think about all of you who are taking care of a special need child and all of you who are enjoying your healthy cavaliers. I have to think that for all the sick cavaliers out there , there are thousands of healthy ones playing and living long and healthy lives. As for trying again. well there's an old saying. " A ship is safe in the harbor but that's not what ships were meant for". Life is about chances and I've decided to take another chance on the most wonderful breed of dog I have ever had the pleasure of loving. Thanks guys. Merry Christmas and Happy New Year.
Love my Cavaliers
13th December 2009, 04:03 PM
As for trying again. well there's an old saying. " A ship is safe in the harbor but that's not what ships were meant for". Life is about chances and I've decided to take another chance on the most wonderful breed of dog I have ever had the pleasure of loving.
That is the most beautiful statement Kloey. I wish you luck with your new cavalier. I know you will be in love and will be a phenomenal mom to your new fur baby no matter what happens in her life. Have fun with her and treasure her life.
13th December 2009, 04:22 PM
With all due respect,I think maybe the animal health trust neurologist should then be talking to others about technique and approach if his results have been poor -- those figires would be considerably below the norm, which is 80% improvement post-op with over time about 50% having some return of symptoms, but a return of some symptoms is not the same as a return to the original status. Some dogs do worsen, but this is a smaller percentage. Generally over time there's indeed more improvement with surgery than medications all things considered -- this is the indication from all neurologists so far that have written up for publication or presented at conferences. But there are several ways to approach the surgery in technique! Most dogs will improve or at least will have progression of SM halted. I would look always for the most experienced surgeon possible with speciality in neurology.
That said, there are many, many reasons why it may be better in any given case to opt for medications. These include personal finance, personal beliefs and philosophy, degree of symtpoms, width of syrinx on scan, and so on. For many dogs many neurologists feel surgery would not be the right option, for many reasons, too. And as Clare Rusbridge emphasises, these are very personal decisions with many variables and no certainties.
Medications can have life-affecting side affects and often people do not top them up as needed, leaving the dog to deal with unnecessary pain.
This is why you simply cannot just put the dog on medications without regular testing for potential damage caused by side effects (recommended tests are on Clare Rusbridge's treatment diagram on my site and on hers) and without checking in regularly with a neurologist to assess the comfort level of the dog on the current medication regime. MOST dogs seem to need increases in dosage level over time.
On the other side, medications can manage the situation very well for many dogs. Many do not wish to take as invasive approach as surgery. All are 'right' choices for different people and different dogs.
Sadly there are no straightforward or easy choices in treating this disease. I question my own choices *all the time*. I think that is pretty normal as there is absolutely no right answer that suits all.
13th December 2009, 04:33 PM
there's an old saying. " A ship is safe in the harbor but that's not what ships were meant for". Life is about chances and I've decided to take another chance on the most wonderful breed of dog I have ever had the pleasure of loving.
What a great attitude,I love that saying.....:)
I think surgery is an individual choice and considered on a case by case basis.I think like every ailment, one treatment does not fit all.
As Daisy has just been diagnosed I'm taking it one step at a time and considering whether or not to go down the route of medication but personally I don't feel that surgery would be an option,even if there was a significant deterioration.I'm not convinced that the surgical expertise exists in Ireland to consider it seriously.
Also the gain would have to outweigh the pain and trauma both to the dog and to my family.I think personally when all non surgical treatments have failed there's nothing wrong in letting a dog go peacefully and with dignity.
Whatever choices we make I think we should support each other through it all, and respect the choices we make as individuals.
14th December 2009, 12:31 AM
I like that saying too. :)
Of my SM dogs -- I have been happy with the choices I have made so far. I have remained in touch with both Geoff Skerritt and Clare Rusbridge on those choices. Lily will probably never be in a situation where I would need to consider surgery -- she has a tiny syrinx and very minor symptoms. Leo is an ongoing consideration. He's done very well on medications but is fortunate to have a very centrally located syrinx which though large, is not (yet?) touching the sides of his spinal cord, which would be likely to cause more pain. But he is very stoic and is definitely more uncomfortable than he was a year ago or especially three years ago.
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