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anniemac
6th August 2010, 02:43 AM
I have a friend considering surgery with swine tissue that dr. Shores does. I have not heard much about this? Has anyone had this or knows anything about this or have had this done?

lovecavaliers
6th August 2010, 03:04 AM
I heard from a pet owner on another SM group who had a chihuahua that underwent the decompression with swine. She said her dog did great and the post op restrictions were much less, I think only 2-3 weeks of restricted activity (although I am not 100% on that). She also said that Dr. Shores was extremely friendly and available for her questions. She reported her dog is doing terrific and has had no complications.
Of course this is only one case, but I like that it seemed promising as a another surgical option.
Irene, NY

Pat
6th August 2010, 01:59 PM
Don't have time to post all of my notes, but after hearing Dr. Dewey's description of the titanium mesh with screws and then hearing Dr. Shores describe the swine (intestinal submucosa) duraplasty with adipose fat pad graph (taken from the Cavalier's hip/butt area) on top, I would be more favorably inclined to have surgery done at Auburn. (Of course I also live 2 hrs away.) Dr. Shores also does a dorsal laminectomy at C1, which I presume is unique to Auburn, and that would seem to have additional decompression effects. Post-op in-hospital recovery is only about two days.

Auburn has had 23 patients over three years, and they have follow-up stats with 21 patients (longest follow-up is 31 months). Most have been Cavaliers and Chihuahuas. Most have done well, with about half of them on no meds after surgery. One of the patients has not done well and may require a second surgery, but this dog has complications with PSOM and extreme atopy (food allergies). These factors can continue to drive hypersensitivity issues. Auburn does a pre-screening dermatology consult. I've got more notes to post but no time.

LIVS has done about 100 FMD surgeries per Dr. Dewey's speaker notes, so there would be more follow-up stats with those dogs. More on that later. I don't know if they are still using titanium mesh on the west coast or the number of post-surgical patients or length of follow-up and related stats.

Dr. Dewey commented that new thinking is that there is more global compression of the brain and so perhaps there should be additional decompression done at the top of the skull to obtain better post-surgical results. That was an extremely sobering thought to me.

There is a team of residents at Auburn who are all learning the swine duraplasty technique, so it would seem that the Auburn approach will spread to other hospitals.

Caveat: My expressed opinion is not based on indepth study, which of course I would do if I had a dog with SM for which I was considering surgery. With indepth study, my opinion may be different.

I should add for those not following other threads that these two speakers presented at the AVMA convention in Atlanta on July31/Aug1 which I attended. Also, I reported earlier that there were about 15 attendees at Dr. Dewey's session; there were 17 attendees at Dr. Shores' session. Dr. Shores' first comment was how disappointed he was at the number of attendees. (In contrast, at some of the sessions on liver, pancreatitis, etc., there were probably 300-400 attendees.)

Pat

anniemac
6th August 2010, 02:58 PM
That was such good information and I will pass it on. I always tell people that even when considering whether or not to do surgery it is how you feel and also how that person feels about which place to go to. It seems like they are still learning so much each day. I know that Dr. Dewey and Dr. Shores are pioneers in this but I have heard nothing but good things. I went with a neurologist where I live which I love but he was not as experienced with these techniques and if I was going to choose to do one of those, I personally felt more comfortable not being one of his first. I am pleased with Ella's results but of course without the mesh or swine tissue, I believe, there is more likely a chance for scar tissue to form? However, for me having a neurologist I can go to each week if I want and is very familiar with Ella was more important.

I really wish I could have heard Dr. Dewey and Dr. Shores but I know it was costly to go to that but it would have been nice for more neurologists to go. I know my neurologist is going to talk to Dr. Shores so maybe he will start doing that in the future, but I think my friend is going to travel to Auburn. There is so much to learn and I have so much respect for the people that are finding improvements through drugs, research, screening, surgery. It seems to me there has been some progress but it is still an upward battle. Thank you so much! This is a friend that lives in Charlotte that goes to my neurologist and I hate when people ask me my opinion because what works for Ella is not best for others. It is great to have this forum to get other people's knowledge.

Thank you!:thnku:

Furrfoot
6th August 2010, 05:14 PM
I read an article about it, and I'll see if I can find it for you. We are also only 2 hours from Auburn and my sister lives there, if your friend ends up there with her dog and needs any help about where to stay, etc. feel free to pm me.

Okay, here it is *warning* surgery pics included! Scroll down for the swine surgery: http://www.cavalierhealth.org/syringomyelia.htm#--_surgery

Pat
6th August 2010, 06:18 PM
It seems like they are still learning so much each day.

I really wish I could have heard Dr. Dewey and Dr. Shores but I know it was costly to go to that but it would have been nice for more neurologists to go.

IMO, the surgery is in its infancy still and is still evolving. Hopefully I can post more comprehensive notes soon.

The AVMA convention is geared toward GP vets - so that they can learn the most current thinking and treatment protocols and so that they can keep up with continuing education. Neurologists, cardiologists and specialists would not want to attend this event - they would have their own specialty conferences that were "higher level," and I'm sure they would have a much more controlled criteria for admittance. Cost for non-vets at AVMA was only $250, and it was worth every penny for someone like me with wide interests and I attended 25 hours of sessions. $10 per hour is pretty darn cheap! I'd guess that the majority of pet owners really would not want to attend this kind of event. I had to be careful to ask the kind of questions that a GP vet would ask rather than questions that a pet owner would ask.

Dr. Shores said that he was disappointed to see so few GP vets at his session because SM is an emerging condition that may well be widespread in certain popular breeds and GP vets are missing the diagnosis because they don't know about the disease. After the session, I spoke with him and told him that among Cavalier owners, there is a grassroots pet owner education movement where pet owners are actually referring other pet owners to neurologists; for instance, I have referred pet owners to Auburn.

Pat

Reminds me of a funny story - when I picked up my badge holder/lanyard at the registration desk, the person asked me what I "was." I impulsively replied that I was a human being! She was not amused.

RodRussell
6th August 2010, 09:07 PM
...Dr. Shores said that he was disappointed to see so few GP vets at his session because SM is an emerging condition that may well be widespread and GP vets are missing the diagnosis because they don't know about the disease. After the session, I spoke with him and told him that among Cavalier owners, there is a grassroots pet owner education movement where pet owners are actually referring other pet owners to neurologists; for instance, I have referred pet owners to Auburn. ...

The fact that so few general practice vets attended these SM sessions emphasizes the importance of the Cavaliers' owners learning as much as possible about the symptoms, diagnosis techniques, and treatment alternatives. We usually can by-pass the ignorant GPs and get appointments with the specialists.

anniemac
6th August 2010, 10:38 PM
I agree with Rod and Pat. My GP Vet knew a little bit about SM but I am the one that was pointing out the symptoms I had read about. He thought it was not an issue but I called him and made him refer me to a neurologist. It is hard to notice some of the symptoms but when you are familiar and can put them together, I just knew it had to be SM. I was not going to wait and see because my Vet said it probably wasn't. Thank goodness, but also my GP Vet has another cavalier with SM but really a neurologist or specialist would know more. I believe at least from my experience.

lovecavaliers
6th August 2010, 11:21 PM
Thank you Pat for sharing your information. I too feel that as pet owners, especially cavalier owners we need to be aware of these things. I reallly like the idea of less hospitalization time with the swine tissue. I live in NY but if/when the time for surgery is deemed necessary, I have a feeling I may be taking a road trip from NY to Auburn :)

As for the GP vet. It's true, many (not all) don't know a lot about CM/SM. I heard a friend of mine who was talking to a "old school" GP vet who stated, "that SM stuff is all a bunch of crap" Oh how I wish I could have been there to give him my input :mad:

It was so sad to hear that not many vets attended the seminars. I too practically told my GP vet that I think my dog has chiari like malformation and then took it upon myself to go to a specialist. To give my GP some credit, he has since become very interested in it and hopefully this will raise his awareness wihen treating his other toy breed patients.

gyoselyn
7th August 2010, 06:22 PM
Hi All, I'm anne's friend gemma and my pooch name's corey, he's 2y 10mo and is diagnosed with a severe sm and will be going to see dr. shores on 8/25. Anne - thank you so much for your support and posting corey's story in this forum. Thank you everybody for your support and thank you pat for sharing the information about dr. shores, you give me confidence to go on 6 hrs drive to go to see him. I hope corey's experience will help other cavaliers that are going through this horrible condition.

Irene - I thought driving 5 hrs is long enough, I can't imagine driving from NY!

I'll keep everyone updated with corey's surgery and please feel free to email me if you have any questions.

Thanks :luv:

linderbelle
11th August 2010, 07:54 PM
I used to be a regular on here but due to personal stuff I'm hardly ever one. This is my first visit in many months but I did see your post. My Abbey had surgery with Dr. Shores March 2009 so its been 17 months I guess. I have a website which I also need to update but if your friend would like to talk to me privately message me privately in here and I'll send you my e-mail.

I know people are going to recognize me in here and right away wonder how Abbey is and all of you that supported me through my terror a year and a half ago I apologize for not posting about her.

Abbey is not doing as well as she once was and I don't have time to post BUT I will update her website within the week. My life has been crazy the past year and just not enough hours in a day.

LInda
Abbey's Mom

linderbelle
11th August 2010, 07:58 PM
Anniemac.

My website is here:

http://abbeygeorgelinda.blogspot.com/

There is a place on the page where you can e-mail me. I told you to pm me in here but I haven't been here in months and not sure when I will again although I want to catch up in here.

Karlin
12th August 2010, 12:23 AM
Good to hear from you Linda; sorry Abbey is not doing as well as we'd all hoped. :(

linderbelle
12th August 2010, 11:40 AM
Well, since Chelsea woke us all up at 4:30 a.m. today barking and barking to let us know there were two baby raccoons on our deck I am up--lol.

Abbey is no worse than before her surgery and that was always our goal in regards to doing the surgery to keep it from progressing. Pat showed Dr. Shores report at least I think she did but I'm going to share the one I got about a month ago from him that is current just in case she is going from a previous one as some are on the net.

Follow-Up 21 Cases
Longest: 31 mo
Initially Improved: 21 patients
Continue to do well / w/o medication: 10 Continue to have major difficulty w/ medication: 2 Had to restart medications because of difficulty: 2 May need a second procedure: 1

I e-mailed him after receiving this report and asked where he classified Abbey and unfortunately she is the one that may need another procedure. He has recommended another MRI to us BUT we have chosen not to do so as I won't do anymore surgery on her. The trouble started a few months ago and we had to put her on predisone which helped tremendously but my vet tested her liver a couple months ago and the change was remarkable and he consulted with Dr. Shores and they decided because of the risk of Cushing's disease that she must get weaned off of them. We tried but the outcome was not good. Abbey was miserable. Not screaming like some videos you see but I'd compare it to almost what I was seeing before the surgery--maybe a bit less. My vet on a phone call to me heard her in the background and I have a wonderful vet and he directly heard her. He then consulted with Dr. Shores again and it was agreed by all including us that she probably would have to be on them. I told my vet that I'd rather risk the Cushing's than to see her uncomfortable. I just can't handle it. It breaks my heart to see her scratching etc. She was on 1 1/2 pills once a day and as of now we have it on 1 pill a day and may try decreasing it even more but the pills are so hard to cut since they are so small. Some would ask if we are sorry if we did the surgery and my reply would be no. We knew there was no cure for this and as I stated our goal was to keep it from progressing. I wish she had not been misdiagnosed for so long and maybe the scenario would be different. She is being kept VERY comfortable as of now and is a very happy dog and spoiled rotten. After a year and a half of dealing with all this I have a different attitude also. I just want her comfortable and if her life is shortened because of the prednisone then there just isn't anything we can do about it. I cheerish every day I have with her. I've had a few dogs in my adult life and have 4 of them and she is an amazing little girl. She has been through so much and she is such a trooper and such a loving dog

If anybody ever wants to e-mail me privately then go to Abbey's website and there is a link to do so there. I unfortunately just don't have the time to come in here like I used to but I will always have a connection to CT as this site helped me figure out what was wrong with Abbey.

To all that helped me a year and a half ago I will never forget you.

Linda Muchin

http://abbeygeorgelinda.blogspot.com/

Pat
12th August 2010, 02:22 PM
Linda,

I haven't yet posted all of my notes from Dr. Shores' session, but I will try to do that this weekend. These notes came from his continuing education session at the AVMA convention in Atlanta on August 1, so the info is current. Dr. Dewey also had a session at this convention.

An important reason that I was waiting to post is because I knew that Abbey was the one dog that he thought should have a second surgery. He discussed her case (using no names of course) during the session, and I recognized her from his description. We talked privately afterward. I wanted to be careful about what I posted until I contacted you, but you've replied here quite candidly so this isn't an issue anymore.

Best wishes to you, Abbey and your family,

Pat