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View Full Version : General Question - Pain Control or Surgery- How to Decide Answer Please .



Brian M
17th September 2010, 09:46 AM
Hello

Fortunately this is a question I do not have to answer or face but how a person would arrive at their own decision to a question of this nature I do not know .When reading the far too many posts regarding our Cavaliers and that horrible curse of SM how do some of our unfortunate owners decide to go down the path of surgery rather than pain management by drugs .If anything should happen to any of my girls in the future I honestly don't think I could ever decide to put any of them through surgery and does it seem more of an option in the US rather than here, and what are the success ratios of improvement if one opts for this rather than control by drugs .Have many Cavaliers in the UK had surgery for SM and what has been the success rate or improvement in quality of life. ?

Sorry to have come up with a gloomy question like this it is rather unlike me as my attitude to most things is to decide and tackle as and when problems develop rather than worry over things that may never happen ,but when I read stories of people and dogs that have chosen surgery I often wonder why and how .

Jane P
17th September 2010, 10:23 AM
Hi Brian.

I had to make this decision recently with Dylan as he has not responded that well to medical management. Clare Rusbridge is very understanding and explains exactly what the surgery would involve and the likely outcome but does not push you to choose this option. For the time being I have decided against surgery because in many cases the symptoms are only relieved temporarily and the dogs deteriorate again within two years and sometimes in just two months. Also surgery does not always improve the syrinx and the dog has to remain on the same medication post operatively. I found it fairly easy to make this decision but I think it is approached differently in the US.

anniemac
17th September 2010, 02:37 PM
Well Brian, thanks for bringing this one up since I am deciding on doing a second surgery. :lpy: I think that surgery is not a cure and how my neurologist stated it should be a last resort after all avenues are taken. He felt that it is a lot to put a dog through but what do you do when they are progressing fast and are medication is not helping. I had a feeling that Ella did not have time to play around with medication to see what would help. Watching her go downhill and knowing that if I at least did not try to do something, killed me. I would point out that Ella is very different. Just the fact that the size has almost doubled and she has continued on multiple medications is tought.

I have always believed that surgery is not a cure and to hear some of the neurologists comment about how many do not ever need medication alarms me. My friend went see Dr. Shores and she told me he recommended surgery if a dog has a syrinx .3 or larger. I don't think you can make a statement like this because there are so many other things to consider. I am thankful you do not have to and I am very thankful that you are trying to understand the hard thing that we have to go through. cl*p

I decided it would give her relief and time to figure out which medication will help. I prayed that she would not end up where she is now, but many don't. That is a risk you take. Do I feel bad for putting her through that. No. If you could see the difference in her eyes after the surgery, you would understand.

I would like clarification on deteriation. Is that as a result from the surgery? If they would have been on medication this would not happen? Now I am so confused. I know the scar tissue could cause future problems etc. but I would really want to know if this is just because overall surgery is not a cure or is it something that causes more problems.

:sl*p: Please someone PM me or something because now I am really upset and I don't know what to do.

Brian M
17th September 2010, 03:03 PM
Hello Annie

Just sent pm:(

Love my Cavaliers
17th September 2010, 04:55 PM
Ah Brian, that indeed is the million dollar question. My first response has always been that Riley's case has been clear cut - two different neurologists looked at her MRI and said that her best chance of a longer and better quality of life was to have the surgery, so I opted for the surgery. Seeing her now running and loving life, I am very happy that I did it. But, if another owner had Riley and loved her as much as I do, they may not have had the financial means to do the surgery, they may not have had the heart to put her through the surgery, there may have been many other extenuating circumstances that I can't think of that made them decide to opt for the medication route rather than surgery. And I couldn't fault them for their decision at all because they made an informed decision with Riley's best interest at heart and one that they felt was the right one for them.There is never any right or wrong decision in the SM world - it is just what is the best one for you and your dog and only you can make that decision once you have the best and most complete information with which to make that decision.

Margaret C
18th September 2010, 10:37 AM
Five years ago I took two dogs to have a scan through the low cost breeders scheme & found that I had two dogs with SM.
One was seven years old & had no symptoms whatsoever, the other was five and very occasionally would give a little yelp for no reason.

At that time there was the suggestion that surgery for younger dogs with very mild symptoms would prevent more nerve damage and offer the best chance of a pain free life.

For a variety of reasons I decided not to go the surgery route, knowing that in 6 months time I could be faced with a rapidly deteriorating situation and would have to face the fact I made the wrong choice for Tom.

Was I right? Well, there was no rapid worsening of symptoms but I still cannot know for sure.
Tommy is still with me, on gabapentin & metacam, symptoms sort of controlled, but I think he is quite uncomfortable sometimes. He looks and acts older than his ten years.

Would he now be better or worse if he had had decompression surgery all those years ago?

There are no answers to some questions. As has been already said, all you can do is make the best decision you can with the information you have been given, and then cross your fingers and start praying.

Sandrac
18th September 2010, 11:18 AM
There are no answers to some questions. As has been already said, all you can do is make the best decision you can with the information you have been given, and then cross your fingers and start praying.

I so agree with this, I may well be in the situation with Minnie at some time in the future.

I sincerely hope that with all the different surgeries that seem to be taking place and a better history of the outcomes together with the continued research into the condition that the decisions may become easier for us.

This does not really help anyone faced with currently making that decision, but whatever anyone decides it is so great that we have the experience and support of everyone here, especially those that have gone down the surgery route.:)