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View Full Version : Scary/Bizarre problem. Sudden attacks of pain or terror!?!



Gatsbys Dad
2nd November 2010, 04:04 PM
Hi everyone: so for about five days now my little Gatsby has been having the most bizarre and scary problem.

It all started when we came home late from a Halloween party on Friday night. I took Gatsby out to do his last business for the night. Then I told him he was going to get a cookie, and he excitedly raced back into the kitchen, where my wife proceeded to get him said cookie. However, right at that moment, as we were both standing over him in the kitchen, he suddenly freaked out, started mewling/howling as if in pain or terrified, and raced away towards his little safe area by the window, where he proceeded to sit and continue barking/howling while my wife tried to soothe him. It lasted about 30 seconds.

We figured that night he must have heard a racoon or something (we live out in rural Maine) and been spooked. However, the next day it happened AGAIN three times: twice while in the kitchen, once while out walking. Two of these times the howling was accompanied by urinating himself...and Gatsby NEVER has accidents.

We thought he might be having seizures, so we raced him to the animal hospital after the third attack. The vet did a full checkup and he seemed fine: good vitals, decent bloodwork (on the slight borderline of anemic), no fever, no sign of pain or distress in joints, etc. The doc said it sounded like it might be seizures, and said if they continue it might call for an MRI or CT Scan. She gave us some liquid diazepam in case he had a long attack, but as we were leaving, walking Gatsby out on his leash, he suddenly had ANOTHER attack, he bolted away from us, into the back room of the vets office, where he proceeded to cower and howl while my wife soothed him. I'm glad the Vet got to see this, because she said then it DiD NOT look like a seizure. The nurse said it looked like he was feeling sharp sudden pain and trying to get away from it, as though it were a pinched nerve or perhaps a back injury.
They did another exam right there: however, they could not produce any pain reaction no matter how much they poked and prodded. We walked him around on the leash to try to recreate it (he's a puller, and I thought maybe his neck when he strains on the leash...?), but nothing. She said it was possible it was a pinched nerve or back injury, and she sent us home with antiinflammatories and told us to observe him, restrict his exercise, and take him for a recheck with our regular vet.

Home that night, we started him on the anti-inflammatories. We set up the air mattress in the living room so we could all camp out together and so he wouldn't want to come jump up in the big bed to sleep with us. For the next two days, we kept a close eye on him, kept walks to a minimum, and tried to keep him from getting excited. We had two days with no attacks, and began to think maybe the AI drugs and limited exercise were working.

Then, this morning, after his morning walk in which he was getting a bit excitable (trying to coax me to run with him, etc.), I brought him in, gave him his breakfast, and he began happily muching. I noticed he kept looking back while he was eating, and thought maybe noise from the baseboard heat was distracting him. I left him in the kitchen and a minute or so later I heard him RUNNING toward the living room! He bolted in, started barking and howling, and knocked over everything in his path on his way to get to his safe spot by the window, where he proceeded to do his barking/howling routine again. This one was shorter, and he didn't wet himself. But still, very scary!

He's snoozing/snoring away right now on the air-mattress, and for the life of me I have NO IDEA what's going on. If it's a pinched nerve or back injury causing him pain, why is there no rhyme or reason to the attacks? Why can't we recreate/locate the pain? If it's some kind of fear response, what in the world could be causing it? Or could it be some kind of seizure?

Any thoughts, advice, similar experience?

Scared, worried, and confused...
:confused:

-Dan in Maine

Karlin
2nd November 2010, 06:43 PM
I can imagine how distressing all this is. It is indeed disturbing to watch and must be very frustrating too.

I don't have any definite answers, but given the experience of many of us here, I think you may want to go read some background information on a neurological problem in the breed that is sadly quite common, called syringomyelia. A lot of vets don't really know anything about it. A neurologist will. It can cause severe and sudden pain and what you describe is the kind of behaviour people sometimes see, though there could be other causes. I would definitely try to see a neurologist though to at least get a clinical exam and see if you need to do further testing, which generally involves an MRI.

There's lots of information here on the site as well as an SM forum within the site. Also you can get information at:

My site: www.smcavalier.com
Cavalier Health: www.cavalierhealth.org, including lists of neurologists in the US
Neurologist Clare Rusbridge's SM FAQ: http://www.veterinary-neurologist.co.uk/faq.htm

Some current estimates are that at least 50% of cavaliers eventually get SM though not all are symptomatic. Two of my five are confirmed with SM by MRI and I suspect a third also has it (the only dog I have not MRId). There are documents you can download on all the sites above -- I have done a symptoms sheet and also have Clare Rusbridge's intro to SM and her treatment diagram. Clare's documents are on the other sites too.

Gatsbys Dad
2nd November 2010, 08:08 PM
oh no. This is terrifying. Thank you for the tips. I will definitely mention SM to my vet.
:(:(:(:(

Karlin
2nd November 2010, 08:42 PM
There are lots of us here with dogs with this condition, which can range from mild to severe. There are various alternatives to managing it ranging from surgery to medications -- the main thing being getting rid of the pain. There are also many scenarios for dogs diagnosed with SM, on a long scale. I have a 7 year old dog diagnosed at one who leads a pretty normal life, and two others who are so mild they are not on medications -- but there can be very serious cases too. We have people here with all types of cavaliers dealing with all degrees of SM. The best thing is to get a correct diagnosis and as this episode is baffling your vet too, and your vet hasn't heard of SM in the breed most likely, it is good to let them know and then proceed from there, so that at least it can be considered as an explanation. You could find it is something like slipped disk, but this too can only be accurately diagnosed (and SM eliminated) by MRI.

You could ask your vet to have a look at Clare's treatment diagram and get him onto one of the painkillers that addresses this condition well, if he continues to have painful sessions.

If your vet is suggesting an MRI anyway I think this is the direction I would go for, but do it with a neurologist familiar with the condition. Hopefully it is a disk problem that can be resolved, but the kind of reaction he had is unfortunately familiar to many of us with SM dogs, where they have startling episodes of pain. My most affected dog Leo had a similar session while we were on holiday during the summer and defecated all over himself and howled with pain. We think it was triggered after he fell off a bed during a period of weather that seemed to really bother many SM dogs (hot summer weather, but also rainy.changeable weather seems to affect them probably because of changes in air pressure). I think he hit the area where his syrinx is (fluid pockets in the spine). He has been fine since after some heavy painkillers at the time and there's been no repeat in the last 4 months.

Reptigirl
2nd November 2010, 10:46 PM
My puppy was having similar terrifying "nervous" moments. Where out of no where he would become terrified of everything (even things that were not there), sometimes he would yelp or whine (even bark at things that were not there) and then run and hide. An MRI showed he had CM (malformed skull). Ever since he started the medication for neurological pain he has not had a single episode of "fear". If it continues I would mention to the vet about CM/SM. My pup had seen 3 different vets and none of them had any idea of SM/CM and it wasn't until I put up a big fight with my latest vet that I was able to get the referral to get the MRI. It's like I have a different puppy now :razz:

Best of luck!

Gatsbys Dad
3rd November 2010, 05:26 PM
So, the vet was able to locate Gatsby's pain, making him yelp with pressure on his lower back/lumbar region. X-rays confirmed flattened discs toward the base of his back and to his tail, two or three. He indicated that Gatsby shows no neurological distress.

He thinks this is almost definitely the cause of Gatsby's pain. Gatsby exhibited no pain the head or neck region no matter the manipulation. He has been prescribe muscle relaxers and anti inflammatories.

I pray to God this is truly the cause. Never has a bad x-ray been such a relief.

Karlin
3rd November 2010, 07:10 PM
I know what you mean about the xray; as hard as it is to know theres something there causing pain. Hopefully this will resolve the problem. But please be sure to tell your vet that actually he cannot tell much about neurological pain or SM just by pressing the spine and looking for pain in this way. Also vets do not have the neurological qualifications to be able to do anything more than the most basic tests -- and they routinely mis-ascribe neurological pain to being caused by disk pain or allergies or ear infections, with SM. A neurologist can tell considerably more from a basic clinical set of tests than any vet can just as a cardiologist can about heart disease with dogs. It is the difference between going to your GP with a condition as serious as SM or leukemia, vs going to a specialist. A GP -- the same role as a vet -- has nothing but the most basic training in these specialist areas and generally is not qualified to make a proper diagnosis and will miss things a specialist will pick up immediately, or know how to properly test for and interpret. Even radiologists miss SM and CM as it is a neurologist's specialty condition and radiologists wouldn't have the specific training. Even I have correctly identified CM and cerebellar herniation missed by radiologists simply because I've seen so many digital MRIs at this point! I only have a cursory ability to read an MRI, but I know what to look for in comparison to many radiologists who may never have seen this condition before in a dog.

If I were in your position and the short term rest and treatment doesn't improve his back, then I would opt for an MRI. Not only will it far more accurately enable a neurologist or vet to see what is actually happening with those disks, but it will show whether there is SM and PSOM. In particular I would not consider any surgery for his spine without an MRI with a neurologist who knows SM. A lot of unnecessary spinal surgeries are done on dogs who actually need medication for CM/SM.

On the other hand: I have a dog who at 9.5 scanned clear for SM and with only very mild CM who did have two bouts of disk pain which while not as extreme as what you have experienced, was resolved with rest and anti-inflammatories and she has had no problems since. So it is quite possible you are dealing only with disk issues as the breed is also prone to those.

Hopefully the treatments will immediately bring some relief for him and then it will be a waiting game to see how he does. The very best of luck with his treatment! :flwr:

Karlin
3rd November 2010, 07:13 PM
PS I would definitely put him on a harness, ideally a front clip no=pull harness like the Sense-ible or Easy Walk harness (available online). That neck pulling is bad for the trachea ad spine and some neurologists feel it can worsen or even cause syrinxes (SM) in a dog prone to the condition. A front clip harness will make it 100% easier and more pleasant to walk him, too. :thmbsup:

Love my Cavaliers
3rd November 2010, 08:21 PM
Just to throw a wrinkle into your vet's diagnosis - Oliver has had years of disc problems. He never had screaming bouts like Gatsby, but he would have days in which he would retreat to his "safe" space which was a large crate in which all four of my dogs can fit and he would not move for days. I would have to pick him up and carry him outside to pee and poop. X-rays confirmed disc problems near his hips. He was always treated with anti-inflammatories and sometimes with steroids. At the end of last year his pain cycle lasted so long and no medication was helping, that I opted for an MRI. The neurologist told me that his discs near his hips are problematic but his cervical discs (in his neck) were really bad and were definitely the cause of his pain and had been for years. No vet had ever been able to elicit pain reactions in his neck. He had ventral slot decompression by the neurologist right after Christmas last year and within two days he was like a new dog.

I guess my take-home message is similar to Karlin's. If Gatsby doesn't respond to a period of rest and anti-inflammatories I would go right for the MRI instead of wasting time . I feel like I put Oliver through years of unnecessary pain because I didn't know what to do about his pain. Or even if Gatsby responds to the meds and rest, but it recurs soon, I would go right for the MRI. Better to know what you're dealing with sooner than later. A bonus was that at 9 years of age, Oliver scanned clear for SM. I have another dog who is severely affected by SM so that was truly a Christmas gift for me.

Gatsbys Dad
3rd November 2010, 09:37 PM
Thank you all for your kind words and caution. I am not 100 percent convinced, but I am willing to see if Gatsby responds to this treatment. The Metacam and muscle relaxers seem to be improving Gatsby's situation. The hardest thing right now is keeping him resting: of course, he wants to play and make trouble as usual. After four episodes in 24 hours, since starting the metacam and now adding the relaxers he has only had a single episode in 4 days. We do have Pet Plan, so I am ready and willing to get the MRI/neurology consult if the situation doesn't resolve itself, but I will need a referral for that. I doubt the vet would give me much of a fight if I insisted...it's my money, after all.

So, rest assured I will be keeping a close eye on my boy and reevaluating things in a week or so.