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RodRussell
18th November 2010, 05:02 PM
Read the new article in cavalierhealth.org about cerebellar infarcts -- brain strokes -- in the cavalier King Charles spaniel at http://www.cavalierhealth.org/cerebellar_infarcts.htm

Karlin
19th November 2010, 12:09 AM
Thanks for that -- very useful addition to the site. :thmbsup:

Pat
19th November 2010, 12:42 AM
Rod, I read the article and I have many questions.

In the past 15 years, I have had four (of twelve) Cavaliers experience seven (multiple episodes for several dogs) separate vestibular episodes. Most of these were more severe than the description of the cerebellar infarcts. In all cases, the dramatic symptoms completely resolved within several days to several weeks. One dog was left with a very slight head tilt. The symptoms were classic vestibular, and the vets did not seem uncertain about the diagnosis. There was no treatment given other than supportive care (meclizine, etc). (Early on we used steroids but the side effects from steroids actually made things worse so I stopped doing that.) My understanding was that the direction of the nystagmus made the diagnosis certain.

From what I've read in the article you've posted, I should have rushed all of these dogs two hours away for a $2,000 MRI plus a lot of other tests. Is that your take away from the article? I just can't see myself doing this after my long experience with vestibular.

Thoughts?

Pat

RodRussell
19th November 2010, 03:20 PM
...From what I've read in the article you've posted, I should have rushed all of these dogs two hours away for a $2,000 MRI plus a lot of other tests. Is that your take away from the article? I just can't see myself doing this after my long experience with vestibular.

Thoughts?

Other than the MRI, that may appear to be the "take", yes. But remember, neurologists are the people who write the articles recommending how to treat these disorders. The drafter of the cavalierhealth.org article does not make this stuff up.

The facts are that most of the statistics of infarcts are from MRIs of alive cavaliers for CM/SM exams, with the discovery of past infarction events being spin-offs of the CM/SM reviews of the MRIs. Infarcts leave evidence -- wedge-shaped areas of dead brain matter -- which subsequent MRIs can pick up. So, obviously these dogs had survived the infarction events.

The advice about emergency care would apply to the possibility that the event you witness could be a major one which could cause serious damage if not treated promptly. Brain swelling is a major issue, and early treatment could eliminate that and the consequences of it.

The statement that only an MRI can accurately diagnose an infarct is just a fact, just as it is for diagnosing CM/SM. So in the absence of a hurry-up MRI for a dog with symptoms -- and I don't know what effect anesthesia would have on a dog having the symptoms -- the vets probably should be aware of the breed's predisposition for infarcts when deciding how to diagnose the cause of the symptoms.

I think a key clue, at least to knowledgeable examining vets, is that some of the symptoms tend to mimic those of paradoxical vestibular syndrome. If those symptoms appear in a cavalier, the vet may suspect -- or even assume -- an infarct as the cause and treat the dog that way. I don't know enough yet about vestibular dysfunction treatment to know if these disorders are treated similarly. If so, then treatment options would be less problematic. All we are talking about intially is administering mannitol intervenously.