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jessie22
19th April 2011, 06:26 AM
Hello all,
I have a 2 year old tri-color girl named, Ruby. We have been to 2 vets in the last 2 weeks, and they are stumped. I'm hoping my Cavalier friends may be able to help or throw ideas at me.
It started a little over 2 weekends ago. I went to wash Ruby's face (right under the eyes) as I do every morning. When I wiped the left side she pulled away and yelped. So, the area that bothered her is right on the little slope of her nose, under her eye where it curves into a little crease. As the next 2 days passed, I noticed when she'd "wash" her own little face after meal times (this is the nose dive onto the carpet, once on each side!--sure you've seen it!) she'd yelp when she did the left side.
Went to the vet. They trimmed her hair there and everything looked great, no sign of trauma. Ears: looked great. Eyes: looked great. They sent me home and said nothing to worry about, probably a scratch or something. I didn't like this, she doesn'e yelp and not let me touch her face for no reason!
One week later, new vet. (symptoms getting worse, won't let me touch her face.) Vet is "stumped". Says it may be a tooth root abcess and gives her antibiotics and Rimadyl for pain. I'm supposed to call in a week if she doesnt improve. Then, they want to move onto an x-ray/dental appt. Well, that was 3 days ago. I have seen her do something quite scary twice today. She looks panicked out of nowhere, yelps, paws at her eye and them runs off yelping all while sliding her little eye area on what ever is availible.
This is not her neck/shoulders. It's a precise area right under her eye, when I push, I feel tooth roots/upper jaw. She HATES if I even slightly brush that area with my finger to get her (usual) eye discharge. I mean, if I BREATHE on that area she yelps.

Any ideas? It's breaking my heart that her pain is seemingly worse, and the vets says she looks "great"!
--Thanks everybody!

Jessie and Ruby

Oh: I should tell you, she eats and plays as though nothing is wrong. Though, on our walk this afternoon, she did paw at her eye, cry and then kept on going...
Also, are there some kind of plants that burrow into the skin making it hard to diagnose? A friend of mine mentioned "foxtail grass"...

Blondiemonster
19th April 2011, 07:45 AM
Wish i could help.. All i can think of is an abcess.. A nerve? but theres some really experienced people here im sure can help!! Poor little baby of yours....

GraciesMom
19th April 2011, 04:54 PM
May need one to get this diagnosed if your other vets are not finding it. They should be able to tell if there is an abcess I would think. Poor girl... I hope she is better soon.

Soushiruiuma
19th April 2011, 05:33 PM
I would ask the vet to do x-rays, etc now, rather than wait. This sounds very painful, I would want to know what's going on ASAP.

jessie22
19th April 2011, 07:14 PM
Thanks everyone!
I'm calling her vet today, it certainly has gotten worse. I hope all of you don't think I've been cruel in waiting it out a little while. I've just been trying to trust the "experts"! (though, I almost don't think they know as much as we all do sometimes...)
Thank you very much for your ideas, I was beginning to do what I'm sure we all have done and think SM, but as it is only under her little eye, I have my doubts.
Also, I wanted to add, her eye looks clear and white, and her mouh smells normal. One more question: would it smell necessarily if there were an abcess? She LOVES chewing sticks, and I can imagine slivers, wood particles ect being caught up there...
I'll be definitley letting you all know what I find out soon! I hope this finds all of you and your doggies well. :)
--Jessie and Ruby too

Furrfoot
19th April 2011, 08:16 PM
I hope they find something simple to fix and she's feeling better soon!

GraciesMom
19th April 2011, 08:31 PM
We want to make sure it all works out okay.

Nicki
19th April 2011, 09:27 PM
Hmm bit of a mystery but I think I would rule out dental causes first, so would go ahead with an x-ray/dental appt.

It's hard when the vets don't really know the answer, do you have any dental specialists in your practice or local area?

I think it's unlikely to be SM, it's too specific an area. Wondering if it is something like a cracked tooth? That can be very painful.

The only other thing that occurs to me is the early stages of masticatory muscle myositis but you don't mention any problems with opening her mouth?

Please let us know when you have any more news - thinking of you both.

Tania
19th April 2011, 10:05 PM
She LOVES chewing sticks, and I can imagine slivers, wood particles ect being caught up there...



Have you mentioned to the vet Ruby chews sticks? It could be a stick has splintered and a fragment is embedded in her mouth.

Poor little girl, I hope she is sorted out soon.

jessie22
20th April 2011, 02:01 AM
Hello again,
Ruby is going to the vet tomorrow for dental x-rays.The vet thought it shouldn't wait any longer. (thak goodness!) Please pray/think good thoughts for us. I'm sure I'll be a little nervous wreck here at work while waiting for results! Thanks again everyone for your imput! :)
--Jessie and Ruby

Tania: Oh yes, the vet does know she likes her sticks, I made sure to reitterate that today on the phone! ...I'm also flashing back to the days not too long ago when I'd catch her with rocks, coins, the metal clip on her leash. -Ugh, she'd chew on everything! (I stopped it when I saw it, but who knows, maybe she damaged herself back then.)

mommytoClaire
20th April 2011, 03:46 AM
I'm just catching this thread, just wanted you to know I'm thinking of you both, and sending a prayer on her behalf! Hoping it's something simple, and that you'll have answers after tomorrow.

Cindy and Claire

jessie22
20th April 2011, 11:35 PM
Hi all,
Well, Ruby went in this morning for dental x-rays, skull x-rays and a full dental cleaning.
I was feeling pretty good the vet would find something. I got a call about an hour ago from the vet who said "her teeth and roots look great, just a tiny bit of plaque." They found nothing out of the ordinary, and are still not sure what it is. :( I'm so sad. I want her to be better. The last few days, she'll be laying down or even walking and will stop, curve into a funny U-shape (almost looking at her rear end) and start pawing her eye. It started 2 weeks ago just being sensitive to touch and I've seen it really quickly progress to this. (last 48 hours)
I asked the vet if he had any ideas and we came back to "possible trauma, like a bruise or nerve damage." He said he in no way thought it was neurological as she seems just fine except for that one little area under her eye. He is putting her on a different pain medicine, one they typically use for nerve-pain. It starts with "G", but I don't have it (or her) with me yet, so I don't know the name.
I'm heartsick and frankly, not relieved one bit at all. Do any of you think I should be freaking out, or keep going with the wait and see game. It's been two weeks...
Also, as much as I hate typing this: do SM dogs ever only have one sore spot under the eye and act normal everywhere else? I massage her neck, shoulders and she never yelps. Also, I can hold her by the chin and move her head all the way up to look at the celing with no complaint.
My vet doesn't think I need a neurologist one bit. Do any of you? This is killing me.
Thanks again,
Jessie

Also, if any of you have friends with SM dogs, could you ask them or pass this along to them? (if you think it looks like I should be worried about it.) Thank you!

Blondiemonster
21st April 2011, 02:58 AM
Is it possible the medicine he gave you is Gabapentin? They give it to dogs with SM for nerve pain too. So either way, she should feel better if it's nerve pain.
SM usually doesn't come on so suddenly however: it can. My girl had an acute "attack" of SM , where she went from healthy to completely freaking out on leash. (airguitar so she had to sit down on leach and couldnt walk) However, that went away and it hasn't come back that way, though now we are aware what she has as she has some other symptoms.

If there is really only one point under her eye that hurts it seems unlikely to me that it is SM. U should at least see some other symptoms. I massage my girls neck too and she can look up to the ceiling, however she has a massive syrinx so I don't think you can exclude SM that way. But if u don't see any other symptoms like scratching, shaking head, yelping when picked up, air guitar, etc.. I think its unlikely you are dealing with SM though i'd certainly keep an eye on it cause it is not impossible... It's very hard by a regular vet to diagnose, so I'm not surprised your regular vet doesn't think you need a neuro. If u want peace of mind I'd say go see a neuro and spend the 150 on a clinical exam that will right away tell you if there is a neurological problem, SM or anything else neuro related. An opthalmologist is another way to go.

anniemac
21st April 2011, 03:16 AM
I am so sorry. It must be frustrating to not know. I really don't think its sm because like nicki said it seems like a pretty specific area. I would hate to jump to that conclusion without any other symptoms. An opthamologist might be where to go? Maybe others will have ideas. I'm so sorry

Sent from my Droid using Tapatalk

mommytoClaire
21st April 2011, 03:18 AM
I was thinking the same thing as Blondie's mom, maybe an ophthalmologist is the way to go, just to rule out anything with the eye. I'm not sure where you live, but here where I live, I know my initial consult with one (Michigan, USA) was about $160 (not for Claire, but my other dog), and was well worth it.

Hugs,

Cindy and Claire

SuzRN
21st April 2011, 03:54 AM
Definatly an opthomologist, rule out anything from a scratch to glaucoma. Good luck hope she feels better soon.

lovecavaliers
21st April 2011, 03:56 AM
Just reading this now, my heart goes out to you and Ruby. I can imagine how frustrated you must be. I agree with the others. I would go on my own and get a neurology exam and/or opthalmology exam just for peace of mind. It will be well worth it. I know for people there is a speciality in neuro-ophthalmology, wonder if such exists for animals?
Thinking of you both and let us know what happens.

jessie22
21st April 2011, 09:30 PM
Hi friends,
I'd hug you all if I could. :) It means so much to have you all to help me out and send well-wishes.
I've called a neurologist and an opthomologist. The neurologist said I could come in for an evaluation, but as many of you've said it doesn't sound too likely to be SM. So, my first plan of attack is the eye specialist tomorrow morning. Let's hope they can figure it out! I've read they are the best and most kind in the area.
Until then, it's tramadol and rimadyl and a poor girl who keeps rubbing her eye even when drugged. I'll tell you all what happens tomorrow morning.
Hope you are all having a good day!
much love,
Jessie and Ruby

Brian M
21st April 2011, 09:48 PM
Hi

And best wishes to you both for tomorrow and we will all look out for your GOOD
news .:)

Furrfoot
22nd April 2011, 05:25 AM
I hope she's feeling better soon- how frustrating! Hopefully, it's something simple and she'll be much improved very soon.

jessie22
22nd April 2011, 07:54 PM
Hi friends,
My heat is breaking as I write this. Please forgive any speeling errors, I can barely see through my tears.
The opthamologist did a thorough exam this morning and her eyes were "perfect". He also has had 2 Cavaliers. Each had SM. One had similar symptoms as Ruby. I'm being sent to the neurologist right away in just 2 hours. Here we go. I'm so so sad. Will I need to put her down? I cannot afford surgery. I'm afraid I won't be able to afford medicine if it's very exspensive.
She had an episode of pain in the waiting area as I was getting my bill. The desk girl had to give me tissues and hug me. How many Cavvies are put down immediatley? She is only just turned 2, so is this really a bad sign. She is a puppy mill rescue and also was diagnosed with severe hip displasia at 7 months old. She's been through so much pain and hardship. Please, if you have expirience, set me straight on this. I don't want my baby to live a life of pain just so I can love her longer, it seems selfish.
Thank you all, I'm so glad I have all of you for kind words and support.
--Jessie and Ruby

Kate H
22nd April 2011, 09:29 PM
Dear Jessie

SM is NOT a death sentence. You have done absolutely the right thing by taking Ruby to a neurologist, who will be able to advise you about MRI scanning Ruby to find out the extent of the problem, and then set up a regimen of pain prevention, frusemide or similar to reduce fluid in the brain (and this can sometimes prevent a syrinx getting bigger), or a mix of the different types of drugs available. At 2 years old, Ruby may well be a good candidate for decompression surgery. You will find a wealth of experience and support on this forum, and many of us have Cavaliers with SM who live more or less normal lives.

At the moment you are - very understandably - in shock, but Ruby needs you to fight on her behalf. SM is a terrible disease, but there is a lot that can be done to help dogs who have it. I do hope you have pet insurance, though!

With hugs from Kate:hug: and love and wags to Ruby from Oliver (with SM) and Aled

Love my Cavaliers
22nd April 2011, 10:09 PM
Jessie - My Riley is almost 9 years old and has had SM since before we got her at 11 months old. She had decompression surgery and is doing really well. She still needs medication even after surgery, but she is my miracle girl. Like Kate said, SM is not necessarily a death sentence. Most times it can be managed very well with medication although it may take a while to find the right cocktail of drugs and dosages for Ruby. Surgery is also an option. It was the right option for Riley. Pease let us know what the neurologisist says.

Your heart is understandably breaking right now. SM is so much to take in. It is a life sentence. But please don't imagine the worst case scenario right off the bat without knowing all the facts. It's just so hard to look into those beautiful eyes and think of them being in so much pain. You are doing everything you can for her right now. Soon you will have a diagnosis and can make some plans about how to proceed. Right now, remember to breathe. Hugs.

Tania
22nd April 2011, 10:16 PM
I am so sorry you are going through this. As Kate has stated, being diagnosed with sm is not a death sentence.

My Molly also has hip dysplasia. She was diagnosed with sm at 18 months. I was devastated, I had not found this forum at this stage and I felt terribly desperate. Molly's neurologist at that time told me she would not make her second birthday.

Molly has been given the appropriate drugs and has lived the last two years without too many problems in fact her scans have shown she has stabilised.
Molly will be celebrating her fourth birthday next month.

We are all here to help and support you. You have to try and be strong for Ruby as she will sense your distress.

We send you both lots of gentle hugs.

lovecavaliers
22nd April 2011, 11:48 PM
Will I need to put her down? I cannot afford surgery. I'm afraid I won't be able to afford medicine if it's very exspensive. --Jessie and Ruby

I am so sorry you and Ruby are going through this. As the others said CM/SM is not a death sentence. Please know that many dogs have done well for years on the less expensive meds i.e. gabapentin (in the US you can get a 3 month supply at CVS for ~$20 give or take) and drugs like omeprazole (a csf reducer) can be purchased as human prilosec and cut to appropriate dose. While only your neurologist can tell you what drugs are needed, please don't give up hope at this point, you still have many avenues to explore. If surgery is indeed the only option, many vets offer carecredit which allows you to spread the payments over/up to 60 months. I can only imagine how tough this all is to take in; take one step at a time.
Thinking of you and please let us know what the neurologist says.
Lots of hugs to you both.

mommytoClaire
23rd April 2011, 12:04 AM
So, the good thing is you're going to someone who can help and answer what is going on. I'm no expert on this whole thing, but even if you can't afford the MRI, it's seems others have said that their Vets have put the dog on SM meds, and if it gave relief, then they were on the right track.

There are several here who have been in your shoes, so just know they will be here for you and help you through and give you support on all the details, IF this is what is going on with Ruby.

I'm praying that you'll get answers very, very soon. Big hugs to you both, and let us know the moment you hear anything.

Cindy and Claire

Blondiemonster
23rd April 2011, 01:22 AM
Please be strong and don't think about having to put her down! U haven't even had a proper diagnoses yet... I understand your reaction, since you are sad and confused.. When I found out I was pretty much hysterical, btw...
However,many of us here have dogs here with SM and hearing you talk about euthanasia that way actually makes me uncomfortable, since lots of us have been going through a lot with our dogs, and not for selfish reasons but simply because lots of SM dogs have great quality of life for many, many years with the right care and in the right hands. It isn't a death sentence at all.

jessie22
23rd April 2011, 05:28 PM
First to Blondiemonster, so SO sorry I offended you. That was not my intention at all. I in no way think people with SM dogs on medication are selfish. (or surgery!) I was v-e-r-y upset, and only meant that if Ruby were like a 10 on a pain scale of 1-9, I wouldn't want to keep her around for MY benefit. So please accept my appology if I offended you. I swear it was not directed at ANYONE but my case.

Here it is: (I will write it in technical terms, as I'm still trying to understand it myself, and it's all on a paper for me to copy)...

Her condition is : "Cervical spinal syrinx, mild COMS, slight protrusion of C2-C3 inetrvertebral disk."
Our fantastic/kind doctor is calling us this morning with her spinaltap results. She is concerned for Ruby as her spinal area appears "inflamed" and would like to rule out Meningitis or Myelitis.
Her new medicine regime is pretty easy (so far!) Here it is:
Codeine 15mg , 1 pill, 2 times a day (started this miorning)
Prednisone 5 mg, 1 pill, 2 times a day (starting Tuesday AFTER Rimadyl is flushed out her system, guess she doesn't like those to be mixed)
Gabapentin 100mg, 1 pill, 2 times a day. --Rats! it's a capsule, sure is harder to give to her! Any tips/pointers?
So there you have it, I woke up to her half little bald head (spinaltap= aswesome new hairdo) ;) on my pillow. When my eyes opened that 'thump-thump' of her tail made my morning. :) She has already gone out into the sunshine with her black lab brother, Otis, had her breakfast and her medicine. And you know what, for the first time in weeks, Ruby didn't mind at all that I lightly washed her face with her little wash cloth this morning. (to get her morning eye-goo) :)
Once more, PLEASE anyone else who was sad/offended by my comment(s) yesterday. Know that I NEVER meant I thought poorly of ANY of you. I was just so very freaked out, and to be honest, this week found out my step-mother has Cancer. (My Mom just died 2 years ago, so mortality is a tough subject for this girl). I hope that clears things up. Thank you all for such kind words/help this last week. You've really helped more than you know.
Very looking forward to seeing what you have to say about this,
Happy Saturday,
Jessie

P.s:
Our neurologist is an angel. An MRI, spinal tap, exam fee, ect would normally be well over $3000. Because of Ruby's breed, her good heart, and her knowing I had no pet insurance and "clearly loved this little sweetheart so much", did all of this for $700 on a loan basis where I make monthly payments. I feel so blessed to know there are some REALLY wonderful people out there. :lotsaluv:

lovecavaliers
23rd April 2011, 05:40 PM
Ruby's degree of COMS/CM/CLM sounds a lot like my Jack's who was dx'd at a little over a year and will be 3 in December. He is currently on meds and doing ok.
I am so happy to hear Ruby is wagging her tail and doing better. I know about the little rectangle spinal tap hair cut; Jack had that last summer, it grows back pretty quickly.:o
Thank heavens you found such a wonderful neurologist. It sounds like you are in very good and caring hands. I completely understand how overwhelming this all can be, I remember being in your shoes over a year ago and was a complete and total mess!
As for the gabapentin capsules, try molding pieces of american cheese slices over the capsule to make sort of a cheese ball, Jack eats them up with no problem. There is also those Greenies pill pockets which are pricey compared to the cheese but very appealing to dogs. I have heard others use cream cheese.
Keep us posted
:lotsaluv:

Blondiemonster
23rd April 2011, 05:52 PM
U sound relieved and positive! The not knowing is the hardest part. No worries i wasnt in any way offended i just felt a bit "challenged" :) sounds like your neuro knows what shes doing and that is excellent. Ruby will feel better soon. Wbat a weird thing this sm is. It comes out in the oddest ways.
Much much love from blondie and i!

GraciesMom
23rd April 2011, 05:56 PM
Any kind of news like this is earth shaking.... and you made it very clear that you were very emotional. While the news is sad, it sounds like meds are already helping sweet Ruby. It may be that another condition is going on like the vet mentioned and treating that specifically can also help your little girl. Your vet derserves a big hug for the discounted rate on the scans. wooo hooo!!! Stay positive and do not let others upset you.... I have learned that we are all emotional about our babies and sometimes means taking things the wrong way. Hang in there!! give Ruby a kissy from my Gracie.

Kate H
23rd April 2011, 09:22 PM
Hi Jessie

Your neurologist sounds a treasure! The leading UK researcher, Clare Rusbridge, has a useful page of treatment options designed to help vets dealing with SM. If your neurologist hasn't seen it, it would be worth printing it off and showing it to her - you can find it at http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

Starting an SM dog on drugs can make an amazing difference - glad you're getting the old Ruby back! Sorry that you're having to deal with your stepmother's cancer at the same time - that's really tough.

Cavaliers with SM do quite often seem to have other back problems as well - Oliver has spondylosis (osteo-arthritis of the spinal vertebrae), but after a spell of crate rest it doesn't seem to cause any problems, except that he walks with his hind legs a bit apart to balance himself. He takes his gabapentin squashed between two small slices of tasty sausage - only has to hear the tub being opened and he's queuing up (and Aled gets the sausage without the gabapentin so that he doesn't feel left out!).

Kate, Oliver and Aled

Rubysmum
23rd April 2011, 09:35 PM
just read this .im so sorry your going through this,like so many others . it sounds like you are feeling stronger now you know what your dealing with. i live in fear of MY Ruby developing symptoms , she turns 2 in august . my thoughts are with you and Ruby xx

mommytoClaire
23rd April 2011, 11:13 PM
Well, it's sounding like you have a fabulous neuro, and one who REALLY cares about the pets he treats. You are blessed!

I am so sorry to hear about your step mom, especially in light of the recent passing of your mom. Sometimes, all these things add up to a highly emotional situation, and then with the dog on top of it, I am sure you were and still are a bit overwhelmed.

It did my heart good to hear about the thump, thump thump of Ruby's tail this morning. She will be fine, and as others have mentioned, there are so many ways to control this disorder. Keep the faith!

Hugs,

Cindy and Claire

Cathy T
24th April 2011, 04:41 AM
I was so hoping to hear she simply had an eye issue that could be easily resolved. But am so relieved to hear the change of tone in your postings. You sounded so incredibly distraught (and rightfully so of course!!) but it was so nice to read your much more optimistic post following. When Shelby was diagnosed I was upset but I already pretty much knew that was what was going on, so I didn't go through quite the same range of emotions. Great that you've got a neuro who is going to work so kindly with you....that is fantastic on the price discount!! Hang in there and know that they are so many people out here with so much experience to help you and guide you. You are surrounded by caring loving people, so many who have been in your shoes to one degree or another.

mellie
24th April 2011, 08:33 AM
So glad Ruby is feeling better! I use the Greenies Pill Pockets for giving capsules to my girls Bella, and Koda. They LOVE them. When I say "lets go take your medicine" they get so excited you'd think they were addicts! :grin: I find them at PetsMart, or Petco. Most specialty pet supply stores carry them. You can also order them online from several websites.
I will keep sweet Ruby in my prayers. I dread the day I have to go through the diagnosis of SM or other painful problems. Bella has had bilateral patellas repaired... at the age of 16 months. Her hips are in terrible shape and will be replaced at some point. She is on Rimadyl for that now. She was also a rescue puppy, so I am prepared for the worse, and pray for the best. Looks like we are in the same boat! Celebrate the fact that you have wonderful veterinary care close by. We have NO neurologist, cardiologist or even an optomotrist/opthomologist in my entire state! I will have to travel to a vet school out of state to get even an MRI.
Best of luck with Ruby. Keep us updated on how she is doing! :hug:

Blondiemonster
24th April 2011, 05:38 PM
Have you had any news on the spinal tap yet??

jessie22
24th April 2011, 06:30 PM
First of all THANK YOU everyone! Wow, you are all so great! It means a lot to see all the love and support!
Her spinal tap isn't good, but isn't bad. It's confusing! So, it looks very inflamed, and they are treating her with antibiotics. Something like possible toxomytosis(?) was mentioned over the phone. Most likely sterile, not viral. does that sound right? I wish I had it written down! Also, she mentioned it's a bit like menengitis...
Oh! I read last night on Cavalierhealth.com that long term use of prednisone is not recommended. Do you know how long "long-term" is? Just want to make sure I don't hurt Ruby! Have you heard this too?
I'm expecting a call from her sweet Neurologist tomorrow, and I'm going to try and understand better her spinal results! (it was a vet tech in a hurry who called me yesterday!)
Thanks everyone!

--Jessie and Ruby

Hey! She's acting pretty good today! She did her "Breakfast Boogie" dance, and got super excited for "cheesey medicine"! She's presently snoring on my pillow as loud as a trucker... ;)

Kizzys Mum
24th April 2011, 07:20 PM
Hi, sounds like Ruby is doing better already :)
"Long term" pred use is quite a long time I believe. Our westie has GME, a form of meningitis and has been on a slowly tapering dose of pred since August 2010. It is not great to keep them on it, but it can be a real lifesaver for some dogs. I hope you get some clear answers soon and you can get started on a treatment plan :smile:

Karlin
24th April 2011, 09:42 PM
Long term with prednisone is generally anything over 2-3 months. That said it is hugely beneficial for many people and animals that have little help from other medications and the problem/foe is the disease, not the prednisone if it helps and brings relief. Your vet/neurologist will be very familiar with weighing the benefits against the risk and the goal will be to achieve a low maintenance dose. We'd all like to avoid using them but for people and animals, not all of us have that choice.

You will need to have a conversation with the neurologist about prognosis and how long Ruby can be maintained on meds like this though, just so that you have a reailstic sense of what is going on -- for early affected dogs with severe symptoms and/or a poor scan, surgery is probably the only option with any medium to long term possible prognosis and medications will be focused instead on giving a decent quality of life for as long as possible.

For some dogs this can be a full lifespan or many years. I have a 7.5 year old dog on gabapentin now for five years who has a very good quality of life (few would recognise he has any problems at all) -- but his symptoms took a long time to progress from mild to moderate and his short syrinx is very centrally positioned, which helps in terms of pain. He now has a grade 3 heart murmur and it may be that in the end it is heart disease and not SM which limits his life.

With SM, much depends on rate of progression (meds do not stop progression) and type of syrinx (eg small and narrow and central (better) or wider/lopsided (poorer). It can be very hard to make an accurate prediction. Most likely medications need to keep being adjusted as the condition progresses.

Love my Cavaliers
24th April 2011, 10:22 PM
Riley, my SM girl, has been on 5 mg prednisone daily for almost 2 and 1/2 years and she absolutely needs it. Without it, she can barely walk. So for her it is a miracle drug. She has lost some of her fur - her tail looks like a rat's tail and her belly fur is very thin, but so far that is all I notice in terms of side effects. She has her liver enzymes checked every 4 months and takes a supplement to protect her liver. So far so good. As Karlin said, every case has to be evaluated separately and prednisone is giving Riley a good quality of life.

I'm so glad Maggie has responded so quickly to her medication. I also use the Greenie's pill pockets for Riley. They are really easy to use and as soon as she sees me getting one out of the packet she acts just like Mellie said Bella and Koda act - like an addict! What a relief to finally have a diagnosis and your neurologist sounds like a dream. Keep in touch. We all need the support from each other.

GraciesMom
24th April 2011, 11:55 PM
Glad you have the results even if they are somewhat confusing at this point. Just know that you and your sweet Ruby are in my prayers. So glad she has such a lovely caring mommy

Blondiemonster
25th April 2011, 02:09 AM
Is it possible to maintain some dogs on prednisone over the course of a lifetime? Lets say 5 + years? I would be curious to know...

BrooklynMom
25th April 2011, 03:01 AM
Wow. I am just getting to read this thread the whole way through...SO many hugs to you and Ruby :hug:

It sounds like you are learning a lot along the way and have a wonderful team helping you out. I would be so distraught like you if this was happening to Brooklyn, but the more informed we all become, the more we can help our little ones. You are a special one to take in a puppy mill rescue and she was given to you for a reason...the powers the be knew that for whatever reason you can handle this, so stay strong, shower her with love (which it sounds like you are doing really well!) and stay strong.

Isnt it amazing by the way what love a wagging tail can bring. It is almost as if to say "it's gonna be alright, I love you". Nothing beats a wagging tail when our pups see us first thing in the morning. Cherish that.

Brooklyn and I are thinking of you!! :lotsaluv:

Holly
25th April 2011, 03:41 AM
Sorry to hear you are dealing with this. I have a girl with SM and she is doing great on her meds and is a very happy girl. I give her meds to her using canned "spray" cheese and she loves it. It's much cheaper than using pill pockets.

Good luck to you. How wonderful that you have such a caring neurologist.

jessie22
25th April 2011, 07:59 PM
Hi everybody,
Thanks again for all the kind words! You're the best! I have two questions for anyone who can try and answer them for me.
The first one: Is COMS the same as SM? I've tried to figure this out online and still don't quite understand. I know she has "one syrinx at the level C2-3, Chiari-like malformation"
Also, last night, before bedtime and this morning after she'd been up a little while, Ruby did the head floor/couch wipe. She yelped one little yelp. It used to be many long yelps. The one last evening was about 12 hrs after her morning med dose (she'd just taken her night-time dose) and the am episode was right after her morning dose. Maybe her med levels were low? So, I guess this is my question: Even on pain management meds, do they still sometimes do thier "episodes" a little bit?
Thanks ahead of time for taking the time and responding to me. Like I said earlier, I'd hug you all if I could! (hey! maybe take you all out for dinner at this point!)
Have a good day,
Jessie

Holly
25th April 2011, 08:05 PM
My SM girl gets her 100 mg Gabapentin three times per day- from what I understand, it lasts 8 hours in their systems. I can tell as soon as it begins to wear off and it's time for her next dose. If I am even a little off schedule, she starts up with the scratching and bunny-hopping. As long as I keep her on a regular schedule, 3/day, (sometimes 4, depending on timing) she is kept very comfortable. Perhaps you should see about giving the Gabapentin 3/day? I am not sure if you are also doing Omeprazole, but Scarlett gets that, as well (1/day, 10 mg)

lovecavaliers
26th April 2011, 01:11 AM
Hi Jessie

To better understand the terms, I would check out the website cavalierhealth.org . It seems the terms Chiari-like malformation (CM or CLM) and caudal occipital malformation syndrome (COMS) refer to the same thing. SM or syringomyelia is when there is a syrinx present usually as a result of CM/CLM/COMS. Most (not all) cavaliers have a degree of COMS/CLM/CM but not all have SM.
Please anyone correct me if I am wrong.

Karlin
26th April 2011, 01:23 AM
COMS is a term that was supposed to have been dropped but even some of the people who actually agreed to drop it at a symposium in London -- because it is inaccurate and confusing -- still use it (I was there and saw them all agree that this was a very poor term for the condition.... :rolleyes:). It basically means the whole complex from CM to SM and can include either. All the grading certs evaluate SM as the relevant factor, not CM as CM alone only rarely causes pain (but obviously any kind of pain symptom should preclude a dog from being bred anyway so this is not really an issue with the certs).

Dogs often still have symptoms on medications and medications do tend to stop working. Leo still scratches occasionally and has some sensitivity sometimes. When he looks uncomfortable at all I add in metacam each day. If a dog is still showing pain then meds probably need to be addressed but generally you need to give two weeks or so -- just a few days isn't enough to gauge if a dosage is appropriate as it can take time to work. Gabapentin more than 8 hours apart generally does not seem to work for dogs with a lot of symptoms for the gap after 8 hours and until the next dose.


Is it possible to maintain some dogs on prednisone over the course of a lifetime? Lets say 5 + years? I would be curious to know...

Yes -- lots of people take it for a decade or more, so dogs can manage a much shorter time span, but there's always the risk of side effects over time. A lot depends on the individual (whether people, dogs, cats etc) and the dose level. The lower the dose, the better. Often it can eventually be given on alternate days once the dose is tapered down to the lowest possible. It is in some ways (and was at first believed to be) a miracle drug -- it can literally make crippling pain totally vanish within hours -- but unfortunately has potential side effects over time (not everyone gets side effects and you can do things to mitigate them with supplements, diet etc).

Karlin
26th April 2011, 01:28 AM
You can read the minutes of the discussion on using the term CM/SM rather than COMS or other options here:

http://sm.cavaliertalk.com/research/london/london/minutes.html

The relevant bit relating to COMS:


Occipital hypoplasia and Caudal occipital Malformation Syndrome (COMS) -
These terms were rejected because there is no proof yet that the condition is related to
either a malformed or hypoplastic occipital bone(s). Current evidence suggests that
there may be other significant factors in the pathogenesis. In addition these terms can
be confusing as for example the term COMS may imply the malformation only or the
malformation and syringomyelia.

The majority vote was for the term Chiari-like malformation and syringomyelia
(CM/SM) to be adopted (at the current time). This term was perceived to have the
following advantages.

1. Chiari malformation is accepted for the description of the disease in the human
species and is the most commonly used term in scientific publications.
2. Chiari-like malformation refers to the complex syndrome seen in the human
species however the “like” implies some differences in the canine.
3. The term can be easily abbreviated to CM/SM– having a simple acronym is
especially important to dog breeders and owners.
4. The term Chiari-like malformation (CM) can be used to distinguish dogs that
do not have syringomyelia

Chiari-like malformation (CM) is currently defined as decreased caudal fossa
volume with caudal descent of the cerebellum, and often the brainstem, into or though
the foramen magnum.

Syringomyelia (SM) is currently defined as a condition that results in the
development of fluid-containing cavities within the parenchyma of the spinal cord as
a consequence of abnormal cerebrospinal fluid movement.

Holly
26th April 2011, 03:40 AM
Also, if she is having a bad night (it seems worse at night or when it is bad weather coming in), I give her Tramadol. I can gauge how she is doing just by watching her-- when she is having a rough time, you can just see it in her eyes, and she pants, fly catches, and digs at her bedding. Thankfully, it is rare for that to happen.