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BrooklynMom
5th June 2011, 03:43 AM
Hi all,
So, I already have the vet on top of this little mystery I am going to explain, but I am hoping maybe you guys have some thoughts too (or maybe even a suggestion if it sounds familiar).

So...after Brooklyn was spayed, and we took the cone off, she began to (way more than normal) rub her head/ears on the floor, scratch at them and generally enjoyed us rubbing them way more than normal. I thought "ear infection", so off to the vet. But, she couldn't find any sort of infection. She said her ears were "sort of pink", but not anything to signify an infection. Seeing as Brooklyn has already been on a round of antibiotics about 2 months ago for her itchy skin (if you guys remember, she was going at her right leg and back leg like crazy), so they didn't want to dose her with antibiotics again. But the vet though, this might be an allergy since there are no signs of infection...so she gave her a round of low dose steroids to see if that would help. But it didn't. She is still ear rubbing and head rubbing on the floor a lot...way more than normal.

I am clueless. The vet is calling me back about what we should think to do next, so in the mean time, I was wondering if you all had any thoughts. I think the leg/foot biting and itching might be related the head dragging/itching on the floor, but who knows. She has laid off her leg a lot (that is great) still at the paws sometimes, but I can just tell she is uncomfortable in her ear/head area and just always pushing it into the floor or using her paws.

Anyway, if anyone thinks of something we might have missed, just let me know! I wonder if it still might be an allergy...hummm.
P.S. Brooky is now 7 months.

Thanks!!

Blondiemonster
5th June 2011, 03:51 AM
Mmm.. No idea. Probably allergies I would think.. Hopefully it will go away..
Head rubbing and itching and footbiting are also symptoms of SM but Brooky is too young and it came on pretty sudden, but I still thought I'd mention it.

Jasper and Holly
5th June 2011, 04:28 AM
Have you changed her shampoo? Maybe the the cone had something to do with it? I know Holly couldn't stand to have it on.
Has she been sitting in the sun? One of my cats loves to sit in the sun and her ears go all pink and sensitive, but that's the cat.
I have always used a natural shampoo by dermcare even with my last Cav he always used to get itchy especially in Summer and I had to used the one by dermcare that you had to leave on for 10 mins then wash off.
That's all I can think of. Sorry I can't help. Hopefully your vet will find out what's causing it.

Margaret C
5th June 2011, 10:15 AM
Mmm.. No idea. Probably allergies I would think.. Hopefully it will go away..
Head rubbing and itching and footbiting are also symptoms of SM but Brooky is too young and it came on pretty sudden, but I still thought I'd mention it.


Sorry, but SM can show up in puppies younger than Brooklyn, and with the symptoms that have been described I would be asking to be referred to a Neurologist that knows about SM and PSOM.

Karlin
5th June 2011, 10:25 AM
I would agree with Margaret.

If your vet has been unable to find any other source for this, then as Margaret says, I would see a vet neurologist, ideally one familiar with SM. There is one woman in Sydney as I recall. I can check to find out who it is. If steroids didn't help then I would think it almost certainly cannot be allergies. The single most common misdiagnosis -- often for years -- for SM in cavaliers is allergies, meaning many do not get the treatment they need.

Clare Rusbridge has seen puppies as young as 12 weeks with SM, but anecdotally, I know people (including members of this forum) who have said their puppies had symptoms at younger than that, as early as 7-8 weeks. Many dogs would be diagnosed at younger than a year.

If this is SM, you would definitely want to have it diagnosed now, as this gives you the greatest number of options to consider. It is not a diagnosis any of us wishes to receive, but the earlier you know, the better for making decisions. There are many of us here who have gone through this process and have cavaliers with SM (I have three of my five :( ). It is a problem now endemic in the breed. People here can offer lots of support and advice if you find you are in the situation so many of us find ourselves in, managing dogs with this condition.

There is a lot of info in the Health Library section and pinned to the top of the SM/MVD forum. Also see www.smcavalier.com, www.cavalierhealth.org for some basics. You might find it especially helpful to view the videos on my site, www.smcavalier.com, as you can see cavaliers with a wide range of symptoms and can compare those with what you are seeing with Brooklyn.

The most detailed information is on Dr Clare Rusbridge's website. She is the leading researcher into this condition: http://www.veterinary-neurologist.co.uk/faq.htm

Blondiemonster
5th June 2011, 12:21 PM
U know what dawned on me that having the collar around her neck couldve set sm symptoms of... Having anything around the neck area thats tight.

Blondiemonster
5th June 2011, 03:13 PM
Sorry, but SM can show up in puppies younger than Brooklyn, and with the symptoms that have been described I would be asking to be referred to a Neurologist that knows about SM and PSOM.
Margaret, yes:
I guess i knew that since reptigirls flash is younger than a year and i remember a discussion on this fron a long time ago, but i just didnt really wanna say it i guess since i dont know enough or feel qualified to alarm brooklyns mom. I also just dont wanna accept it unconciously :(. Brooklyn is so innocent and young!!!!

Reptigirl
5th June 2011, 03:38 PM
Mmm.. No idea. Probably allergies I would think.. Hopefully it will go away..
Head rubbing and itching and footbiting are also symptoms of SM but Brooky is too young and it came on pretty sudden, but I still thought I'd mention it.

Remember Flash came to me at 12 weeks showing almost those exact symptoms... They also progressed very rapidly....some days he would just wake up with new and stronger symptoms... It was not SM yet but very sever CM... I would recommend a neurologist visit...

Blondiemonster
5th June 2011, 03:40 PM
Remember Flash came to me at 12 weeks showing almost those exact symptoms... They also progressed very rapidly....some days he would just wake up with new and stronger symptoms... It was not SM yet but very sever CM... I would recommend a neurologist visit...

Yes i remembered read the post above yours

Margaret C
5th June 2011, 04:31 PM
Margaret, yes:
I guess i knew that since reptigirls flash is younger than a year and i remember a discussion on this fron a long time ago, but i just didnt really wanna say it i guess since i dont know enough or feel qualified to alarm brooklyns mom. I also just dont wanna accept it unconciously :(. Brooklyn is so innocent and young!!!!

I know what you mean. It is horrible to think this can happen to such young puppies.

I hesitated when I first read BrooklynMom's post and rather hoped that someone else would suggest her little girl should be checked for SM.

I really do not like being the bearer of bad news and it does feel so unkind to put such a worrying idea in someone's head.
I very much hope that Brooklyn's symptoms are due to something else.

The truth is though, if a cavalier has SM it will not go away. The owner will have to face the diagnosis at some time and it is better that it is done before the little dog has suffered long periods of discomfort without any pain relief being prescribed.

I have had so many phone calls from owners who spent two years or more watching their cavalier suffer while their vet checked for allergies and orthopaedic problems.

Contrary to what many cavalier owners think, SM is not a rare condition. In the last few years it has become apparent that it is widespread through the breed.

Over half the young cavaliers that are scanned through the low cost centres in the UK have SM. They may not have symptoms ( or at least no symptoms that their sometimes un-informed owners would recognise ) but most of them will do as they get older. It is a deteriorating condition.

It is not only widespread through the breed, it is widespread throughout the world. All cavaliers originated in England; some countries imported SM genes along with their earliest cavaliers, many others are still importing it in unscanned stud dogs from UK kennels that have produced SM.

Charlifarley
5th June 2011, 04:44 PM
Unfortunately, I have a dog that showed SM symptoms well before the age of 1, and thanks to then watching the PDE programme and joining this forum, I knew that the symptoms I was seeing were going to be diagnosed as SM. :-X
Like has been written earlier, the sooner you can get Brooklyn to a neurologist the better. :xfngr:

BrooklynMom
5th June 2011, 11:22 PM
Thanks everyone. My heart is through my stomach right now :( I appreciate everyone comments though...to be honest, I have been having this fleeting feeling in my gut that these were SM type symptoms, but I kept saying to myself "your crazy, stop thinking everything your dog does is an SM sign" (I think all of us have had the crazy SM paranoia before).
So I guess that is why I asked you guys and unconsciously left the question open ended. I think I was scared to even ask about SM.

Okay, so a few questions about this:

First, can a dog still get SM if their parents are MRI cleared? As well as some of her grandparents etc? I put in so much effort on health standards from the get go, but who knows now.

Second...I took out pet insurance this weekend. Obviously, I need to wait until this goes through and the 21 day waiting period passes before I can do anything as I know that if any SM talk or investigations whatsoever go on my file, the Insurance (we took out PetPlan) will not cover it, ever. So, can I wait a month to further pursue this? Is that safe for Brooky? *If* this does have anything to do with SM, I know I am going to need this health insurance for her but I also don't want to keep her in any discomfort related to whatever this is.

And lastly...Karlin, would you mind sending me the name of the neurologist in Sydney if you can find it? I am not sure yet how much my vet knows about SM, but when we chat I will have a better idea. She is an amazing vet, so I know she will help guide me along this path even if she is not an expert.

Obviously this might not be SM too, but like you guys said, I don't want to be naive either if something is wrong and I can help her sooner rather than later. I am going to start taking video of her doing her "symptoms" too...someone mentioned that on another thread for their dog (sorry, can't remember who), but it's a great idea for any investigations moving forward even if it has nothing to do with SM, so I will get on that.

Thank you all...I appreciate your thoughts, honesty and support.

GraciesMom
5th June 2011, 11:33 PM
I know that sometimes I see little things that I wonder about... I think we all do have those moments and know that eventually it will truly point in that direction. It also could be PSOM or other inner ear issue.... and pray that it will be something more readily treated than SM. I just want you to know that I care about what happens to you and Brooklyn... you are in the right place for sure to get support. I am always willing to lend a shoulder when needed.

I do not know all the answers to your questions except that parents can be MRI clear and the offspring get SM. It has happened to two Cavs that I know about. One ended up suing breeder because the MRI was fake....no kidding. The other case the parents really were clear... but it still surfaced when the dog was 4 years old.

mommytoClaire
6th June 2011, 04:43 AM
Oh my, I thought SM as soon as I started reading. None of us want to think that direction, and I know you are probably a bit stressed over this.

I know you've mentioned the need for the insurance should something big happen. And if that is the case, you will certainly need to wait out the 30 period. At this point it only sounds like she is head rubbing, correct? If you do anything before that 31st day, it will be considered preexisting, and not covered.

Keeping you and Brooklyn in my thoughts and prayers as you wait this out and decide what to do.

Blondiemonster
6th June 2011, 05:28 AM
Make sure the insurance covers MVD and SM for starters.. I think it's probably ok to wait 30 days before going to the neuro. SO sorry you have to go through this...
It's very stressful, I know.... It could indeed be PSOM related too, best case scenario! Keep in mind , she doesn't have to have SM to show symptoms, it could just be CM, and honestly it's hard to find a cav that doesn't have CM these days it seems, but of course far from all of them are symptomatic. Hope this gets sorted out soon. We are all here for you. I've been through the same thing and everyone was so supportive...

Piper
6th June 2011, 06:04 AM
:hug:Our dogs really do seem to be twins :( I also took out insurance recently because of suspected SM. I think it has been a month already but I so scared to go and pursue looking into SM. I know I should do it soon but I haven't been able to bring myself to do it yet. Maybe when your insurance goes through we can do it together :hug:

BrooklynMom
6th June 2011, 11:08 AM
Okay...so here is a video I just took of her doing her "head thing" just to share for visual support.

http://www.flickr.com/photos/32200327@N02/5803394049

Thanks all for your thoughts, support and input. Anyone else who can answer any of my additional questions above would be so appreciated. Poor little pup. I am prepared to just make her happy and comfortable, whatever the diagnosis...big or small!

Her mama (me!) has had her share of health issues and hospital visits over the past year, so it isn't anything my hubby and I can't handle. I just want to make sure I am taking all the right steps to ensure her happiness and best health...and thanks to this board, I have educated myself to be able to do this the best I know how.

I am thinking I need to pause and wait for insurance to kick in before anything else moves forward. Does anyone think this is a bad idea...to wait? I don't want to put her in harms way, but I also want to make sure (if I can) that insurance is in full force before I investigate further.

Thanks everyone, you are making all this stress and worry much easier on me. I am so grateful for the support.

Jasper and Holly
6th June 2011, 11:58 AM
So sorry you are having to deal with this along with your own health Issues. Hope everything goes well for Brooklyn.

BrooklynMom
6th June 2011, 12:01 PM
Thanks Deb xx

lovecavaliers
6th June 2011, 05:23 PM
Hi Brooklyn's Mom! I am sorry you are even having to think about SM/CM, such a dreadful thing!
I watched your video of Brooklyn (absolutely adorable pup by the way) and was wondering if she was washed, combed, or eaten anything prior to the head rubbing? Part of it looks just like crazy puppy stuff but I do see it appears in excess which is why the concern.
I noticed similar things with my Jack when he was 6 months old (this is all in retrospect, at the time I didn't think much of his "odd behaviors") I didn't address it with a neurologist until he was over a year:( I know it makes me sound horrible but I didn't know about much if anything about this disease and I also think I was in a bit of denial! Insurance wasn't an issue, as he was covered fully at 3 months old. Anyhow Jack was MRI'd and found to have mild-mod CM with ? pre-syrinx. He has now been on meds for over a year and we are taking it one day at a time.

As for your insurance, that is a tough one. I know how extremely expensive this disease can be and would be in credit card debt had I not had his insurance . I would see if you could wait it out, especially if you cannot seriously consider caring for an CM/SM dog without it and would end up becoming financially drained. THat would be bad for both you and Brooklyn's future. Of course you don't want her to suffer for 21 days so I would watch her closely to ensure that overall she is managing. I know others might say I am being cruel but many (myself ) have had dogs showing similar signs and waited months to seek neuro help (just because we didnt know better and were in denial) and I don't think 21 days as long as nothing worsens will make her prognosis any different should it turn out to be SM.
P.S make sure your regular vet isn't documenting any of these possible SM signs in her notes because insurance will most likely ask for all her medical records on your first claim and they may use that as an excuse that it was pre-existing:mad:

Piper
6th June 2011, 06:06 PM
I don't think it's bad to wait as long as she doesn't show any signs of serious pain. That's how I've been looking at it. I know that scratching can be a sign of discomfort but I know with my pup that if he was in any kind of real pain he would be yelping and making it very obvious since he is quite the wimp :rolleyes:

Reptigirl
6th June 2011, 11:01 PM
I really hope it's not SM... but as mentioned before it could even be from CM alone... That video would have me worried too. Blitz does this sometimes when he is excited.. looks exactingly like your video. I think its because he gets so excited he aggravates his SM.

Here are a few videos from when Flash was about 6 months. He was diagnosed with CM at the time of these videos. These were from when he was the most sever before medication. His symptoms started slowly and continued to get worse. When I first noticed a problem it was because it was happening almost every day, some times several times a day for unknown reasons.

http://youtu.be/s8TIAuOVrhc
http://youtu.be/s8TIAuOVrhc

Also, I think it was already mentioned but if you had done a bath, ear cleaning or grooming recently that could just be normal. All of mine do it, even my German Shepard, right after a bath. I think it's because they feel so much better :p

Also it could be something simple like an ear infection. I think having insurance sure would be safe. Because the insurance companies could easily call it "pre-existing" if SM showed up later.
I think you would be okay waiting.

I can't remember where i saw it... I'm sue someone can better explain. But even with an A X A mating isn't there a chance that some of the pups can get SM? Like 25%? I can't remember for sure... so don't quote me on it. But I'm SURE I saw that somewhere.

Also @Piper. I know what you mean about if they were in serious pain they would yelp...At least that is what I originally thought.... but just something to think about: Blitz has been given less then a year to live, with SEVER CM/SM. The syrinxs are taking up most of his spinal cord... and he doesn't yelp. Even on his most sever episodes his tail is usually still wagging. Flash has only yelped a hand ful of times prior to being on medication. Usually he would jump up from a deep sleep, let out a little yip & run to hide... He doesn't usually yelp even during any of his most "sever" episodes. His tail wags through nearly every episode. His tail almost never stops wagging. Holly on the other hand is a LOT more sensitive. Yelps for just about everything. From being picked up, being brushed to having her nails trimmed. She screamed for a good several minutes after getting vaccinated. She even screams if she gets a grass bur in her paw. But her "symptoms" are the least sever and if I didn't know about CM/SM I probably wouldn't think twice about her mild episodes.

mommytoClaire
6th June 2011, 11:10 PM
Refresh our memory on whose insurance you have?

I watched the video, and I have to agree, it looks a bit suspect, and since so many have been dx'd with allergies, when it wasn't, of course it becomes a concern. She doesn't look in distress.

I guess this is how I would look at it. SM can be very expensive. You want to be able to give her the best care possible, if, and that is a big IF she has it. So, you are only talking about another 3 weeks. I would wait it out. I wouldn't call your Vet nor even inquire with the neurologist at this point. All of that could be considered preexisting.

I think your Vet has only considered allergies, and she seemed to clear up. So, it could have been a bit of an allergy problem too. Now I would wait it out. I personally would go at least a couple weeks beyond the 30 days. Then, I'd contact my own Vet again and say she's doing something different.

I guess that if something did happen and she does have SM, you might not be able to properly care for her and then what? So, waiting out another month or so wouldn't be an issue for me. This is me. She doesn't seem in pain, and I don't think you are being cruel. You are trying to do the best by Brooklyn, and being able to properly care for her through insurance is exactly the best thing for her.

Does that make sense. This is just my opinion. But being financially desimated is not in the best interest of any of you.

Margaret C
7th June 2011, 12:13 AM
I can't remember where i saw it... I'm sue someone can better explain. But even with an A X A mating isn't there a chance that some of the pups can get SM? Like 25%? I can't remember for sure... so don't quote me on it. But I'm SURE I saw that somewhere.



Yes, you are quite right, no mating can guarantee puppies that are SM free. If you buy a Cavalier, you risk seeing it develop SM.

A study of the Netherlands breeders showed that with an A x A mating 75% of the puppies were also graded A when they are 2.5 years old.
25% would therefore have had a syrinx by that age.

All other matings result in 50% or less of the puppies being graded A.

These figures were given at a seminar in October last year. I blogged about it here........

http://www.cavaliertalk.com/forums/entry.php?135-The-BVA-KC-Chiari-like-Malformation-Syringomyelia-Scheme

Reptigirl
7th June 2011, 12:20 AM
Thank you Margaret! I read so many things & have so many things going on at any given time I can't always remember exactly where the original source was.

Blondiemonster
7th June 2011, 03:37 AM
Interesting. I had a discussion with my partner today about having anither cav in the future. Im in love with the breed. We were just weighing the risks and the troubles... I would def not buy fro
a breeder who doesnt scan, and then i guess i would maybe take the shot.. I know it would mean being on a waiting list, but i dont mind. @ reptigirl; what r blitz his symptoms ? R u considering surgery considering his bad prognosis? I am interested since blondie has a syrinx down her spine too. A year ago it was at 90 percent. Blondie doesnt scratch or yelps or rubs her head and i havent seen any strokes if air guitar for two months now. I can tell sometimes she gets headaches. I can just tell. Shes on gabapentin. Ive always said that id do surgery if any weakness showed up at all or if symptoms and or pain increased significantly.

BrooklynMom
7th June 2011, 09:05 AM
This is a great discussion for me, thank you so much everyone. It is really helping me put together some thoughts, questions and plans.

I think it is of our best interest to hold off conversations with the vet until I know Brooklyn is covered by insurance (we have Pet Plan) and through the waiting period. If it is not SM and something else, well then, I will be covered for that too. It feels so wrong to wait, but like a lot of you said, if I can push this a few more weeks, the coverage could be the best thing...for all of us. My husband and I were prepared for something like this if we chose not to get pet insurance, so I am not just doing this to save a buck, but I do want to give it a shot if I can push it. If anything changes or she seems to get worse/new symptoms, I will take her in. Her health is the most important thing to me so it is now a balancing act.

As for dogs being able to still possibly have SM even if parents/grandparents are MRI cleared is an interesting new fact! I had no idea! I honestly don't think it would have changed my option to get a Cavalier at all, but it is something that people don't talk about. At least I know I did the best I could in terms of health checks, research and waiting for the right breeder. There is nothing more than doing your best, and I have to keep reminding myself of that when I feel guilty that maybe I didnt do enough. Regardless (and I told this to Brian over PM) I am happy that she is with us, regardless of what pans out, in a home where love is abundant and she will always be taken care of. We will always provide for her and help her to get what she needs...in sickness and in health as they say!

I did notice that she pushed her head against the floor a lot when I took her Pupia harness off (because you have to pull it over the head/ears??) so I am not using that right now, went back to the front clip harness tonight and she didnt rub her head afterward...though she was at it this morning. It is hard to tell when/why it is happening, but I am writing down everything and video taping to try to see if there are any patterns and at least I feel like I am doing something so that I will be more prepared at the vet come our next appointment.

Oh, and to note one persons question...nope, we have not changed detergents or done anything to her ears recently. She got bathed last week, but she was doing this before then.

Okay...thanks again everyone. I'll keep posting with updates, questions or any new videos if she starts to do anything different. You guys are all I have to rely on for support for the next few weeks until we can start again with the vet/neurologist after insurance kicks in! Whew.

Margaret C
7th June 2011, 12:23 PM
I'm away for a few days but good luck, I will be thinking of you.

I hope Brooklyn stays okay long enough for you to fix up the insurance.

Best wishes

Blondiemonster
7th June 2011, 05:19 PM
Well be here!

Sydneys Mom
7th June 2011, 05:53 PM
I'm just catching up with this thread. Poor Brooklyn, I feel a kinship with her since I'm a New Yorker. I sure hope her symptoms get better. You are doing the BEST things for her. Hugs.........

Reptigirl
7th June 2011, 08:12 PM
@ reptigirl; what r blitz his symptoms ? R u considering surgery considering his bad prognosis? I am interested since blondie has a syrinx down her spine too. A year ago it was at 90 percent. Blondie doesnt scratch or yelps or rubs her head and i havent seen any strokes if air guitar for two months now. I can tell sometimes she gets headaches. I can just tell. Shes on gabapentin. Ive always said that id do surgery if any weakness showed up at all or if symptoms and or pain increased significantly.

Now that he is on medication I don't see many symptoms. Mainly just scratching... But on his bad days he still face rubs, scratches & rolls on the carpet. Just not as bad as before. Since starting on medication I have only seen 1 noticeable episode of hind leg weakness and a few minor episodes where he looks a little odd in the hind legs for a minute. I can tell they all get head aches from time to time.

BEFORE medication on bad days:
*He had pain episodes. You could clearly see he was in pain just by his face. He only had 2 major ones before medication. He would refuse to move and just looked terrible.
* Trouble jumping. Actually he had a couple of flare ups where he just could not jump up at all... not even 1 foot off the ground
*Hind leg weakness ~ Normally happened after a noticeable fare up you would see his legs looked funny. Almost jello like.
*Scratching ~ only at 1 ear (while my other two scratch both sides)
*Pawing at head
*Lots of face rubbing in the carpet/on furniture & rolling on the ground

WOW, I didn't know Blondie had a syrinx at 90%! I'm so happy to hear she is still okay after a year. My neuro seems to think that immediate surgery is the ONLY way to save Blitz. That is why he said he had less then a year. I WANT to do the surgery. I'm just scared of it too. Mainly scared of HOW on earth I'm going to keep him totally calm & confined for 8-12 weeks. He plays like a puppy now and is very energetic. I have put off the surgery and have seen major improvements on the medication. While he still has some symptoms he is like a different dog. My neuro told me that I could wake up one morning and be past the point of no return. That the surgery needed to be ASAP! But my heart & head tell me to wait it out just a bit. I keep saying I will do surgery but I am waiting it out a bit. I know the medication is keeping him comfortable. It's just such a terrible situation to be in IMO.

I'm having trouble getting videos to upload but here is one showing his rubbing episode a few weeks after we got him. http://www.youtube.com/watch?v=eviqRHnxuEM

lovecavaliers
8th June 2011, 12:42 AM
[QUOTE=Reptigirl;392555]*My neuro seems to think that immediate surgery is the ONLY way to save Blitz. That is why he said he had less then a year. I WANT to do the surgery. I'm just scared of it too. Mainly scared of HOW on earth I'm going to keep him totally calm & confined for 8-12 weeks. He plays like a puppy now and is very energetic. I have put off the surgery and have seen major improvements on the medication. While he still has some symptoms he is like a different dog. My neuro told me that I could wake up one morning and be past the point of no return. That the surgery needed to be ASAP! But my heart & head tell me to wait it out just a bit. I keep saying I will do surgery but I am waiting it out a bit. I know the medication is keeping him comfortable. It's just such a terrible situation to be in IMO./QUOTE]

I completely feel for you, it is the after surgery things like keeping them quiet, reaction to all the new meds they will get immediately after surgery and the development of scar tissue that completely freak me out whenever I start think about surgery. I know others have done it and survived. I guess you get to a point where you just know you have to do it.
As for your neuro vet's claim. One neuro vet told me that surgery should be done ASAP because in 6 months he would be suffering from paralysis. Well it's been over a year and he can still run and jump,. I don't think one can predict with this disease, even the best docs. Just my opinion. :o

Blondiemonster
8th June 2011, 05:09 AM
I totally hear you. My gut says surgery is not urgent euther but just like irene it was predicted blondie would be paralyzed by now. ( she walks on two hind legs like a circusdog) I honestly have a feeling this syrinx has been there for way longer before she was diagnosed. I rather wait and see i dont want to feel threatened or pressured. Sometumes i feel a bit worried like what if im doing the wrong thing but surgery makes me so uncomfortable and i rather wont do it until i got no other option.

Blondiemonster
8th June 2011, 05:12 AM
Also a question: how many dogs with massive syrinxes out there live long lives or Are never diagnosed ir mri'd? If it wasnt for her post frontline breakdown last year i wouldve still not known today abouy the sm.

Karlin
8th June 2011, 10:47 AM
I don;t think there are many dogs with massive syrinxes that live without pain -- though pet owners and breeders may not notice symptoms. The number of posts here from people/vets who are sure their dogs have anything except SM but are showing some possible SM symptoms, really underlines to me that the only person who can certify a dog as without clinical symptoms is a neurologist.

There is published research showing pain correlates strongly to width/lopsidedness of syrinxes and it would be pretty unlikely a massive syrinx would not grow to the size to start to cause disability/pain. The exception to this, and Dr Marino and others have discussed it, is that the syrinxes sometimes come on so slowly that the dog slowly adjusts to living with what can only be extreme neurological pain. He has a talk in which he shows a slide of a dog with a massive syrinx and moderate clinical symptoms where he notes that if a dog scanned like this where syrinxes came on suddenly -- eg after an accident -- the pain would be so extreme that it would need to be pts immediately. Syrinxes are NOT normal and should never be acceptable regardless of whether there are clear clinical signs of SM.

Whether a poor scan convinces anyone to do surgery -- if this is at all a possible option people are considering, there's clear evidence that waiting means more permanent damage and a poorer prognosis for recovery. If there are clear symptoms it is worth talking to a neurologist for an honest opinion on how much of this is pain related.

If Leo had scanned with a massive or even a large syrinx I would have done surgery right away when he was younger. Dogs that are symptomatic with large syrinxes generally do not end up doing well and the younger they are, the poorer the overall prognosis and likely lifespan before the dog will need to be euthenised because of pain.

set against that -- some specialists do seem to push for surgery even if there are few to no symptoms, as long as there is a syrinx of any size. If symptoms were minimal and especially if the dog were over 4, I'd be pretty reluctant to do the surgery unless there were clear signs of pain. I do think, given all evidence, that there is absolutely NO evidence to argue that all dogs will progress towards paralysis and extreme pain. I have been baffled by such aggressive recommendations for surgery on minimal signs now for a couple of years.

As I have said before -- I have two dogs around 6-7 with minimal and mild symptoms. One has had the same level of symptoms for 4 years. She scanned with a tiny syrinx. There is no way I'd have considered surgery with those symptoms combined with that scan.

Surgery is a very personal decision and there are many potential pros and cons. It is never the only right decision or the only wrong decision. That said: people should not deceive themselves that symptoms combined with a poor scan, especially in a younger dog, means that doing surgery is not the best choice for the best overall prognosis for a dog. All evidence is that it is very unlikely such dogs will last very long or live without pain or not progress and the likelihood is they will progress faster than most cases, have more extreme SM, and need to be euthenised at a younger age. BUT this is still not an argument that a dog MUST or SHOULD get the surgery. This remains a personal decision with many factors going into it and palliative care *where the dog is carefully monitored by a neurologist to maintain an adequate level of pain relief* is a perfectly valid choice. My worry is and always has been that people so badly want their dog to be OK and not have serious SM that they disregard evidence and continue to convince themselves that the case isn't serious when it is; as time ticks away their options reduce and meantime too often the dogs are not getting adequate pain relief as they remain symptomatic. Deciding NOT to do surgery does carry the responsibility to make sure a dog is getting adequate care with this insidious and painful condition -- the care the dog needs, not the care we think or hope the dog needs. :thmbsup:

I do think it is worth getting a second opinion from a less aggressive specialist if anyone is advised that they must or should get the surgery, if their dog has moderate or small syrinxes that are not very wide or lopsided, and the dog shows few or mild symptoms or even moderate symptoms if the dog is say, over 5.

I constantly weigh whether I have made the right decision for Leo, who has lived with his SM diagnosis now for over 6 years. He has a wide but short syrinx that fortunately is very centrally located and not lopsided. he has never had a pain session excepting once when he fell off a bed on holiday and now, I believe this was more likely due to resulting pain from the fall, perhaps even solely spinal pain, not the SM on its own. A year on, he has never had a repeat. Gabapentin manages his scratching well and also his occasional sensitivity on his body.

Those are my own views based on having read the published papers, attended the two SM symposia with Clare Rusbridge and other speakers in the UK, and remaining in touch with a couple of specialists on this condition, and many people who have cavaliers and other breeds with SM.

One clarification on the 'risk' of the surgery: the surgery itself has not been shown to be 'risky' -- very few dogs have died as a direct result of it, and very few have complications right after due to the surgery. However that does not mean the surgery cannot introduce later problems such as scar tissue formation. t seems to me that most often the dogs do better even with some scar tissue formation than they did and would have continued to do with their syrinx and CM. The surgery is also not a cure. But there' has been no evidence that it is in any way 'risky' under any definition used in vet medicine and this is reflected in several published papers.

Blondiemonster
8th June 2011, 02:58 PM
Karlin, i hear you... All i know is that blondies syrinx we found rather accidently (post frontline) was , according to dr. West, the exact same size after 7 months at next scan. We will scan her again after a year and compare apples to apples. I can only see what i see: is a dog who goes for hour walks running through thr fields runs of and of The stairs and jump on and off coaches for fun while playing. I am not saying that i am dreading the day where i notice she wont do any if these things and surgery will be becessary. When dr marinos prognosis was paralysys within a year i went todr west whi did a complete neuro exam and said she has NO SYMPtOMS. (hence me wonderung about undiagnosed dogs with large syrinxes unless we are a complete exception which is possible) It wasnt till 8 minths after he noticed something and thought shed be better of on meds. He never said surgery wouldnt ever be necessary as this is a weird disease thats unpredicatable i do realize that too. I dont just badly want her to be ok ( well i do :) but i think i know her really really well and i can tell when she feels good or not as she lets me know.. Also it took a ton of courage to not do the surgery at first as i felt completely defeated and pressured and sad as the leading u.s specualist was advising surgery instantly and my first instinct was to immediately do what he said but feeling uncomfortable as hell about it in my heart. I know theres gonna be a day sooner or later even the second neuro will advice surgery ( hes mentioned the possibility) and then i will be facing decisions again. Ive always told him not to let me get to a point of no return. Its why i go in every 3 to 6 months... Also she is now 4 and a half i thought id mention so rather young. One more question; r there cases of puppies born with a large syrinx? Also the statistics are against dogs with sm, but all statistic are based on dogs that are symptomatic or am i wrong? It would seem particularly interesting to study thosr who are asymptomatic with a syrinx that was discovered accidently... Or is therr such a study? Forgive me my ignorance im always learning