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Sabby
20th July 2011, 01:51 PM
Little update on Ebony’s disk problem.
Well at the moment I am pleased to say that Ebony is getting better with cage rest, when I am not quick enough she manages to jump onto the sofa again, for me that is a good sign but to be avoided at all cost. We saw the vet yesterday again and he says it will take a while. She is not 100% but I hope and pray she will get there without surgery. Also they don’t know if the syringe from the SM is making it worse as it is directly over the disk. He is sending the Scan and report to Clare Rusbridge and hopefully I will have a better picture about her CM/SM.

This is some of the Report including CM/SM

BRAIN & SPINE
There is moderately severe chiari malformation with rostrocaudal compression of the cerebellum with indentation of the caudal border of the cerebellum by the occipital bone. The caudoventral part of the vermis has herniated through the foramen magnum and there is ventral depression of the brainstem resulting in a kinked cervicomedullary junction. Secondary to the Ciari malformation there is mild syringomyelia from C3 to C4 and T1 – T3 with mild dilation of the central canal. There is increased signal of the grey matter of the olfactory bulbs on the T1W images but not on the other sequences. The flair images show symmetrical increasd signal of the dura lateral to the abnormal contrast enhancement is seen. The lining of both bullae are mildly thickened but the lumen are air filled. No abnormal enhancement of the bullae is seen. The extracranial structures are otherwise normal.

Conclusion
Chiari malformation and Syringomyelia
Left sided ventral extradural compression dorsal to disk – small disk extrusion with vascular dilation
Spinal cord swelling with hyperintensity TL junction – ddx syrinx formation (subacute) or less likely inflammatory disease

The changes at L1/2 disk are most likely to represent a low volume disk extrusion. A type 3 disk (high velocity with cord concussion) usually has signal changes in the spinal cord immediately dorsal to the disk due to contusion of the spinal cord. The degree of compression is relatively mild but is larger than would be seen with type 3 extrusions. In this case the cord changes are cranial to the disk enhancement (at least peripherally) to the extradural tissue at L1/2 and this would be more typical of a subacute/chronic extrusion. Some of the extradural compression appears due to be due to dilation of the left ventral vertebral venous sinus. The cord changes at the TL junction are severe and appear diffuse within the grey matter and the changes would be consistent with an early syrinx with oedema within the cord rather than overt cavitation but inflammatory disease could look similar. It is likely that the acute disk extrusion has exacerbated the pre-existing spinal cord pathology.
The signal changes within the brain on the FLAIR are I think probably artefactual due to the coil used rather than reflecting genuine pathology, the distribution of changes would be unusual for inflammatory disease. If Ebony does not respond to conservative treatment then you should consider a CSF sample for analysis.

Kate H
20th July 2011, 03:20 PM
Glad Ebony is doing OK - rest really does work for back problems.

I was interested that the report said 'It is likely that the acute disk extrusion has exacerbated the pre-existing spinal cord pathology' - Oliver's spondylosis (osteoarthritis in three of the spinal vertebrae) is directly underneath his syrinx, which was diagnosed a couple of months after his spondylosis flared up. It seems as if other spinal problems could facilitate CM turning into SM, and as skeletal and disk problems are quite common in Cavaliers, they could possibly be a contributory factor to the progression of CM. Really, this disease gets more labyrinthine at every turn!!

Kate, Oliver and Aled

GraciesMom
20th July 2011, 03:26 PM
I know this is not information you wanted to hear, but now you can move forward with making Ruby more comfortable. I expect to deal with some of theses issues too someday but sorry you are dealing with it now

Tania
20th July 2011, 09:23 PM
Hi Sabby, glad things are starting to settle down. You must feel relieved. Hugs to you all :hug:

Nicki
21st July 2011, 09:06 AM
So pleased that Ebony is feeling better, it's a wonderful sign that she wants to jump up on to the sofa even if she shouldn't not be doing so!

Thank you for posting the report, it is very helpful as it helps us understand what is going on with poor Ebony, but also to learn more about the condition. It makes sense that other spinal issues would exacerbate CM/SM especially as they are going to be causing more pressure.