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Bet
16th August 2011, 12:24 PM
Just had to to ask this Question,Looked at the Petty Bickering still taking place on other Forums about the Positioning of Cavaliers for MRI Scans, what does it matter ,are some Cavalier Breeders still in denial that 85 ,YES 85 Cavalier whelps ALL HAD CM.

Thank You All for the Best Wishes you have sent me, but the news is not too good ,the Cancer Bug has returned and that caused rhe DVT ,and a Clot has now moved to my Lung..

I am getting so much Warfarin ,if I was a Rat I'd be a gonner.

Bet

Karlin
16th August 2011, 12:42 PM
Take care of yourself, Bet.

On the arguments over head positioning–all I can say is this is just the classic attempt by this usual circle of breeders to have everyone miss the forest for the trees. :sl*p: By any measure, this is a fairly modest issue and doesn't even relate to their grade results on their scans. It's also a study on a very small sample group and so needs to be looked at in discussion with the experience of numerous neurologists who have carried out head scans in recent years.

That breeders are focusing on this, of all things, is just laughable–or would be, if it didn't trivialize and deflect attention from the far more serious issue that this breed now has one of the most painful conditions known to humans, endemic in its worldwide population (though, perhaps that's the intention?).

There is a massive, massive problem with this condition in the breed–a problem that would be hugely helped if breeders would scan, share information, support health initiatives, follow health protocols, push in their own countries for low-cost scanning programs- yet, what this usual bickering crowd of breeders has decided to focus on publicly is whether a dog's head is in one position or another for a scan.

Perhaps if the very same people busy making these “let's focus on anything except the important issues” comments on various forums and e-mail lists would push their committee representatives to resolve the impasse that their club has come to with the Kennel Club and the British Veterinary Association over the MRI scanning program it supposedly wants, they might find answers to some of their passionate concerns about head positioning–this is After all, part of the recommendations for the scanning program and as far as I understand, has been considered by the researchers.

I am sure the various welfare groups examining the issue of dog breeding in the UK and reporting back to Parliament will find it fascinating that Cavalier breeders are more concerned about how bent the neck of their dog is during an MRI than they are about actually doing something to resolve the problem for which the dog is being MRI'd in the 1st place. :|

Karlin
16th August 2011, 01:04 PM
And of course one might also note that many of the same circle of breeders were quick to dismiss or advise caution over the recent foetal tissue research results–the study sample there was apparently too small, the research hadn't gone on long enough, blah blah blah, but this paper on head positioning for MRIs is apparently far more important. :sl*p:

And yet as you note, every single one of the 85 whelps examined for research so far has had the skull malformation anda recent study of clinically symptomatic cavaliers shows CM caused symtpoms on its own in 25% of them: http://www.cavaliertalk.com/forums/showthread.php?36821-25-of-cavaliers-with-SM-symptoms-have-CM-only-not-SM

tuppenlil
16th August 2011, 01:58 PM
I am sure the various welfare groups examining the issue of dog breeding in the UK and reporting back to Parliament will find it fascinating that Cavalier breeders are more concerned about how bent the neck of their dog is during an MRI than they are about actually doing something to resolve the problem for which the dog is being MRI'd in the 1st place. :|

In my opinion, it is an attempt to discredit the researchers, and to cast doubt on the validity of the scans that have been done to date.
What seems to have been conveniently forgotten is that several neurologists and radiologists got together to decide how best to perform scans.
And several neurologists and radiologists will decide how scanning is best performed in the future under the BVA/KC scheme, taking all the research into consideration.

As I read that limited extract, I could draw no comfort from its findings. If all dogs had been scanned in a flexed head position, results would not have been any better.

Maggie

Karlin
16th August 2011, 02:32 PM
Another relevant thread on this issue:

http://www.cavaliertalk.com/forums/showthread.php?39133-News-on-the-BVA-KC-Official-Scheme-for-CMSM

The delayed (for over two years) KC/BVM MRI scheme, blocked by club breeder intransigence (they want to not have their health results published although results are published for EVERY SINGLE OTHER SIMILAR KC HEALTH SCHEME. But Cavalier breeders, they argue, are entitled to a special degree of secrecy with a condition that affects at least 70% of the breed by the time they are seniors).

And some comments posted previously by Margaret, made by these same breeders on the foetal tissue research results (authored by some of the SAME people on the head positioning paper, examining a similarly small number of dogs... :rolleyes:):



I see this announcement brought the usual reaction from breeders who demand they should be given up-to-date information, but then attack anything that suggests there really are deep seated health problems in Cavaliers.

An abstract written by leading researchers, including the formerly highly praised head of the Foetal Tissue Research, gives proven facts about 12 cavaliers and suggests what may be happening.

Below is an illustration on how it was received.

In a couple of weeks time the highlighted words and phrases will be parroted by people that have not even read the report..................

Some people are very good at making the bullets for others to fire..........................

"A study conducted on 12 dogs ............ I have faith in the researchers, but find it difficult to accept on those figures that one could make any hard and fast statement, surely?"

"I just find it really difficult to swallow these sweeping statements based on such a small percentage of dogs"



"What I have a problem with it how can you reasonably expect anyone to take as "gospel" something based on 12 dogs".

Hard and fast statement? sweeping statements? gospel?

No, I don't think so. Just a report on a piece of research and a suggestion as to what it may mean.

I think you are right, Maggie.

Publicly disputing select bits of research enables that group of breeders to (rather pathetically) try to discredit researchers and projects if they are finding anything truly significant that is directly related to choices the breeders make when breeding, and that actually supports scanning and following protocols. Head positioning of course, doesn't have any direct relationship.

GraciesMom
16th August 2011, 04:00 PM
I am so tired myself from Gracie's recent surgery for SM that I am not going to weigh in now on the scanning issue and my own extreme disappointment with breeders overall. I just want to tell you that I have you in my prayers and want you to get better. I hate to hear your health news. Sending you licks from Gracie who is on the slow mend. I am exploring in my heart what is the best role for me to play here in USA to help our Cavaliers. I know that I must do something but just not sure what it will be yet. For now, we want you to know we care about you and want you to get better.

anniemac
16th August 2011, 04:45 PM
I am so tired myself from Gracie's recent surgery for SM that I am not going to weigh in now on the scanning issue and my own extreme disappointment with breeders overall. I just want to tell you that I have you in my prayers and want you to get better. I hate to hear your health news. Sending you licks from Gracie who is on the slow mend. I am exploring in my heart what is the best role for me to play here in USA to help our Cavaliers. I know that I must do something but just not sure what it will be yet. For now, we want you to know we care about you and want you to get better.

Keep all your energy and strength for gracie right now :) I will bet you money that the issue with CM/SM, more research developments will still be here once she recovers :)


Sent from my Droid using Tapatalk

Margaret C
16th August 2011, 05:26 PM
For now, we want you to know we care about you and want you to get better.


I would second that.

Dear Bet,

I hope you are being a good patient & doing just what the doctors tell you, ( although I somehow doubt it ) because you are missed by many of us here.

Nicki
16th August 2011, 06:00 PM
Thank You All for the Best Wishes you have sent me, but the news is not too good ,the Cancer Bug has returned and that caused rhe DVT ,and a Clot has now moved to my Lung..



Bet, I'm so terribly sorry to hear this news - our thoughts are with you. I know you have battled and won before, and you have the strength to do so again. Many on here have come to know and care about you and I'm sure their thoughts will be with you too.

It's good to see you posting, take care of yourself :flwr:




I think it's so tragic that all they can concentrate on is the positioning which again seems to be a smokescreen to hide the real issues - I wish some of them would come and read the posts here, the suffering of some of our beloved companions and the heartbreak of those who love them.


Karlin quoted Margaret - so true, they dismissed small sample sizes previously but it's ok when it suits them...

RodRussell
16th August 2011, 06:41 PM
Bet, keep your faith, and things will work out for the best.

Tania
16th August 2011, 07:18 PM
Thank You All for the Best Wishes you have sent me, but the news is not too good ,the Cancer Bug has returned and that caused rhe DVT ,and a Clot has now moved to my Lung..

I am getting so much Warfarin ,if I was a Rat I'd be a gonner.

Bet

Bet I am so sorry to hear you have been so unwell. My thoughts are with you at this difficult time. :hug:

dozyrosy
16th August 2011, 08:38 PM
Well, with respect, if I was a breeder I would certainly be concerned about, and want to discuss, any reports suggesting different positioning of dogs' heads for MRI scanning may give different results. I would want to know when I'd spent time and effort (and money) having my breeding stock scanned, that I was getting the most accurate result possible, otherwise it wouldn't be much use in any breeding decisions I had to make, would it?

Or am I missing something here?

Rosemary

meljoy
16th August 2011, 08:46 PM
Hi Bet,
So sorry to read your post. Although we've never met I have the feeling you are a "tough Ol' bird" and will get through this.

Best wishes
Mel

Karlin
17th August 2011, 12:01 AM
Well, with respect, if I was a breeder I would certainly be concerned about, and want to discuss, any reports suggesting different positioning of dogs' heads for MRI scanning may give different results. I would want to know when I'd spent time and effort (and money) having my breeding stock scanned, that I was getting the most accurate result possible, otherwise it wouldn't be much use in any breeding decisions I had to make, would it?

Or am I missing something here?

Rosemary

Well, yes, actually you are :) -- I'd say misunderstanding something though, rather then “missing” something – the "accuracy" of the scan, as far as breeders are concerned (as they are primarily scanning to get a grade) has little to do with the question about head positioning (indeed, if breeders wanted the most accurate results, they would choose neurologists with the most up to date scanning machines, who followed the head positioning protocol for consistency of interpretation for the scanning certificates).

So it isn't a matter of anyone spending money and not getting quality results. The very same breeders, many of whom chose to use scanning programs that used older, lower quality MRI machines, or shorter exposure MRIs, would have a more legitimate concern about the quality of their scans on such machines, as they are well aware, because their scans are already considered substandard for the BVA/KC scanning program. This issue of the quality of the scan was actually raised at various times so it isn't as if some of the informed club people were not aware when they made the choice of where to scan, and certainly there were people on the club committee over time who also were aware of this issue and chose not to discuss it at club level, apparently.

Clare Rusbridge actually raised the issue of the quality of scans obtained with certain scanning methods a long time ago, and has a document on this issue for vets on her website. I would think that the issue of the quality of the scan–which could actually make it look as if a syrinx doesn't exist, when one does–is of far greater importance than the issue of head positioning and herniation: http://www.veterinary-neurologist.co.uk/sm_screening_vets.htm

The position of the head only relates to how much herniation Is seen, and the view of the space between the back of the brain (cerebellum) and the brainstem:


Cerebellar herniation and CSF space between the cerebellum and the brainstem were larger in a flexed head position..

Herniation is not a consideration for how a dog is graded for breeding purposes or for how it will be graded under the proposed BVA/KC MRI scheme. CM is only noted as being there, or not there, on the certs -- the degree of CM doesn't influence the grades. As far as I understand, it also would have little influence on any decision about whether to do decompression surgery or not. And it certainly would not influence decisions about medications. It is an alternative way of viewing herniation etc., but I think it would be disputable whether one way of looking at things is better or more useful than another. Herniation is not even seen as a major determinant of pain or of the seriousness of this condition–all the studies have so far have indicated the primary determinant of pain is the width of a syrinx and whether it is symmetrical or asymmetrical. (I am not saying it is irrelevant, but it certainly is not as great a concern as whether there's a syrinx or not.)

So basically, this is a huge drama being created to do precisely what it has succeeded in doing for you –totally confused the issues to make it seem as if this is some massive matter for dispute, and as if there is some criticism to be made about particular approaches to scanning, when actually it is a pretty minor consideration and has already been discussed, as far as I understand, in relation to the stalled BVA/KC scanning scheme that the Cavalier club has roadblocked for months.

RodRussell
17th August 2011, 12:39 AM
... Herniation is not a consideration for how a dog is graded for breeding purposes or for how it will be graded under the proposed BVA/KC MRI scheme. CM is only noted as being there, or not there, on the certs -- the degree of CM doesn't influence the grades. As far as I understand, it also would have little influence on any decision about whether to do decompression surgery or not. And it certainly would not influence decisions about medications. ...

This is consistent with how I read the article and my understanding of the grading (or "coding") of MRI scans.

However, the authors recommend:

"Based on these findings it may be appropriate to position patients in a more flexed head position for optimal imaging in order to identify morphologic changes more accurately. This is important to consider for imaging CKCS with CM especially when studying the pathogenesis of CM/SM."

Another topic covered in this article, if only briefly, is this:

"When CSF space between the cerebellum and brainstem was compared in CKCS with and without SM, there was a significant increase in CSF space in CKCS with CM alone compared to those with CM/SM when head position was flexed. In their cine MR imaging study of CSF flow dynamics in CKCS with CM or CM/SM, Cerda-Gonzalez and others (2009a) found that turbulent CSF flow and jets are associated with SM presence and severity and CSF flow velocity at C2/3 is inversely related to the presence of SM. The reduced CSF space in CM/SM dogs reported in this study could explain this jet like CSF flow in dogs with CM/SM compared to those with CM alone."

I wonder if this means that the severity of CM/SM, or even the presence or future presence of SM, could be predicted based upon the measure of cerebrospinal fluid (CSF) space between the cerebellum and the brainstem. If so, this could go a long way to distinguishing whether a CM-only cavalier is either likely or unlikely to develop SM in the future.

This distinction could be a way to fine-tune a breeding protocol, considering that we now know that over half of cavaliers with SM develop it after their 3rd birthday. If we could reliably count on this measurement of CSF space to tell us if a young dog will, or will not, develop SM in the future, then we could more reliably select SM-free breeding stock at a younger age than the present 2.5 years and the 3+ years the researchers may recommend in the future.

mommytoClaire
17th August 2011, 06:20 AM
Bet, I am amazed, with all you have going on personally, here you are once again, battling for these beautiful dogs!

Just wanting to send my good thoughts and prayers for you. Take care of yourself and don't give up the fight!

Karlin
17th August 2011, 11:54 AM
However, the authors recommend:

"Based on these findings it may be appropriate to position patients in a more flexed head position for optimal imaging in order to identify morphologic changes more accurately. This is important to consider for imaging CKCS with CM especially when studying the pathogenesis of CM/SM."


Yes, I think it is interesting– though as you note, still not at all relevant to how the dogs end up being graded–especially if the authors are not arguing that CM would be entirely missed. And I would certainly say with confidence, the variation that may be found with head positioning would be no different then the variation that you already get between some neurologists for the interpretation of CM–I am absolutely sure some of the people who were told their dogs did not have CM were told this incorrectly, because I have seen myself MRIs that have been interpreted in 2 different ways by 2 different people on this (and I have one myself). And many neurologist do not seem very familiar with CM at all–especially outside of the UK.

Overall, it is important to note that researchers have always recognized that head position (as well as the quality of the MRI itself) could influence what shows on the MRI and to what degree it shows -- as a matter of fact all these considerations are the basis of why the BVA-KC MRI scheme was created! I do understand from discussions in the past, that some neurologists felt there was an increased risk of complications during MRI if a dog's head is flexed too much, which influenced I am sure the initial decision on a standardized head position. And of course, all of this has been part of the discussion for the BVA/KC scheme. But again, the difference in head positioning would have absolutely no relevance for breeders regarding the certificates they get or their 'quality'.

It would be wonderful if MRIing at alternative angles could help produce a technique for estimating the chance that a dog will go on to develop more severe SM! :)

But really–it is a bit sad overall that all these elements related to MRIs are still to the forefront when the goal is really to be able to understand the genetic likelihood and have such information linked to a DNA test. That way, breeders could end up only having to spend a minimal amount on a DNA test, and also can use the EBV's for breeding information, and would not have to be doing costly scans. And: the kind of information that comes back from the scans of older Cavaliers gives precisely the information researchers need to understand progression!–again, this would be a far more precise tool than trying to guess from images, and certainly, very few pet owners or breeders are going to of CM/SM and to understand its genetic basis, that owners of cavaliers would feel they need to do costly scans to determine when their dog is likely to get SM, and how much it is likely to suffer. :(

If breeders would support research by scanning their older dogs, scan their dogs generally and submit the scans for research, support an open health scheme like the BVA/KC MRI scheme, and actually do something, they would get the answers they want, faster.

We are all lucky that researchers take any interest at all in this problem in the breed and that an increasing number are adding to the range of studies done. As with any research, a study is added to the mix and may stand or fall depending on further research, analysis, and insight.

dozyrosy
17th August 2011, 03:57 PM
Well, yes, actually you are :) -- I'd say misunderstanding something though, rather then “missing” something
....
So basically, this is a huge drama being created to do precisely what it has succeeded in doing for you –totally confused the issues to make it seem as if this is some massive matter for dispute...

Well, actually, I'm neither misunderstanding or confused by anything other than why such a huge issue is being made here of the fact that breeders on another forum are debating a topic that is of interest and relevance to them. That is why I was asking what I might be missing, as I completely fail to see why they are apparently being damned for doing so. IMO it's surely much more important for the health and welfare of our breed to concentrate on ways of educating those who care s*d all about the health of their dogs, rather than to continually find fault when a few breeders choose to discuss health issues elsewhere - as far as I'm concerned that's focussing on completely the wrong target...

Rosemary