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murphy's mum
26th August 2011, 06:54 PM
I'm in turmoil as I type this post. I feel so confused, and my conversation with the vets hasn't cleared anything up :?

I've been worrying about Misty over the last few months. She's always been a head rubber since we first got her, but lately she's been having scratching episodes when she is excited, which go away when she calms down. We've been to the vets and she's been treated for ear infections, and had cream for her jowls in case there was an irritation there too. She's also started whipping round and looking at her rear end, not everyday, just on the odd occasion. She does seem to like to sleep with her head up, especially on my pillow.

We went to the vets tonight as I wanted to talk to them about SM. I had brought it up before with their head vet, but was brushed off. His opinion seemed to be that as there was no treatment for it, why prove a dog has it:yikes. He then suggested I keep her ears clean, and trimmed short as it's more likely to be ear problems. Tonight I saw one of the small animal vets and listed her symptoms, and asked what he thought? I basically spilled my guts about how I'm worrying about her, and how I wondered if it could be SM. He said it's a possibility that her symptoms could be SM related, but as there are no treatments for SM, would it be worth putting her through all the tests to find out. He said I need to weigh up the process against how much pain I think she could be in. I asked, is it not worth getting scanned so she could be properly medicated. His response confused me even more. He said it's so hard to balance the meds, and that most of the time the results are not successful.

He sent us home with Metacalm to see how she responds.

I have such a sore head, and none of my worries have went away. Is he telling me there is no point in getting her scanned? Is it because her age? Are her symptoms not severe enough to warrant a scan? What if the Metacalm does work, would he then try and medicate her without any test? Honestly I can hardly think straight. We only have two good vet practices in our area, but should I seek another vets opinion? Would that affect out pet insurance if we do need an MRI scan?

Zumie05
26th August 2011, 07:11 PM
I would get a second opinion. If my vet told me there is no point to scan, I would be furious. It is nice that this vet is being somewhat honest, but perhaps he has not witnessed any success stories? A lot of Cavaliers imrpove dramatically once the right medication and dosage is figured out. We read about that on CT all the time!

Even if there was "no hope" for treatment, all scans of cavaliers are valuable to research. When I have Coco scanned in the future, I plan on sending her results in to help with research.

I would be confused in your situation too :(

Brian M
26th August 2011, 07:29 PM
Hi

And all Cavaliers are different too .

murphy's mum
26th August 2011, 07:52 PM
A lot of Cavaliers imrpove dramatically once the right medication and dosage is figured out. We read about that on CT all the time!

This is what I was thinking. I'm wondering if it's because it's a rural practice, that they don't have much experience with SM.

murphy's mum
26th August 2011, 07:53 PM
Hi

And all Cavaliers are different too .

Sorry Brian, my brain is fried, I don't understand.

Sydneys Mom
26th August 2011, 07:59 PM
We went to the vets tonight as I wanted to talk to them about SM. I had brought it up before with their head vet, but was brushed off. His opinion seemed to be that as there was no treatment for it, why prove a dog has it:yikes.


He said I need to weigh up the process against how much pain I think she could be in. I asked, is it not worth getting scanned so she could be properly medicated. His response confused me even more. He said it's so hard to balance the meds, and that most of the time the results are not successful.

All your vet would have to do is read CT forum and know there are treatments and medications that would help with symptoms and pain.:bang:


We only have two good vet practices in our area, but should I seek another vets opinion? Would that affect out pet insurance if we do need an MRI scan?

At the very least, I would get another opinion. I would also call your pet insurance and ask what would be covered.

Please know I'll be thinking of you and Misty and hope you can get this all sorted out.

Kate H
26th August 2011, 08:01 PM
I wonder if your vets have actually seen any Cavaliers with SM? A second opinion might be a good idea, but you could also educate your own vets by looking at Clare Rusbridge's website and printing off anything you think might help your vets to get a more balanced view of SM - which as you know well from many members of this forum and their Cavaliers, is definitely NOT a death sentence and can in many cases be well-controlled with medication. I suspect they've only seen Pedigree Dogs Exposed and not kept up with their professional reading (fair enough - SM is only one of many diseases they have to deal with and they can't be expert in all of them - but then they should admit ignorance and not give you bad advice!). In particular, print off Dr Rusbridge's algorithm of treatment, which is intended to help vets manage SM with medication. You could also suggest that they look at the website themselves:


www.veterinary-neurologist.co.uk (http://www.veterinary-neurologist.co.uk) and for the treatment algorithm:

www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf (http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf)

As a first step, why not ask your vet to give you a referral to a neurologist, who would be able to give you an idea of whether Misty needs to have an MRI. And if they don't want to do that, just go to a neurologist anyway - I'm sure someone on this forum could recommend one in SW Scotland.

Kate, Oliver and Aled

Reptigirl
26th August 2011, 08:16 PM
No hope for treatment??? :bang::bang::bang:

It may not make the SM go away but dogs can live very good lives when managed on medication! I have 3 with CM/SM on medication. It's like a difference between night and day!

Either Pregabalin or Gabapentin alone can province significant relief! I am SHOCKED a vet would say it is not necessary. It is a MEDICALLY MANAGEABLE CONDITION. True you can't necessarily stop the progression without surgery and even that is a gamble, but why leave them in pain? While you may need to play around a little with the medication to find the right dosage but its not impossible! Depending on the severity of the MRI and they symptoms a specialist will be able to come up with a treatment plan to start with!

I'm just shocked a vet would recommend leaving a dog in pain due to the fact its not a curable condition! I would be looking for a new vet ASAP ... OR DEMANDING a referral for a specialist. IF it is SM it is manageable! TRUST ME! Otherwise my 3 would be in terrible pain! Without medication I'm sure at least 2 of them would have to be given there wings due to there symptoms being so sever. Thanks to medication they are able to enjoy a happy and relatively normal life!

Also just because a dog is not screaming or yelping does not mean that abnormal or painful sensations are not there. Scratching & face rubbing from SM is likely due to abnormal, uncomfortable or painful feelings or sensations. Before starting medication on my dogs I think I greatly underestimated the amount of discomfort they were in. They may not have been screaming in pain but after starting on the appropriate medication they are obviously much happier and more active.

murphy's mum
26th August 2011, 08:34 PM
Also just because a dog is not screaming or yelping does not mean that abnormal or painful sensations are not there. Scratching & face rubbing from SM is likely due to abnormal, uncomfortable or painful feelings or sensations. Before starting medication on my dogs I think I greatly underestimated the amount of discomfort they were in. They may not have been screaming in pain but after starting on the appropriate medication they are obviously much happier and more active.

Thank you. I did doubt myself, wondering if I'm over reacting, but I know I'm not really. The symptoms are there, and I know my dog.

He was more receptive than the first vet, it was the first one who said there was no treatment, and brushed me off:mad: Like I say he has given me Metacam, and said to see if there was an improvement at all.

Kate like you say maybe they haven't seen any Cav's with SM/CM symptoms, and he's trying not to get my hopes up as he hasn't heard of positive results. However, I've read success stories on here that are heart warming. I think that if I go back and ask for her to be referred, then he will do it. Maybe I let his cautioning words put me off. I'm not fully aware on the testing process, is it a consult and then an MRI scan? There aren't any risks involved in any of it are there?

I'll start the Metacam tomorrow morning though. Should I see if there are any improvements before demanding a scan? Any idea how long it would take for any improvements to show?

HollyDolly
26th August 2011, 10:58 PM
She's also started whipping round and looking at her rear end, not everyday, just on the odd occasion.

He said it's a possibility that her symptoms could be SM related, but as there are no treatments for SM, would it be worth putting her through all the tests to find out. He said I need to weigh up the process against how much pain I think she could be in. I asked, is it not worth getting scanned so she could be properly medicated. His response confused me even more. He said it's so hard to balance the meds, and that most of the time the results are not successful.





The whipping round and looking at her rear end could be anal gland related. Did the vet check them?

In response to the latter half of you post I am astounded that a vet could say this.
It is like telling a cancer patient hey sorry no treatment so will leave you in pain. Shameful.
I hope you opt for a second opinion.

Nanette

anniemac
26th August 2011, 11:59 PM
Thank you. I did doubt myself, wondering if I'm over reacting, but I know I'm not really. The symptoms are there, and I know my dog.

He was more receptive than the first vet, it was the first one who said there was no treatment, and brushed me off:mad: Like I say he has given me Metacam, and said to see if there was an improvement at all.

Kate like you say maybe they haven't seen any Cav's with SM/CM symptoms, and he's trying not to get my hopes up as he hasn't heard of positive results. However, I've read success stories on here that are heart warming. I think that if I go back and ask for her to be referred, then he will do it. Maybe I let his cautioning words put me off. I'm not fully aware on the testing process, is it a consult and then an MRI scan? There aren't any risks involved in any of it are there?

I'll start the Metacam tomorrow morning though. Should I see if there are any improvements before demanding a scan? Any idea how long it would take for any improvements to show?

I a second what has been said and I'm shocked! You need to trust your instincts. Like shannon said, they don't always scream in pain. Ella would only if I picked her up the wrong way. Also, some scratch more, some have more of a balance trouble walking etc.

I am glad you are on this forum and yes it can be tough to get right medication but there is a significant difference. I can't believe a vet would give no hope or try treatment.

Well you have many supportive people and it looks like you may try to see dr. Rusbridge. Either her or another neurologist familiar with SM will help a great deal. *sigh*

Sent from my Droid using Tapatalk

mommytoClaire
27th August 2011, 12:06 AM
It seems everyone here that has suspected SM/CM has gotten a consult with a neurologist first. If you aren't comfortable discussing it with your current Vet, I would start looking for one on my own. Even checking on several sites that are linked here at CT might help you locate one. Or, just pose that question over at the CM/SM forum, as I am sure someone can give you a recommendation,

In the meantime, I do believe that several have mentioned the looking back at their backs as being tied into the disorder, as it can cause funky sensations along their spine.

Praying that it's not what you are thinking.

Desrae
27th August 2011, 12:11 AM
A second opinion is a good idea, yet you might just get the same from the second opinion vet. We have tried a couple of times talking to vets about SM/CM. The first vet we talked to just shrugged it off and said it wasn't worth giving such a young dog an MRI and the experience he has had with cavalier owners getting scans is that they all turn out negative :bang: Our girl Belle has exhibited the rear end turning (rarely) and chin rubbing (getting more frequent), but seems to be a happy healthy dog otherwise. A few months ago we went to a recommended vet and he said she probably has SM as all cavaliers have it and just keep an eye on her and if symptoms appear more or get worse then we'll opt for medication. So it's a tough one. Sometimes I worry so much about our dogs health and bring them into the vet, I'm afraid they think I'm one of those neurotic moms who thinks their kids are always sick. I don't know- it's like waiting for a time bomb.

Our Bobby seems fit as a fiddle, yet he has the wonky knee, which is at a grade 1 right now. It's all very sad. I don't know if I would ever get a purebred puppy again, cavalier or any other, there is just too much heartache and worry involved. :cry*ing: That is the way I feel at the moment anyway. I want the cavalier breed to survive, and would like to contribute to helping the cause any way I can, even if it's donating a few bob to Rupert's Fund.

GraciesMom
27th August 2011, 02:08 AM
They are not well informed at all!!! Agree you need to ask around about a vet that knows more about the condition...or look for neuro on your own. You know your dog better than anyone. My first vet also said ears and when that did not fix it, I went elsewhere for help. I hope you are doing okay and we are here rooting for you.

murphy's mum
27th August 2011, 08:57 AM
Thank you for all the replies, and most of all the support:)

Nanette, yes, we get glands emptied on a regular basis as Misty doesn't scoot until they are really bad, so we go every 6-8 weeks to keep on top of it.

I spoke to Axa last night to find out whether a MRI scan is covered, I was sure someone on here, mabye Pauline, had had one done through them. The advisor said that MRI's can be covered, but it's taken on a case, by case basis. I pointed out that I haven't claimed for anything remotly similar for Misty. so shouldn't it be covered. He did say that if I can find out how much it would be for a scan than it could be pre-authorized, if they will cover it. So I need to find out how much a scan will be, both for the insurance campany, and in case they cannot cover it and we need to pay ourselves.

I'm going to speak to the other vets this morning. I'm just worried that they'll be the same. If they are "backwords" like our current practice seem to be, then I'll stick to the younger of the two vets I spoke to last night. They have always been very good to any animals I've had treated there, my horse, hamsters, rats, cats and now my dogs. Misty has needed so much done to her since we got her poor soul, and I cannot fault their care of her. She's had teeth done, both eyelids operated on, surgery to remove a peach stone she swallowed, and they provided excellent care everytime. I think there is a hole in their knowledge when it comes to SM though, however, I do think if I out right demand an MRI he would refer me. If not I will need to try and find a neurologist in Scotland or the North of England. I'm quite friendly with on of the ladies on reception, she rescues Ragdolls, so she may be able to help me find one.

When we do get Misty scanned, and we will, there is no doubt in my mind now, is it the neurologist that decides her meds or would that be up to which ever vet I end up with?

Thanks again
Paula

BrooklynMom
27th August 2011, 09:18 AM
Yes, sometimes we have to just demand these things. I had to ask my vet for a refferal too, she didnt offer at first. It was much easier than your story though, she did know about SM, but just told me that if I hadn't of brought it up, she would not have even thought of it in relation to Brooklyn. She immediatly called a neuro for me though while I was in the office with her and got some more info and said "yup, referral it is". Some vets just don't think to look for it and some actually just don't think it exists. The good ones are the ones who once they hear you...go on a quest to learn more and get involved. They are only GP's after all, so we have to stay informed and on top of them too, but once we do, they should listen, learn and come with us for this journey.

I am so sorry to hear about all of this. Hang in there, here to help however I can. Hugs to you.

murphy's mum
27th August 2011, 12:26 PM
Bloody hell, I am so f***ing mad right now. Went back to our vets this morning, he was in surgery, so he's just called me back. I asked him outright for a referral, and I now have no doubt he's trying to put me off getting one done:mad:

I said I had thought about it overnight and I would like a referral to a neurologist as soon as possible, and as my insurance company wasn't saying yes or no to whether it would be covered, then could he give me a rough estimate to the price.

His reply was similar to last night so I'm not imagining his hesitation. He said I would need to weigh up the "need" for her to be MRI scanned. Is it really something that would benefit her, or would it be something to bring me peace of mind, by confirming my suspicions. There are three ways to look after SM:

~ One, if there are mild symptoms then just monitor the dogs condition

~ Two, if there are more serious symptoms try and medicate appropriately

~ Three, in the worst cases where meds are not working to try surgery

He said we were trying to medicate her symptoms by starting her on the Metacam. I ask how she can be medicated without an MRI scan to show the extent of any CM/SM she may have. And he said a MRI scan doesn't help to decide what meds a dog should be on. All a MRI scan does is prove whether or not she has it.

How can he be looking to medicate my dog without knowing if she has CM or SM or POSM? God!!!

I asked would he be looking to give her any pressure reducing drugs if he didn't have a MRI? He says most of those drugs come at a heavy price for long terms use and would not consider using them without trying to relieve the symptoms using NSAID's first. Why jump into something when we haven't found if the NSAID's work on her.

I am so mad, and upset I'm nearly breaking my keys as I furiously type. He's made me feel as if I want a MRI scan for my bloody benefit, and not to try and help Misty have a better quality of life. I've never heard of anyone on here being medicated without a MRI scan being done first.

I told him I still want him to call for a referral. His reply was he would not get anyone at the weekend, but will call the neurologist next week to discuss Misty's case, and to see what they think. He will call back on Wednesday night to speak to me.

I've contacted the only other vet in town, and I am waiting for a call from them, unfortunately they are very busy today, so I may not get a call till Monday. We only have the two full time practices in Dumfries, there is another one which opens part time, but I wouldn't consider using that one. I don't know if I should look further a field for a vets, but what is the point of having a vet if it's not close in an emergency?

Sorry the flood gates are now open, must go.

Kate H
27th August 2011, 01:37 PM
The only way you can definitively diagnose SM is by MRI scan - period. You cannot treat the symptoms until you know what you are treating. My Oliver has a small syrinx which doesn't seem to cause any problems; what he does have is CM which causes seriously dilated ventricles which give him bad headaches - and no vet could pick that up without a scan. He has been mildly light phobic all his life, and we only discovered why when we saw the size of his ventricles, pressing on to the back of his eyes.

I would think your nearest neurologists are at Glasgow and Edinburgh University veterinary schools. These are the details for Glasgow - you could find Edinburgh by googling. Nicki, living in Scotland (though the other side to you!) may have more ideas.

Gawain Hammond MA VetMB MVM CertVDI DipECVDI FHEA MRCVS
The Small Animal Hospital
School of Veterinary Medicine
University of Glasgow
Bearsden Road
Glasgow
G61 1QH

Tel: 0141 3305848

Email: clinoff@vet.gla.ac.uk
Web Site: www.gla.ac.uk/schools/vet/smallanimalhospital/ (http://www.gla.ac.uk/schools/vet/smallanimalhospital/)

I should phone or email the neurologist and discuss the best way of proceeding - I think they will probably give you an appointment to discuss symptoms and go over Misty and then decide whether a full scan is needed. They may need a referral from your vet, but if you explain the situation, they may waive that - or the other vet in Dumfries may be willing to give it. I'm not sure why your vet thinks a scan is such a big deal - yes, it involves a general anaesthetic, but then so does taking out bad teeth - or does he let them rot in the dog's mouth to avoid giving anaesthetic?!

Kate, Oliver and Aled

PS Oliver and I had a lovely holiday in Lochfoot a few years ago - you live in a lovely part of Scotland!

murphy's mum
27th August 2011, 02:54 PM
I did Google Glasgow, it's referral only it says. Will look for Edinburgh, meanwhile not heard from the other vets, they closed at 1pm too, so hopefully I'll get a call on Monday, or I'll call in if I can.

GraciesMom
27th August 2011, 07:36 PM
Maybe someone here from Scotland can tell you better vet to go to not too far away who WOULD give you referral. I am so very sorry. There are many vets like this in USA who are clueless about SM and othe Cavalier conditions. What about calling the Glasgow neuro office to see if they can recommend a vet?

Reptigirl
27th August 2011, 09:00 PM
I would call the neuro office and tell them your predicament! Like Graciesmom said maybe they can recommend a vet. We had similar troubles and had to switch to several different vets to get a referral. So glad I did! I ended up getting apologies from one of the GP vets. I've always told the vets "It will make me feel better to see a specialist so I know what I'm dealing with". Any vet who does not care what the owner thinks should not be in the profession IMO. After all they are our furry children we are trusting them to care for! Can you imagine the outrage if a human doctor or even worse a pediatrician had similar excuses!!! It would be all over the media! I don't understand how vets can be like this!

I hope you get this all sorted out. Maybe Nicki would have some advise on who to go see?

mommytoClaire
27th August 2011, 09:07 PM
What a mess, just wanted to say I am so sorry you are going through all this. BTW, NSAID's also have long term side effects.......so what the heck is he talking about! Read Pat's post to (I think) Brian about using different fluid reducers that don't have as many or little long term side effects.

murphy's mum
27th August 2011, 09:48 PM
Never thought of calling them direct to see if they could advise something. I know Edinburgh does a normal vet practice too, but hopefully I can find something closer.

Cindy thanks, I saw Pat's post when I read Brian's thread earlier.

You'd think the way the vet was going on that I have asked him to operate on her without a general anesthetic or chop a healthy limb off. All I want is a MRI scan, sure I know there can be a risk with a GA, but she'll be checked first to make sure she's fit. He made me out to be a right selfish cow, as if only I will benefit from a scan:mad:

I guess I need to be patient to Monday, I should take a leaf out of my little Princesses book, she's snoozing right now:D

murphy's mum
29th August 2011, 03:02 PM
Just received a call from the other vets. They have had cavaliers at their practice that suffered from SM. Unfortunately two are away to the bridge, but the fact that they have knowledge of SM is a good start.

I've booked Misty in at 16:50 on Wednesday to be checked over. I did ask his opinion on MRI scans, and he said where the pet is insured or the owner can afford it they advise a referral. He said the more scanned at a teaching hospital like Glasgow the more that can be learnt. He did advise that finding a balance of drugs can be difficult, and depending on the dog may not prolong their life more than a few years. However, not to worry about anything until he's seen Misty in person. He's away to request her records from my current vet.

Margaret C
29th August 2011, 03:45 PM
I'm so pleased to read this. Well done for perservering.

I hope that it turns out that there was nothing to worry about, but you do need to know.

Sydneys Mom
29th August 2011, 04:04 PM
That's wonderful that you found someone who seems willing to listen to your concerns and work with you. Will keep good thoughts your way that Misty will be OK.

murphy's mum
29th August 2011, 05:40 PM
Thank you :)

Within 15 minutes of me speaking to the other practice my vet was on the phone asking if there was a problem. I simply said I was unhappy at the lack of help in trying to get a referral, and I felt it best to get a second opinion. He mumbled something about how he had been willing to speak to a neuro this week, and to call him back it I wanted him to do so. Grrr, funny how potentially losing a client or money is finally enough to prove how serious I am.

I'll let you know how it goes on Wednesday:o

GraciesMom
29th August 2011, 07:24 PM
Should not have to come to this!! And he apparently does not know how much medications can help and even surgery can help some dogs too. He should be more informed on the condition. Maybe you should recommend he some education on Cavalier health in general.


Thank you :)

Within 15 minutes of me speaking to the other practice my vet was on the phone asking if there was a problem. I simply said I was unhappy at the lack of help in trying to get a referral, and I felt it best to get a second opinion. He mumbled something about how he had been willing to speak to a neuro this week, and to call him back it I wanted him to do so. Grrr, funny how potentially losing a client or money is finally enough to prove how serious I am.

I'll let you know how it goes on Wednesday:o

Nicki
29th August 2011, 09:11 PM
So sorry - I wrote a long reply to this yesterday but have been having Internet connection problems and it lost it :x


So pleased you are finally getting vet support - they are very like a GP/doctor and can't possibly be experts in everything. Something like this really needs a referral to a specialist - you can ask a vet for a referral and they should do that - remember you are the client. For some years now I have treated by vets as partners in the care of my dogs - respectfully of course! Sadly I recently had to change vets but now have a really good relationship with the new practice. If a vet is not prepared to listen or be prepared to read information you take in for them and listen to your concerns and suggestions, then they are not the best partner and as you have had to do in this case, you are best finding a new vet.


Glasgow are absolutely brilliant, the neurologist I saw was Maria Ortego but you can't request to see a specific person, it depends who is available. Maria was very thorough, and had a lovely bedside manner with Kayleigh. When we went back in for the results, my friend came with me - she had not seen an MRI scan like this before, and as Jane expressed interest, Maria took the time to explain it to her, and to compare it with that of an [anonymous] dog sadly diagnosed with severe SM a few days before, pointing out the syrinxes etc.

I was really impressed with all the staff, the cleaners kindly asked us if Kayleigh was ok with the vacuum before switching it on in our vicinity :-) [we were there after hours as Maria had been called in for emergency surgery]

Maria has very kindly been answering my questions in e-mails too!

The new hospital is fantastic, it has been very thoughtfully designed to give the most welcoming atmosphere with minimal stress to the animals.

I wish I was a bit nearer as I would meet you there :( please try to take someone with you, it really helps to have someone else to listen and to give support.


There is a cafe area upstairs, with very reasonably priced drink and snack machines [sandwiches, yogurts, even vegan date and nut bars which were yummy!] - and the best coffee I've ever had from a coffee machine!



Often the MRI scan is the day following the consultation, so be prepared for that. The insurance company should be able to do a preauthorisation for you, takes about 48 hours to get a telephone confirmation [they will need to contact your vet], and then a written confirmation. Glasgow ask you to take two insurance claim forms - you have to pay for the consult at the time, but they will claim direct for the MRI if you take in your valid policy.


I do hope the appointment with the other vet goes well, print off the relevant info from http://sm.cavaliertalk.com/, also it helps to take in a history and symptoms you are seeing [you should be able to get your old vets to print off a clinical history, if they won't do this, ask them to fax it through to the new vet]

You will be in our thoughts and we hope for good news

Holly
29th August 2011, 09:31 PM
I would be very angry, as well, that this vet wasn't taking you seriously. You know your dog better than anyone. I am glad it will all be resolved.

I did want to point out one thing, though, in case it helps a dog suffering with SM pain. MRIs are very expensive, especially here in the US (here in Atlanta it is around $2,000). When I first got Scarlett she was about a year and a half-- her breeder had leukemia and had to place her. I offered to take her in. As time went by, I started to notice some SM-like symptoms (air scratching, limping with her back leg- always the same side, head rubbing). At that point in time, I simply couldn't afford the $2,000 to MRI her but I had done a lot of research and knew what I was seeing. I talked with my vet and we decided to try her on the Gabapentin and see if we saw improvements, as typically, Gabapentin helps SM. As soon as I started her on the meds, things dramatically improved. I did take her in to see the neurologist a few months later for a consult and ohysical exam and brought video with me. The neuro agreed it was most likely SM and added omeprazole to her meds. All of this made a huge difference in her quality of life.

I have since had her MRId and she has a horrible case of SM. Even though I couldn't afford the MRI at first, if I hadn't started her on SM meds, she would have suffered quite a bit. So, sometimes, if you work closely with your vet that you trust, you can try the SM meds to see if they help the symptoms. Of course, an MRI is always the best route, but it isn't always financially possible.

Pat
29th August 2011, 09:49 PM
How can he be looking to medicate my dog without knowing if she has CM or SM or POSM? God!!! I've never heard of anyone on here being medicated without a MRI scan being done first.

There are many dogs on medication for SM that have not had an MRI, especially here in the States. I'm glad that Holly posted. If you don't have insurance and/or you are not affluent or if you don't live anywhere near a scanning facility, there is always the option of starting a gabapentin trial to watch for changes in symptoms. This is called "empirical" treatment. It's best to do after a neurologist physical exam and history but many don't even have access to a neurologist. I'd always opt to start with gabapentin for a trial rather than NSAIDs as gabapentin is generally safer than NSAIDS, especially for long term use.

Karlin has mentioned before, and I agree, that insurance companies are likely to eliminate MRI scan for SM for Cavaliers in the future when they figure out how this breed problem is affecting their bottom line. I fully expect that to happen. There will be much more empirical treatment at that point, particularly in this economy, as the average person just isn't going to be able to spend $2k on an MRI.

Pat

Nicki
29th August 2011, 10:37 PM
Thank you for posting that Holly and Pat - even a neurologist consult will really help if you can't manage an MRI scan. that is about £165 at Glasgow.

They quoted me £2000 for the scan, but it came in about £1800 - Also paid £100 for pre GA blood tests - essential in older dogs but advisable in younger ones - it also ruled out other issues. Kayleigh had a spinal tap [similar to a lumbar puncture in humans] - this examines the spinal fluid, checks for inflammation etc. They will have a shaved area on the top of the back in the area of the spine, usually towards the tail but sometimes towards the neck area. [not sure why they use different areas unless it's done after the MRI and they are trying to avoid syrinx areas? Pat might know?]

You can see a needle puncture wound but it heals up very quickly and hair re-qrowth is surprisingly fast.



Kayleigh had an ultrasound due to the weak pulse in her femoral artery - nothing was found and this seems to be another Cavalier thing although as long as they do not show symptoms, it's not clinically significant. This was actually much cheaper than expected, came in around £85.


If medication is needed, Glasgow will prescribe that and give you supplies for about a month, you can then obtain further prescriptions from your vet. It is probably cheaper to get them to issue a prescription and buy them elsewhere. Although vets do rely on income from drugs [this helps keep the consultations fees down...] sometimes they do charge what appears to be an excessive amount for drugs. I came to an arrangement with my vets that if they supply the drugs at a reasonable price [ not more than about 30% more] then I will purchase from them. That takes into account the cost of them writing a prescription - you need to factor that in.

Glasgow will discuss progress and future medication changes with your vet if required - they do ask for a follow up in 3-4 weeks by e-mail or 'phone - especially if you are too far away for further consults.

murphy's mum
30th August 2011, 01:17 PM
Thanks Nicki, I'm glad to hear that Glasgow is so nice. I am a little sad to be in the position to need to change vets, but I do feel it's very much in Misty's best interest. I know I am not an expert by any means, but it did feel as though I knew more about SM that either of the vets at my current practice. And like you say I should not have to be jumping up and down demanding a MRI scan and still getting told it's "pointless". I was hoping the consultation and the MRI would be done in the same day, but not to worry I suppose it's not too bad a journey. The new vets have already called for her history to be faxed over, so hopefully he should be up to speed by tomorrow.

Holly I do understand in those circumstances why and MRI can't always be down, but when I was so intent on getting one down, my vets really have no excuse not to refer Misty.

Pat, I did question the vet about why he wanted to start Misty on Metacam, but he said by starting her on anything else "would be jumping straight" in. She's been on it three days now, no obvious improvement, but I assume it's too soon anyway. Then again given the fact I have nagged, yes nagged, I'll admit it, the vets for months now about her symptoms, I shouldn't be surprised. Up until Friday, when I basically lost my temper, their attitude was very much wait and see.

Sabby
30th August 2011, 02:09 PM
Just to say that I am with AXA and before the scan I had no claims with Harley. They emailed me the Pre Authorisation Form, I printed it out filled it in the vet done the quote and faxed it with Harleys medical history direct to AXA and I had a decision 1 day later where AXA rang me and then my vet to say that itís ok to go ahead with the scan. I needed to take a normal form to the vets so they could claim it direct. But the scan was done at my vets so I didnít need a referral. I will need a referral when I see a neurologist so the consultation for that I will need to pay and claim back.

murphy's mum
31st August 2011, 11:27 AM
Thanks Sabby.

I'm feeling more nervous as the day goes on. I never thought I'd be looking to change vets after six years, it's worrying.

Plus i'll need to get them used to my singing Cavaliers. Murphy and Misty hate waiting at the vets so tend to be very noisy in reception.

Karen and Ruby
31st August 2011, 01:40 PM
Thanks Sabby.

I'm feeling more nervous as the day goes on. I never thought I'd be looking to change vets after six years, it's worrying.

Plus i'll need to get them used to my singing Cavaliers. Murphy and Misty hate waiting at the vets so tend to be very noisy in reception.

I had to change Vets recently with Ruby as her vet left our surgery after 4 years of seeing her. I really panicked as I know that there wern't many vets around whom have knowledge of this disease!

I did alot of calling around and found a vet that was already treating 5 Cavaliers with SM so I took the plunge and got an appointment. I wasn't disatsisfied with him by any means - he knew what he was talking about, Ruby liked him- but then she isn't picky!

But the first time I asked for a Presciption for her meds which I get from Boots I was shocked that I had to pay over £15 and it was only for one dispense!

With my first Vet I only pay £9 for 3 repeats (it does 4 dispenses). To pay £15 every time I went to buy her tablets would mean I might as well buy it straight from the vets ( which I think was what they wanted).

But since then I have gone back to my old vets, for a few different reasons.. One of which being that Charlies Cardiologist is based there and secondly she knows the place and feels happy there if she has to stay over for anything. And it is closer to home (which was a god send when she was extremely sick last month)

And hey- If I can give a vet some experience of treating a dog with SM which can help another dog in the future then I'm happy to do that.

The difference is that I already have a Neurologist in Dr Rusbridge whom I trust deeply and that is another reason I feel comfortable enough to be under the care of a not so knowledgeable vet.

The lady I have now has taken so much time to read through the encyclopaedia that is Ruby's life so far and I really appreciate her for that. She trusts my instincts and will pretty much get on board with anything I need. I have told her about Clares website aswell and she is very interested to learn as much as she can!

For that I am very grateful and happy with the desision I have made.

murphy's mum
31st August 2011, 06:15 PM
:updte:

I've started a new thread in the SM forum as it seems more appropriate. The newest of the bad news is listed there too :(