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Dennis379
26th January 2012, 08:02 PM
After reading and watching videos online about SM I swear my dog does have this. I am so bothered by this because the vet always says it's allergies but I never believed her. I am gonna request no matter what for him to get a MRI. When I was always told its allergies, I have tried everything to different shampoos to medication and nothing works at all. Have always felt guilty I wonder why the vet never even bought this up.

Tania
26th January 2012, 11:16 PM
Where are you and what is your dog called? You are right to get a referral and get this checked out. If your dog has sm, the sooner she/he is on pain medication the better. There is a lot of help,
support and friendly advice here. I see this is your first post so a big welcome to both of you icon_welcome

Nicki
26th January 2012, 11:23 PM
Welcome to the board but sorry to hear about your concerns :(


Have a read through the symptoms on here http://sm.cavaliertalk.com/ and see if he is doing anything else. There is also info to print off for your vet. You would need a referral from your vet to go to a neurologist, but it's possible to have just a consultation [the low cost scans are NOT for symptomatic dogs unforutnately]


I think you need to rule out other causes for scratching as you have been doing but ALL cavalier guardians need to be aware of their health issues, so they are prepared and aware BUT we also need to enjoy our dogs and not become so obsessed that it spoils every day.

At the international conference on Syringomyelia in 2006 it was stated that incidences of scratching due to SM were an indicator of SEVERE pain so you are right to persevere with trying to get help.

Dennis379
27th January 2012, 02:37 AM
His name is Tommy a 9 yr old male CKC. Out of everything I am reading he hasbeen diagnosed with all three already allergies, ear issues and disk problem.About a month ago I came home from work and he was crying out loud and he has never done that before so we took him to Emergency Vet and they treated it as a pulled muscle in his neck, and gave him meds for the pain. Since it healed I guess they saw no point looking further into it. What really hit me was watching the youtube videos also he does all the things the other dogs were doing. Im moving to Florida within Febuary so I really atleast want to get the MRI now before the move. Are vets usually hesitant in looking into SM?

Nicki
27th January 2012, 10:46 PM
Sadly many vets are still unaware of SM/CM, they may not have many Cavaliers in their practice or any experience with the condition. IF you can print out the stuff from the website and take that in, it will really help [and may help other Cavaliers and their guardians in the future]

It's hard but really the vet is a partner in the care of your beloved companion, and if they won't do a referral or take your concerns seriously then you may need to think about changing vets.

Try to keep a diary of Tommy's symptoms, that makes it easier for the vet to objectively assess what is happening.

Kate H
27th January 2012, 11:46 PM
Nicki wrote: the low cost scans are NOT for symptomatic dogs

I wouldn't entirely agree with this. Unless surgery is an option, whether you have a mini scan or a full scan, you still end up simply dealing with the symptoms, not the disease itself. However long your dog's syrinx, there is practically nothing you can do in most cases to make it any shorter or thinner or directly influence the course of the disease. What a mini scan can do, even with a symptomatic dog, is to confirm whether or not your Cavalier actually has SM, since usually at least part of the syrinx will show at the top of the spine, as will herniation and dilated ventricles (not to mention picking up PSOM). This will enable vets and neurologists to stop treating allergies/disks/pulled muscles etc and start seriously treating the symptoms of CM/SM with appropriate medication.

As Oliver gets older, his symptoms of CM/SM are slowly increasing and my vet has been discussing with neurologists whether he should have a full scan (so far he's just had two mini-scans). Clare Rusbridge commented that although a full scan would be interesting, to see what was happening in an older dog, it would really be better if I saved my money to spend on medication to deal with the symptoms. So perhaps we shouldn't dismiss mini-scans as entirely useless for symptomatic dogs - though obvioulsy circumstances will vary.

Kate, Oliver and Aled

RodRussell
28th January 2012, 12:15 AM
... What a mini scan can do, even with a symptomatic dog, is to confirm whether or not your Cavalier actually has SM, since usually at least part of the syrinx will show at the top of the spine, as will herniation and dilated ventricles (not to mention picking up PSOM). This will enable vets and neurologists to stop treating allergies/disks/pulled muscles etc and start seriously treating the symptoms of CM/SM with appropriate medication.

... Clare Rusbridge commented that although a full scan would be interesting, to see what was happening in an older dog, it would really be better if I saved my money to spend on medication to deal with the symptoms. So perhaps we shouldn't dismiss mini-scans as entirely useless for symptomatic dogs - though obvioulsy circumstances will vary.

I think this is very valuable advice and deserved to be repeated, with emphasis, and so it has.

Nicki
28th January 2012, 01:14 PM
The low cost scheme I was referring to - as shown on the Cavalier Club site - states

Mini scans are not suitable where a dog is showing symptoms as a full scan will need to be performed for diagnostic reasons and appropriate treatment.

The scheme was organised for breeders to screen their dogs.


Yes it would be great if low cost mini scans were available for symptomatic dogs - sadly the cost does put many people off if they are not insured, but Clare's comment is so true, thank you for sharing that.


I think the reasoning in the past has been that if you have a mini scan and then opt for surgery, a further full MRI has to be carried out.

Kate H
28th January 2012, 11:11 PM
Oliver had both his scans through the Midland Cavalier Club. No questions were ever asked about whether he was showing symptoms or whether it was likely that he would have SM, and the secretary, who organised the scanning days, knew that I wasn't a breeder. When Aled was also scanned, she was also well aware that he was a neutered rescue. I think as long as there is room for your dogs on the day and you belong to the club, they're happy to let any Cavalier owner take advantage of the mini scans. ChesterGates charges 150 for a mini scan (it was 100 when Oliver was scanned for the first time) and 2000 for a full scan! The Midland Club is having some more scanning days in April,and May so I'm going to get Aled done - he was scanned when Oliver was last done, but he was barely 2 then and is now nearly 5, so I'd like to know what (if anything) is happening. Three years ago he had no SM and no herniation, but mildly dilated ventricles, and so far seems to have no symptoms.

Although the Cavalier Club does say that about mini-scans on their website, it also gives a list of centres that do mini scans, and I would think that if you talked to them and explained any financial difficulties they would recognise that a mini scan is better than no scan at all. And a mini scan plus a session with a neurologist if the scan shows SM is still very much more affordable than a full scan. Anyway, as far as 'no symptomatic dogs' goes, I bet that most of the dogs mini-scanned and showing SM are actually also showing some (unrecognised) symptoms. Certainly Oliver was at the time of his first scan, though both I and my vet woud have sworn that he was asymptomatic. Does such a thing as a dog with asymptomatic SM actually exist - or do we need to learn a lot more about recognising symptoms of pain?

Oh for a DNA test!

Kate, Oliver and Aled

sins
28th January 2012, 11:41 PM
I agree Kate,
There are quite a few centres offering low cost scans, at regular frequency and I'm sure the world wouldn't stop turning if an occasional pet got a mini scan.
In fact it could be a useful dog for the EBV scheme if it's KC registered.A syrinx is a definitive result and an older dog,even if it scratches or face rubs may still not have SM and could contribute too.
Do you know if the scans at Chestergates must now go to the BVA panel for reading,incurring the extra 100 on top of the scan or will Geoff continue to interpret them?
Sins

ByFloSin
28th January 2012, 11:54 PM
Anyway, as far as 'no symptomatic dogs' goes, I bet that most of the dogs mini-scanned and showing SM are actually also showing some (unrecognised) symptoms. Certainly Oliver was at the time of his first scan, though both I and my vet woud have sworn that he was asymptomatic. Does such a thing as a dog with asymptomatic SM actually exist - or do we need to learn a lot more about recognising symptoms of pain?

Oh for a DNA test!

Kate, Oliver and Aled

You are so right on that one Kate. When I did a write up on Rebel's SM symptoms for the vet I went through old photographs I had taken of him and was shocked to find that for at least 2 years he was clearly photophobic, even at the time of his MRI mini scan, also at Chester Gates, where I was told he was asymptomatic. This was quite clear to me when I realised that in all of these pictures he had the same eye very firmly closed when facing normal indoor daylight. The vet agreed with me, although she had no previous experience of dealing with SM. She also noticed that his face was showing signs of great pain, as illustrated on Claire Rusbridge's site. Once the Frusemide relived the pressure I realised she was right.

Yes, I do think that most of us have a lot to learn when it comes to recognising the symptoms of pain. It breaks my heart to think that dear sweet Rebel was experiencing pain without me knowing it and this experience is telling me that there must be many others in a similar position.

Karlin
29th January 2012, 03:58 PM
I know so many people who in retrospect reaise they were seeing symptoms. They can be quite subtle but I think you do get pretty good at seeing what is and likely isn't SM (same for vets I am sure. Once my vets began to have cavaliers coming in with SM, they got to where they can tell pretty much right away that most likely, they are seeing SM -- but of course screen for other possibilities first. Face rubbing is real 'mixed bag' symptom. For dogs WITH SM, you do see this generally when pain gets very uncomfortable, such as around the time meds start to wear off. But also many dogs, many breeds and mixes, simply like to rub their face, especially right after eating. To me I would be more likely to be concerned about face rubbing if it occurs around when a dog is also scratching a lot, just had a lot of activity/excitement, or has shown some body sensitivity or yelped or shown some other classic SM sign. Face rubbing on a carpet right after a meal -- I'd discount this as a worry IF this is all a dog is doing and the only time it is done. I have seen people elsewhere mistakenly stating that SM scratching is non-contact scratching or only to the ear area and anywhere else, it is unlikely to be SM. This is absolutely untrue (and I fear leading a lot of dogs to not get treatment until months and months later than should have happened). Scratching with SM can be to virtually anywhere, and often is contact scratching. So I think a lot of people including breeders look right at clear SM symptoms and don't see them because they have mistaken ideas about what SM symptoms are.

Karlin
29th January 2012, 04:07 PM
With Tommy: given that you have had vets check and treat for other conditions yet you feel you are seeing symptoms of SM, I would discuss with your vet and ask for a referral to a neurologist. It would be helpful I think even to have a clinical exam. Symptoms can be similar to allergies but when they keep repeating and also -- as you are -- you start to see signs of pain too -- I would just go to a neurologist. :thmbsup: Let us know how things go. Given his age, I'd ask about trialing him on some of the basic SM medications as a response to those would be an alternative diagnosis. You would be unlikely to have surgery as an option with a 9 year old dog unless quite fit -- hence not sure I'd be considering an MRI.Many useful comments on both sides on getting MRIs, and low cost vs full MRIs. I've posted elsewhere that I think a lot of people will benefit from getting a low cost MRI and then can pay for a consult on top of that for treatment, it needn't be part of the low cost exam. But I would opt for a full scan IF I were thinking of surgery as an option or wanted the full picture.Right now people really need to be informed about the mini scans to know how to take advantage of them -- most pet owners generally won;t know too much about them as they are directed at breeders.

Love my Cavaliers
29th January 2012, 06:12 PM
Riley had surgery for severe and advanced SM when she was two months shy of turning six years old. Her neurologist said that he generally won't perform SM surgery on a dog over 7 years old, but would treat them with medication instead. I guess there is always an exception, but that's his rule of thumb.

So, for your 9 year old, you might want to just jump right to the SM meds or have a mini scan so that you know what you're dealing with and then go the med route. Neurologists can also tell a lot just by their clinical exam. Within 30 seconds of examining Riley, he told me he suspected she had SM. Good luck to you and let us know what happens.

Nicki
29th January 2012, 08:34 PM
I have had a reply from Clare Rusbridge regarding the mini [low cost] scans:


The main reason why a full scan is important (especially in a 9 year old dog) is that you need to rule out other causes of pain especially intervertebral disc disease. If you do a mini scan and the dog has severe SM then you have an answer but maybe not the full picture – if you do not find severe SM then the 200 etc may have been wasted or at worse misleading.

Also one of the reasons that we try to avoid having pets come on the low cost days is that they have no contact with neurologist – and as you know the dogs need treatment and the owners need support/information. So if the mini-scan option is taken then I think it is important they then book an appointment with a neurologist after they receive the result.

If the dog already has a diagnosis of severe SM then repeat MRI may not actually make a difference to the clinical management – if funds are limited then this is why it may be better to spend money on medication.

Karlin
29th January 2012, 10:04 PM
That's very helpful -- thanks for that! :) IT's very kind of Clare Rusbridge to reply, and helpful for people to get the view of a leading neurologist in the area of CM/SM.