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Mabes
1st March 2012, 08:19 PM
Can anyone please help me out with this?

I haven't been here in a while but my poor Cavalier Frodo is ill. It started two weeks ago when he would yelp if we just walked by him, or tried to put his leash on. It has progressively gotten worse and now he barely moves because he will start yelping and going crazy, holding his right leg up and sometimes walking in circles. We've taken him to the vet three times now (and racked up a ton in vet bills). At first our vet told us it was just a pinched nerve and that it would go away in two to three weeks, but this is week two and it only seems to be getting worse.

We researched SM and honestly the symptoms do not match up. He was not air-scratching obsessively and it isn't like he's going paralyzed. Here is one very odd thing - he lays around all day and will only eat when he put food and water right up against his mouth, but if we take him for a walk he seems perfectly fine! He will trot with me and use the restroom and sniff around, without yelping. It seems like its only when he's inside and sleeping that he will randomly start yelping and act like his paw/arm/shoulder/neck is hurting him.

He went to the vet the other day (again) and X-rays were done. The vet said he saw a mass at the base of Frodo's skull (which scared us, because we know SM has to do with the brain coming out from the back of the skull) and the vet also said he thought he saw two slipped-disks in Frodo's spine. He sent the X-rays for more observation and they came back saying there was absolutely nothing abnormal with them, so we are back to the pinched nerve theory.

As you can see this has kind of been a rollercoaster ride and we are still confused. He's on several medications for pain, and for his heart (he has a leaky valve, and is also going blind in one eye because that eye does not produce tears). Frodo is a mess, but this is just heart breaking and I am hoping someone on here knows of something we can try, or has been through something similar. The vet told us its either wait and see, or send him out of town for a cat-scan, which will be three to four thousand dollars and we cannot afford that.

Any information will be greatly appreciated!! We don't want to lose our Frodo. If it helps, he is of average age (not a puppy, not an old dog). I'm not 100% sure what the age is but I can find out. I would guess seven or eight.

Kate H
1st March 2012, 09:42 PM
Sorry you are so worried about Frodo (like the name!). I picked up on one thing you said (apart from your main concern): He...is also going blind in one eye because that eye does not produce tears'. Unless there is some other physiological cause for this, the non-production of tears in Cavaliers is usually a fairly common condition called Dry Eye. It is very painful, but is easily treatable with medication and should not cause blindness; it is also easily diagnosed with a simple test that your vet can do in a few minutes. My 10-year-old Cavalier was diagnosed with Dry Eye 5 weeks ago; he has ointment put in several times a day (and will have to for the rest of his life), and his eyes have not looked so wide and bright for months! But of course there may be another cause for Frodo's problem.

As far as Frodo's back is concern, has your vet suggested complete rest? This can be really helpful with a variety of back conditions, simply because it takes the weight off the spine and gives any inflammation (such as caused by a pinched nerve) time to die down. Rest does mean rest! Preferably in a crate, with short excursions outside on leash to do business. Some dogs enjoy their walks so much that they are able to ignore any pain they feel (rather like we do with a headache, when we concentrate on something else); Oliver has SM and tends to whimper in discomfort when he is resting - you would never guess there was anything wrong with him when his nose is down following an interesting scent!

Hope Frodo will be better soon:xfngr:

Kate, Oliver and Aled

Nicki
1st March 2012, 09:56 PM
I'm so sorry to hear about Frodo - many SM affected dogs do not show typical symptoms, one reason why it can be hard to diagnose. Many do not scratch at all, some scratch and pull their hair out [originally it was thought they all scratched and didn't connect with the skin] I know of very few who have become paralysed.

Whatever the cause of pain, when they are excited about something, going for a walk etc, the adrenaline level in the body is raised and it's amazing what they can do - sadly often they suffer afterwards. One of my severely affected Cavaliers one time jumped over a baby gate and would regularly clear 4 foot fences to get to me - much to the astonishment of my vet and neuro, as at home sometimes he would be lying moaning in pain :( :(


Lying quietly and withdrawing from activity can be a sign of severe pain - vocalising is also a sign of severe pain - as per the information given out at the International Conference on Syringomyelia in 2006.

It is very much an emotional rollercoaster getting conditions diagnosed and then living with them, especially seeing your dog suffer.


Have a look at these sites http://sm.cavaliertalk.com/, http://www.veterinary-neurologist.co.uk/, http://cavalierhealth.org/syringomyelia.htm#Veterinary_Resources and http://cavaliermatters.org/ there is information you can print off to give to your vet. Many vets are not yet familiar with the condition especially in areas where there are not many Cavaliers.


Obviously the best way to diagnose is by MRI scan, however if this can be prohibitively expensive if you do not have insurance. The next best thing would be to see a neurologist familiar with the condition - there is a list of neurologists here http://cavalierhealth.org/neurologists.htm


Try to record Frodo's symptoms, and if you can video them that would be very helpful for the neurologist.


Please keep us updated.

Mabes
1st March 2012, 09:57 PM
Thank you so much for the response!


Sorry you are so worried about Frodo (like the name!). I picked up on one thing you said (apart from your main concern): He...is also going blind in one eye because that eye does not produce tears'. Unless there is some other physiological cause for this, the non-production of tears in Cavaliers is usually a fairly common condition called Dry Eye. It is very painful, but is easily treatable with medication and should not cause blindness; it is also easily diagnosed with a simple test that your vet can do in a few minutes. My 10-year-old Cavalier was diagnosed with Dry Eye 5 weeks ago; he has ointment put in several times a day (and will have to for the rest of his life), and his eyes have not looked so wide and bright for months! But of course there may be another cause for Frodo's problem.

As far as Frodo's back is concern, has your vet suggested complete rest? This can be really helpful with a variety of back conditions, simply because it takes the weight off the spine and gives any inflammation (such as caused by a pinched nerve) time to die down. Rest does mean rest! Preferably in a crate, with short excursions outside on leash to do business. Some dogs enjoy their walks so much that they are able to ignore any pain they feel (rather like we do with a headache, when we concentrate on something else); Oliver has SM and tends to whimper in discomfort when he is resting - you would never guess there was anything wrong with him when his nose is down following an interesting scent!

Hope Frodo will be better soon:xfngr:

Kate, Oliver and Aled

The vet did give us an ointment to use with Frodo, on the eye that isn't producing tears. So we are giving that to him twice a day. His eyes seem to have cleared up some from it!

We also read online that a crate may be best for him. He literally doesn't move all day, or all night, unless he goes crazy yelping or we try to take him outside to use the bathroom. Otherwise he will stay in the same position for hours and hours :( My only concern with the crate is if he starts yelping and spinning and ends up hurting himself more. He freaks out when he does this, and if someone is near him he will climb up onto them. He even tried to climb up onto someones shoulder the other day! Its such an odd, sad thing to watch.

Karlin
1st March 2012, 10:03 PM
I am so sorry you are having so many concerns.

I think for a start -- I would go to another vet as it doesn't sound like he has much of a clue on a number of levels. :( As Kate says dry eye needs urgent treatment but the treatment is easily done and there's no way he should be 'going blind' if it is dry eye. It is however very painful and I sure hope your vet is actually treating this already!!

I am afraid some of what you describe sounds potentially like SM -- scratching is not seen in all dogs; as a matter of fact it is reported in fewer than 50% of affected dogs, but pain, yelping,leash discomfort could be an issue.

It could also be some sort of neurological problem related to balance if he is going in circles. I must say I have never heard of a vet who could see so many things and just leave it untreated as a 'pinched nerve'... :(

Id go to a different vet, get a second opinion, and go from there. You may need to see a neurologist; you may need scans. I am sorry you may not be able to manage these -- insurance is such a necessity with this breed but that won;t help with pre-existing conditions now. :( Before making any drastic decisions though I would at least get a second opinion and if you feel you cannot give him the scans he may need, then your options can not really include leaving him as he is, as that would be too cruel. If you want him to have a chance, in difficult circumstances you might consider contacting breed rescue for possible help to rehome him as perhaps someone else or a group would try to help treat and rehome.

The yelping though is a sign of severe pain of some sort and really must be properly diagnosed and treated -- best of luck and maybe others have more specific ideas on cause. :flwr:

Karlin
1st March 2012, 10:05 PM
Just read second post -- I really think you MUST try to get a referral to a neurologist. :( That is just no quality of life at all for Frodo and his non-movement indicates severe pain. I'd see a second vet and see if they might let you try some of the meds for SM on Clare Rusbridge's treatment protocol to see if that helps. He really must get pain relief at a minimum -- steroids perhaps as an emergency. :(

sins
1st March 2012, 10:15 PM
The vet told us its either wait and see, or send him out of town for a cat-scan, which will be three to four thousand dollars

Cat scans and x rays will not diagnose SM.
Only an MRI scan will do that.Please don't waste your money.
Take a look through this website,which gives a good basic overview of SM and other health issues.
http://cavaliermatters.org/

Sins

Kate H
1st March 2012, 11:20 PM
Karlin, Nicki and others are helping you with possible SM, so I'll stay with the eye! Is the ointment the vet gave you for Frodo called Optimmune (don't know whether it has a different name in the US)? This is a medication to control the underlying cause of Dry Eye. You might also find it helpful to use ViscoTears on Frodo, if your vet agrees. These are substitute tears that keep the eyes well lubricated and help relieve the pain; they are not a prescription medicine - you can buy them over the counter at a pharmacy or online and are not expensive. They need to be used three or four times a day, or more if Frodo's eye looks uncomfortable. Some vets don't like using artificial tears, as they feel they stop the eye producing its own tears - but as that is precisely what is happening with Dry Eye anyway, I never quite understand that thinking! The eye problem may seem minor compared with Frodo's other pain, but Dry Eye can be very painful and anything that makes him feel even a little bit more comfortable is worth pursuing, until the main problem can be diagnosed and treated.

Kate, Oliver and Aled

Mabes
2nd March 2012, 01:05 AM
Thank you all so much for your responses!!

I went downstairs after my last post and tried to get him up so he could take his medicine, and he wouldn't stand up so I lifted him...and noticed he had peed where he was laying :( I managed to get him to eat quite a bit and then I took him for a walk, where he used the restroom some more. One other odd thing is that he seems to be afraid of our house! When we got back to the front steps he stopped and turned his head, and looked the other way. He stayed this way for a good while, even with me gently tugging his leash to get him to come. Finally I had to pick him up and set him inside the house, even then he wouldn't budge forward. How weird is that??

I have a question about SM - does it come on this quickly? Within a couple of weeks? And would he be in constant pain or just occasional? I would say he wakes up, on average, every 8 hours and yelps. Usually once or twice during the day, then once at night, just holding one leg up in the air.

Kate H - the vet gave us two medicines for his eyes! I looked at the boxes and they don't really seem to have a name, as silly as that sounds. One says "Neopolydex Ophthalmic Ointment" by a company called Falcon, and we are to use that once a day, at night. The other just says "Artificial Tears Ointment" and we can use that regularly.

I truly hear you guys on the point about finding another vet. We actually went from a local one, to this one, because he is supposed to be the best around. He does segments on the local news and is kind of expensive. :( I'm not in control of where we take Frodo (he is actually my mom's dog) but I will talk to her about this and relay all suggestions you guys have!!

Again thank you so much. I feel like I'm going crazy with all of this, and he's such a sweetheart (as all Cavaliers are!) I just hate seeing him in pain but I am NOT ready to lose him.

-edit-

Sins - that is a lovely site!! Very informative and I love the drawings. Thank you!

Margaret C
2nd March 2012, 01:48 AM
It does sound as if your poor Frodo is in very severe pain, so much so that he does not dare to move.

When my Monty suddenly started having bouts of serious neuropathic pain from SM he gradually retreated through the house, ending up in our bathroom. Even between the attacks he would not go anywhere near where he had previously had a screaming episode, not even into the garden. He associated those places with pain.

What you are describing could very well be SM. In fact I will be very surprised if there is any other explanation for what is happening to your poor little boy.

You are the only person that can help Frodo. He needs effective pain relief immediately from your Vet and then he needs an MRI or, at very least, a visit to a Neurologist that knows about SM.

Mabes
2nd March 2012, 02:01 AM
Thank you, Margaret C. Not what I want to hear, but I understand. :(

sins
2nd March 2012, 10:59 AM
Whatever the source of his pain,he certainly needs pain relief.
I hope your vet can manage to get him comfortable until you decide what path to take with referrals.
Definitely,get to a neurologist if you can,even if an actual scan is outside your budget.An expert examination may give some information without the scan.
Sins

Kate H
2nd March 2012, 11:34 AM
Mabes wrote: One says "Neopolydex Ophthalmic Ointment" by a company called Falcon, and we are to use that once a day, at night. The other just says "Artificial Tears Ointment" and we can use that regularly.

Yes, those sound like the Lacri-Lube that Oliver has at night, which is an oily ointment that lubricates the eyes over a longer period - hence using it overnight - but being oily is messy to put in during the day; and the Visco-Tears that he can have in as often as he needs it during the day (it's used for humans as well, so if it is the same thing and money is tight - and your vet is sympathetic - it might be worth buying it yourself over the counter if this works out cheaper. In the UK we can get the overnight one from the pharmacy as well - I get both of them from an online chemist). Oliver has other eye problems that seem to be related to pressure behind the eyes from his CM/SM dilated ventricles. Dry Eye can be hereditary in Cavaliers, and occurs in other breeds, but can also be caused by damage behind the eyes and I do wonder with Oliver whether this is yet another symptom of his CM/SM.

Kate, Oliver and Aled

Mabes
2nd March 2012, 03:29 PM
Kate H - very interesting. I wonder if it is related to the SM too. His blindness/eye issues seemed to come on really fast, along with the yelping. Thank you for the explanation!

Sins - We may have to just take him in for a consultation, at least! We've spent over $1,000 in the past month and that is already quite a bit for us. I wish I could win the lottery or something and get him the BEST care.

A small update - this morning he was walking around on his own! He went and got a drink on his own and followed my mom to the door when she was leaving for work. He hasn't done this in a couple weeks!! I read that SM symptoms can flare up and then go down for a while, so I'm wondering if this is the case. Either way it was good to see him moving again.

Mabes
4th March 2012, 03:50 AM
Just wanted to give another update! Frodo is doing MUCH better. He's up walking around on his own, wagging his tail more, eating, drinking, not yelping nearly as much. I'm honestly not sure what this means but we are going to watch him very closely for any more signs of SM, and we are still going to try a different kind of pain medication on him to see if it helps even more. I'm just so glad to see him getting back to his regular old self.

Karlin
4th March 2012, 06:48 AM
not yelping nearly as much.

But this is still indicating very significant levels of pain if he is yelping regularly (eg several times a week, even) *at all*.

I woud really advise you to print out Clare Rusbridge's treatment programme and point your vets to her website so they can fully and properly educate themselves and please, please try working through her treatment regimen. SM is one of the most painful conditions known to humans -- and relieving all pain has to be an absolute top priority for anyone who cares about their dog. If that means letting him go, because treatment cannot be afforded -- I think you may need to consider that, if a combination like gabapentin and cimetidine plus probably some type of painkiller doesn't address this level of pain. You cannot ask him to hang on because you are bot ready to let him go. If he is so bad he cannot lift himself, is peeing on himself, and yelping several times a day, listless and really struggling now to try and move about again -- he is trying to do this for you. We cannot ask them to suffer if we cannot give them the diagnosis and treatment they need, and *they* are ready.

He just cannot be left as is to see what happens next -- he is still in pain, and though dogs can slowly adjust to tolerating huge levels of pain, it is obviously not acceptable to ask any creature to endure it when there ARE potential medication remedies. Yu must decide whether to get him properly diagnosed by a neurologist, or try him on meds immediately -- your vet at very least should immediately get him onto adequate pain relief while these larger questions are decided.

Please don't wait and see if the yelping decreases before at the very least starting him on some type of SM-related pain programme, since he was not helped by treating for other things and as Margaret says, these are indeed likely signs of SM but at very least -- indicate significant and incapacitating pain and suffering. :(

Hopefully he can be managed for longer on adequate pain relief but he really must, MUST get it right away.

Reptigirl
4th March 2012, 07:24 AM
I have been very busy but I wanted to comment on this post... PLEASE look for a specialist or neurologist ASAP! I have 3 SM dogs and this really sounds like SM. It just sounds SO familiar! This could easily be managed with correct medication! If you can't afford an MRI scan you can at least get a consult with a neurologist or specialist! They can at the very least do a trial with proper medications! One of my severely affected dogs would have pain episodes where he could not move. He would freeze in a standing position and refuse to move. Episodes can come and go at any moment without warning! Our longest episode was a month straight! It took steroids and higher levels of neuro meds to get him right again. Now he runs and plays like a puppy! It took a lot of trial and error but we finally have a management program that works great! We learned the hard way... GO to a neurologist! Vets want to say allergies, pinched nerve, pulled muscle, and a dozen other "well maybe it could be this". If we had tested for everything out vet wanted to treat and test for we would be broke! True the neurologist was 4 hours away and more expensive upfront but it gave us a clear YES or NO answer. Sadly it was a YES but we got on the correct course of treatment! Our vet did her version of a neuro exam and said our dog was fine. The neurologist picked up on his issues right away without an MRI. The MRI confirmed he had nearly 90% of his spinal cord blocked by a syrinx! He had such sever hingleg issues where he would have periods of time he could not walk even our neurologist gave him less then a year... Well here we are, over a year later and he still runs and plays everyday nearly pain free!

If a dog is yelping .. it is in sever pain! With medications our SM dogs do not yelp! They run and play for the most part like normal dogs. Please try to find a specialist that will see your dog! OR a vet that is willing to listen! Our regular vet has taken over treatment for our dogs. Our neurologist is 4 hours away so it is just not feasible to drive on a regular basis. If you find a vet willing to listen or one with understanding of SM they can start treatment to see if your dog improves.

As Karlin said, please don't wait just because his yelping has decreased. SM comes and goes. It has no set schedule. It is not always predicable. You just never know when it is going to roar it's ugly head up and wreck chaos on your dog. It tends to come on at the worst possible times... In the middle of a storm, late at night, on a weekend or holiday. And then you are stuck waiting again why your dog is in pain.

Karlin
4th March 2012, 07:28 PM
Your voice of experience is very helpful and to the point.


Our vet did her version of a neuro exam and said our dog was fine. The neurologist picked up on his issues right away without an MRI.

This is what worries me about an awful lot of dogs whose owners are told by their vets that their dog probably does not have SM -- *especially* if signs include real pain, such as unexplained and repeated yelping. :(

There are indeed some basic things that should be vet-checked for before ever overly worrying that a dog has SM but in my book these are primarily the more straightforward things like ear mites, ear infections and disk disease... things that one or two vet visits will eliminate, relatively inexpensively. I'd be really dubious about a diagnosis of allergies when treatment doesn't help, and of alternative diagnoses of pain with proposals of all sorts of additional tests.

A lot of money can be thrown at vet tests for any range of unlikely things, when a visit to neurologist would be more cost effective and spare a dog weeks or months (even, years...) of pain. There is a point where, given the very high rate of incidence of SM in the breed, it is sadly more likely that given symptoms are going to be SM than anything else.

Charlifarley
5th March 2012, 01:05 PM
A lot of money can be thrown at vet tests for any range of unlikely things, when a visit to neurologist would be more cost effective and spare a dog weeks or months (even, years...) of pain. There is a point where, given the very high rate of incidence of SM in the breed, it is sadly more likely that given symptoms are going to be SM than anything else.

When I joined this forum just over 3 years ago, the standard advice for owners of dogs with SM-like symptoms was to rule everything else out first. Now, sadly, because of the high incidence, it's usually the first thing to be considered. :x
I hope that whatever is causing Frodo pain, you can manage to control it quickly and effectivley for him. SM pain can come and go in degrees of intensity. :hug:

Mabes
5th March 2012, 10:08 PM
Thank you again for all of the responses! I will relay the messages on (like I said I don't really have control over what kind of care he gets, because he isn't my dog and I am a recent college grad with very little money myself).

Frodo is up walking around on his own, using the restroom outside, eating, drinking, hopping...he even started barking again and going after the cat! I am, of course, worried that it is still SM and that these symptoms will still come and go as some of you have said.

When we can get him tested and know for sure, then we'll do our best to manage any pain he has or to make that hard decision :(

Mabes
9th March 2012, 12:47 AM
Thank you to everyone who replied to this thread with help. We lost Frodo today...I posted in the Memoriam section of the forum. I do appreciate all of the kind words and help.