View Full Version : hello: misdiagnosed cavalier with SM

8th April 2012, 10:16 PM
I want to first start out byapologizing for how lengthily this will be, but I want to make sure I do notmiss anything because I feel it isimportant for any new cavalier owner to understand how easily symptoms and orsigns in your puppy can be missed.
I am not a blogger, I don’t readblogs, I don’t write in blogs, etc…this is all new to me. I think this is the best place to post andshare my story.
Over six years ago when I decidedto get a puppy, I was not sure of the breed I wanted, until I went with afriend over a friends house of his in new York city and out from the bedroomcame running this adorable little playful dog who listened to every word herowner said as she were human. I then askedwhat type of dog she was, and then I was asked if I ever watched Sex and theCity? Long story short, the dog thatcame running from the bedroom was actually, Miss Elizabeth Taylor from Sex andthe City. Apparently his friend was amake up artist and when they needed a dog, they chose his….

Now my mind was made up and itwas a Cavalier King Charles that I was going to get. I did my research (so I thought), and learnedall about the breed. The heart problems,the eyes, the hip, etc and found a guy in PA. who had a litter for sale. He seemed to be much cheaper than the normalprice I was finding, so of course I phoned him, and he had just what I wanted….afemale, Blenheim, and about 12 weeks old. I sent him a deposit and the following weekend drove 4 hours to pick upthe puppy.
When I arrived there I learnedhe was nothing but a back yard breeder..the place was filthy and he had no paperwork like he said hewould. My heart went out to the puppywho sat in my lap looking at me as if she wanted a better place to live, andalthough I knew I could give her that, I had to leave her behind because (whichis ironic, as you will see by the end of this story) I could not fall in loveand get attached to a puppy to find out in 5 or 6 years from now, that she wassick, it would absolutely crush me.
So I drove back home andstarted the search all over again, and was referred to very reputable breederin another state who happened to also have a female, 12 weeks old, Blenheim pupply. It was the following week, I headed to theairport to open up the cage door to this incredible little girl who so happyand playful and would end up becoming the most precious thing to me.
As the years went by all wasfine, no problems etc until about 2 years ago when all of the sudden she seemedto have hurt her back . I took her tothe vet, they did xrays, etc. and told me it must be a soft tissue problem andwill heel on its own…gave her some remidyl and sent us home….and within 24hours it did get better but after she had a lot of activity the next day itseemed to bother her again.
After maybe a few month it wentaway..she could do activity, long walks etc and no problems what so ever.
This past November, oneafternoon, she went to jump up on the bed, and didn’t quite make it and fell,and was in pain to where you could see it in the way she walked….she wouldn’t eventry to do the stairs, and we live on the 2nd floor. I made cut out a side of a milk crate and shewould talk into the milk crate and I would pick her up and bring her up anddown the stairs in that.
I decided to goto another vetfor this incident who again, did the xrays, examined her etc and said the samething…soft tissue…, sent me home with Carpofen and tremedor and said noactivity.. it seemed to get a littlebetter and every once in awhile she would do the stairs etc, but it seemed likeif she did, then the next day we were back to the stiffness and wouldn’t dothem again….i never made her because I knew if she would do it she would, andif she couldn’t she would go right into the milkcrate and look at me to pickher up.
About 3-4 weeks ago I noticed alittle limp when she got up from laying down that wasn’t seeming to go away andnow she wasn’t seeming to improving after being on these pills for about 4 monthsnow…I knew something wasn’t right, so took her to a new vet who was now part of this state of the artfacility up here which is very well known. He examined her and had asked me if I ever heard of Chiari…I said no,and he gave me a brochure,,,when I opened it and saw the “SM” word, I said ohyes, I have heard of this but didn’t really pay attention because I had alwaysthought that if your dog had that, you would know it…I thought it was that typeof disease…well, that was my ignorance.
He scheduled an appt. for herto see the neurologist , which we did and she even said, depending what you aregoing to do with the MRI results, meaning if we were going to try to treat it with meds, lets try that first andsee how it goes. So she put her ongabapantine, with the carpofen and the tremador and I was to re visit with herthe following week because she was on vaca the next week.
The following Wednesday, whileshe was on vaca, I phoned the vet who referred me to her to schedule the MRIfor that Friday because she wasn’t getting better, she was getting worse.
She went in for the MRI, and hephoned me to tell me that he could confirm she had SM. I hung up the phone with him and just cried…becausethis poor little girl was going through this pain and who knows for how longand no one knew why…
He told me that I had to followup with the neurologist on Monday to find out her plan, but he thinks thatsince she is not responding to the meds, she will probably want to get her infor surgery. That Monday came and I metwith her and she isn’t recommending surgery yet….she wanted to try a differentdrug first which is pregab something..i am actually waiting for it to come instill..its being shipped from a company,,,,but in the meantime she upped her MGof carpofen and gabepantin, and with in 24 hours she was like 85 percentbetter,,I mean I came home from work, she flew up the stairs after beingoutside (which she hasn’t done in months), and to this day, which is only 5days later, she is still doing great. Shehas never had any of the excessive signs of SM. She hasair scratech, rolled her face on the rug, but nothing that would ever make mequestion it…..she has never stopped once while on a walk to scratch, etc andthe face rubbing I would notice maybe once a week if that, and would only lastmaybe 30 seconds…..i am not sure what anyones advise would be to the drugs andor route I was advised to take as of now, but would love to hear any feedbackyou may have …..

Kate H
9th April 2012, 08:52 PM
Sorry you've had this diagnosis for your little girl, it does tend to put you into a flat spin! But let me say first of all that the majority of Cavaliers with SM are well controlled with medication and can live more or less normal lives. My Oliver was diagnosed at the age of 6 but had probably had it for several years before that; his only symptoms at the time (which neither my vet or I recognised as symptoms - I had other reasons for having him mini-scanned) were squinting in strong light and being a restless sleeper! He will be 11 in June and apart from being a bit wobbly on his back legs when he gets up from dozing, and being light phobic, he still goes everywhere with me (by public transport), enjoys his walks, and is generally a very happy dog, although his symptoms are slowly getting worse. But we still have some medication options in reserve, so I hope he can live out his old age in comfort.

Finding the right medication for a particular dog can be a matter of trial and error over several months. Some do fine on gabapentin and a diuretic, though dosage will vary; others do well on Lyrica (the progabelin your neurologist mentioned). Surgery tends to be considered an option more often in the US than in the UK, and there are some people on this forum who can share success stories with you.

One of the real problems with SM is that its symptoms can look like a lot of other conditions - and other conditions can look like SM! Most general practice vets are not familiar with SM and tend not to make it their first diagnosis, so it can go undetected for some time while the dog is treated for allergies, disk problems etc., etc. But now that you are working with a neurologist, you should hopefully be able to get your girl comfortable and back to her normal happy Cavalier self.

Kate, Oliver and Aled

9th April 2012, 09:20 PM
thanks for the reply, and so far so good with the meds....the panting has finally stopped to where she is soo much more comfortable and happy....that was the hardest for me was to just see her laying there panting because i knew she was hurting and not comfortable.....i will of course keep you updated :)

9th April 2012, 09:24 PM
It is quite possible that her back pain symptoms were not of SM. The breed also is prone to a degenerating disc disease, the symptoms of which often start to appear around age 2 years or a little later. There is an article about this disorder at http://www.cavalierhealth.org/disc.htm

Ordinary x-rays do not usually show this disc disorder, and general practice vets usually do not bother to take the next step, which is a myelogram, which involves injecting dye into the dog's spine and putting it under anesthesia to perform the x-ray.

It is possible that, even though she has SM, it was not the cause of her earlier symptoms. I suspect it is even likely that it was a disc that caused her back pain, rather than SM.

Kate H
9th April 2012, 11:01 PM
I would agree with Rod. Oliver developed spondylosis (osteo-arthritis of the spinal vertebrae) at the time he was diagnosed with SM and it was quite difficult to work out which was causing what! Although his spondylosis hasn't caused any perceivable problems since then, it's still possible that his present wobbly back legs are spondylosis and not SM (though we think it's the SM). So we just treat the symptoms and hope that will work whichever is causing the problem!

Kate, Oliver and Aled

10th April 2012, 04:04 PM
correct...as the vet said, regular xrays would not show any kind of disc problem, but the MRI would. when she had the MRI, it wasnt to JUST look to see if she had SM, it was to check everythign to see what was causing her the discomfort.

10th April 2012, 05:24 PM
correct...as the vet said, regular xrays would not show any kind of disc problem, but the MRI would. when she had the MRI, it wasnt to JUST look to see if she had SM, it was to check everythign to see what was causing her the discomfort.

Yes, an MRI is a good alternative way to diagnose. So, I gather that the MRI scan showed no disc problem? If so, then I guess it was what we call "symptomatic" SM all along, or at least but for the elbow problem.

10th April 2012, 09:22 PM
that is correct...and knock on wood, today is one week and a day, and i have not seen a limp and she has not layed there panting at all, she is actually about 90 percent like her old self. i just hope it continues.

Love my Cavaliers
10th April 2012, 11:07 PM
Getting a diagnosis of SM does kind of turn your world upside down for a while. I have one dog that was diagnosed with SM by MRI and one dog that was diagnosed with degenerative discs by MRI. Both of them had surgery. Riley, my SM girl, was not diagnosed until she was almost 6, but had been symptomatic almost since I got her when she was 11 months old. She just didn't display typical SM symptoms, plus I had never heard of it, and I put her behavior down to "Riley's quirkiness". It wasn't unitl she started having seizure-like behavior that I sought out a neurologist and she was diagnosed and then had surgery. Surgery for her was extremely successful, even though she still has to take daily medication and will never be a "normal" dog. But, she is a happy dog and loves life and her quality of life is a 1000% better than it was before surgery.

That's not to say surgery is the answer for every dog. Most cope very well on medication - as your dog seems to be doing right now. I hope she continues to do well. Keep coming on and talking to us. We're here to give each other support. Trying to cope with SM on your own is too hard.