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RodRussell
12th October 2012, 03:32 AM
Ohio State University's Dr. Cole publishes definitive guide to PSOM in cavalier King Charles spaniels.
http://www.cavalierhealth.org/psom.htm#Dr._Cole_publishes_a_definitive_guide_to_ PSOM

MomObvious
12th October 2012, 06:14 AM
So basically when a cavalier has an ear infection (PSOM- which I know it not like a simple take your medicine and you will be fine human kind of ear infection) it doesn't "look" like an ear infection in other breeds? Sorry to "dummy" down this important info but its good to know since most of us and always on the radar for the best up to date health CKCS news and information.

RodRussell
12th October 2012, 02:49 PM
So basically when a cavalier has an ear infection (PSOM- which I know it not like a simple take your medicine and you will be fine human kind of ear infection) it doesn't "look" like an ear infection in other breeds? Sorry to "dummy" down this important info but its good to know since most of us and always on the radar for the best up to date health CKCS news and information.

Cavaliers get ear infections just like other breeds, and the symptoms of those infections would be just like in other breeds. PSOM is not an infection, but it may have symptoms that make it appear to be an infection.

In a way, PSOM is as insidious as CM/SM. Both of them may have symptoms which mimic those of other, more common disorders. To make matters worse, the symptoms of PSOM and CM/SM may mimic each other, and it is not unusual for a cavalier to have both CM/SM and PSOM.

But to really be sure whether your cavalier has PSOM (or has SM), you need to have an MRI or CT (computed tomography) scan performed. PSOM is progressive, and if it is in an advanced stage, the vet may be able to diagnosis it with a hand-held device.

MomObvious
12th October 2012, 08:08 PM
Oh like a lot of other progressive illnesses finding it early can help a lot.... I understand the relationship now. Ok now silly blonde question do you think we are discovering that the malformation in the cavalier skull causes this PSOM issue as well? If so that would lead me to think maybe there are other unknown problems. Again our poor breed the longer I love this breed the more helpless I feel for the future of them. Sometimes I feel like I own the last generation of a T-rex or something.....

RodRussell
12th October 2012, 08:30 PM
... do you think we are discovering that the malformation in the cavalier skull causes this PSOM issue as well? ...

In a July 2010 study report, UK researchers found an association between PSOM and brachycephalic conformation in cavaliers. In their report, they find, "in CKCS, greater thickness of the soft palate and reduced nasopharyngeal aperture are significantly associated with OME [otitis media with effusion, meaning PSOM]."

But, PSOM is common only in the cavalier. It has been found in three other breeds, like 9 boxers, one dachshund, and one shih tzu. So, it is not a widespread brachycephalic problem. But it could be related to the cause of Chiari-like malformation because so many cavaliers are found to have both CM/SM and PSOM. Then, again, nearly all cavaliers have CM and most have SM, so that combination may not mean much.

I don't know about other breeds, but here is a list of genetic disorders that either are unique to the CKCS or are much more common in the CKCS than most other breeds:

Mitral valve disease
Chiari-like malformation and syringomyelia
Idiopathic asymptomatic thrombocytopenia (low counts of blood platelets)
Macrothrombocytosis (oversized blood platelets)
Cerebellar infarcts (strokes)
Dry eye
Curly-coat syndrome
Abiotrophic sensorineural deafness
Eosinophilic stomatitis
Episodic falling syndrome
PSOM
Masticatory muscle myositis
Chronic pancreatitis

RodRussell
13th October 2012, 04:06 PM
Good news for UK cavaliers: The Royal Veterinary College has commenced an ear, nose, and throat refferal clinic at the Queen Mother Hospital for Animals in London, headed by Dr. Gert ter Haar. Services include advanced diagnostics and treatment for PSOM in cavaliers, as well as CT and BAER diagnostics for deafness (plus hearing aid implants for selected patients), and diagnostics and treatment of cavaliers with brachycephalic airway obstruction syndrome (BAOS).

Telephone 01707 666 365 for more information.

Karlin
14th October 2012, 11:42 AM
All really useful info -- thanks, Rod.

On PSOM -- have spoken with a couple of neurologists including Geoff Skerritt, Clare Rusbridge and Jacques Penderis in the UK, and Dr Marino in the US -- they all say PSOM is one of the most common findings on ALL MRIs they do of ALL cavaliers either with or without SM. It is probably one of the main reasons why so many in the breed start to lose hearing commonly around age 5+ (though there's also a high incidence of congenital deafness in the breed). Of four cavaliers I have had that have been MRId only one did NOT have PSOM to some degree. one that did not have it or SM, went deaf as did one of mine with PSOM but without SM. Another with SM is going noticeably deaf.

Deafness is pretty rare in my friends' dogs of other breeds/mixes unless they are either white dogs (and thus carry a gene for deafness) or are very very old. :(

The other thing about PSOM is that, along with mimicking many CMSM visual symptoms, it also at extremes can bring similar levels of neurological pain. So it isn't a minor issue.

Given a seemingly direct association in this breed with PSOM and its head and muzzle shape (and the new study on how conformation might influence likelihood og SM -- which I think most likely will not find any easily discernible exterior signs except the general small head and short nosed face) -- I do wonder if the appearance of the breed has really got to change significantly -- towards a slightly larger cavalier with a longer nosed and more normal head shape rather than the 1-2 inch long truncated snout. A more normal and natural length would be at least twice that length and might bring back more normal head development.

Researchers already know this head shape totally mangles the interior organisation of important organs (some are turned upside down into the bottom of the head rather than along the top and back of the nose!) and affects the development of the skull. There's significant evidence from a number of studies by different research groups including the foetal tissue research that haywire skull/brain development, where the brain continues to grow beyond the size of the skull, is what causes the resulting problems of CMSM and there's as Rod notes a documented link with PSOM. Seems hard to argue that we should continue to breed dogs with a head shape that brings so many mild to serious health problems including some associated with severe pain and a shortened life. :(

anniemac
14th October 2012, 03:41 PM
In a July 2010 study report, UK researchers found an association between PSOM and brachycephalic conformation in cavaliers. In their report, they find, "in CKCS, greater thickness of the soft palate and reduced nasopharyngeal aperture are significantly associated with OME [otitis media with effusion, meaning PSOM]."

But, PSOM is common only in the cavalier. It has been found in three other breeds, like 9 boxers, one dachshund, and one shih tzu. So, it is not a widespread brachycephalic problem.

I find this interesting and may start a topic on BOAS, but I want to ask a couple questions.

I know even after surgery PSOM can come back. Elton had an MRI after age 5 and did NOT have PSOM. Not that I am worried but is this something that can happen later in life? What I'm trying to ask is you mentioned it is progressive but if one does not have the issue at 5 is it something one should not be concerned with?

I feel Elton has BAOS because even before I adopted him, I was told he has a reverse sneeze which I think is associated with BAOS. Like CM/SM all these conditions are so confusing. I had a cavalier with severe CM/SM and one with very mild CM only and both did not show PSOM on the MRI?

RodRussell
14th October 2012, 03:58 PM
... I know even after surgery PSOM can come back. Elton had an MRI after age 5 and did NOT have PSOM. Not that I am worried but is this something that can happen later in life? What I'm trying to ask is you mentioned it is progressive but if one does not have the issue at 5 is it something one should not be concerned with?

I think that if a cavalier has not developed PSOM by age 5 years, he is very unlikely to do so in the future. While PSOM gets worse over time, I think that the conditions for its start are there either before or soon after maturity.


...I feel Elton has BAOS because even before I adopted him, I was told he has a reverse sneeze which I think is associated with BAOS. ...

Nearly every one of our cavaliers has reverse sneezed from time to time. Not all reverse sneezes calls for palate surgery. But if your dog reverse sneezes often, or cannot pull himself out of a reverse sneeze, he may be a candidate for the surgery. I sure hope not, though, because just reading about soft palate surgery makes me gag.

anniemac
14th October 2012, 04:19 PM
Nearly every one of our cavaliers has reverse sneezed from time to time. Not all reverse sneezes calls for palate surgery. But if your dog reverse sneezes often, or cannot pull himself out of a reverse sneeze, he may be a candidate for the surgery. I sure hope not, though, because just reading about soft palate surgery makes me gag.

It is very often and sometimes I can't get him to stop. I tried your trick of closing his nostrils and lowering his head and teach him to breathe through his mouth. Sometimes helps but not very often. He also gags and coughs which I started to think coughing was heart related. Will find out soon and see vet about BAOS. Thanks and sorry to move off topic.

Karlin
14th October 2012, 04:30 PM
Just to note, have been told this is not a study limited to UK breeders, but is open to international participants (Dr Rusbridge titles it an international study for her blog post :) . So anyone interested in participating internationally should contact researchers. :D So far there is the ability to do the measurements in the UK (so irish breeders could travel); Australia and at least some of Europe. There would be hope to get someone also in North America I would suspect.

http://clarerusbridge-news.blogspot.co.uk/2012/10/tom-mitchell-is-researcher-at.html