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View Full Version : 8mth Old Showing Symptoms - Lost, Please Help - In USA, from UK



ZacAndLeo
11th April 2013, 10:32 PM
Hi all,

http://s15.postimg.org/lqhm55uyz/photo.jpg
I’m really worried about my darling pup’ Leo. He is 8 months old and I have noticed he displays some possible symptoms of SM. I am from the UK, purchased the puppy here in the US though, and am living in Chicago for the next six months. I am shocked by how much more MRIs are here and at 26 years old I will have to do it at least partly on finance unless I can wait to be bac in the UK in Aug/Sept/Oct.
He has luxating pattelas in both his legs. I got him checked at the vets as I suspected so from symptoms and they confirmed grade 1 in the right leg and grade 1-2 in the left.

His breeder is AKC registered and I have spoken to her – they said they have never had a Cav with SM nor luxating patellars or heard from a buyer that it developed in one of their puppies. They seem to genuinely care and offered, “I know it’s not want you want to hear but we can give you a replacement free if worst comes to worst.” I didn’t want to hear that tbh and it sent me to tears but I understand they meant good.

The two symptoms he displays that rang the alarm bells for me re:

Particularly he does these two:

- Scratches his kneck and head, not too rigorously or long (at most 10 secs but usually just a couple) – this happens a few times through the day definitely. I have also seen him do the phantom air scratching while walking – not often but I’ve seen it on occasions.

- He yawns quite a lot but he is just a pup and needs his sleep, licks his lips too but I wouldn’t say he does either ‘’excessively’’. He does the head shake and body shake sometimes, like they do when they’re wet but he does it dry sometimes.

After he is bathed/showered he does the following two a lot, though it could be just because he is wet and freaked out:

"Digging or pushing. Some dogs begin to dig obsessively at carpets or sofas. They may run along the length of a sofa pushing themselves against it. Again, this behavior is normal in many dogs; with SM dogs, the activity is frantic."

"Head rubbing
Some dogs start to rub their head from side to side on the floor as if their heads hurt, doing this excessively (NB: normal dogs will do this with pleasure, often before rolling on the floor). They sometimes 'mush' their face against the floor. In severe cases dogs have rubbed their faces raw on the floor. An affected dog often follows a scratching session by rubbing its face against the floor. "

Also, when he gets a chew toy he wish shake it and his head franticly like he is trying to kill the life out of it. I think/thought this is just normal puppy behaviour though.

He hasn’t yelped other than maybe once or twice in the last six months because he has injured himself. I don’t think he has ever expressed pain other than after a typical puppy accident, like a bump or something.

I have seen him chase his tail a couple of times in a row but only on the one occasion (earlier this week).

He seems happy as pie. He did an 8 hour flight last week and was an angel, no bother on it. I love him to BITS. We have built such a tight bond in the last six months that we have been best amigos. Yesterday though he seemed a bit erratic, I thought it was boredom and took him for a walk which seemed to help. I think he was making slight groans once or twice last night in his sleep. Hard to say if they were anything more than sleepy puppy noises.

UPDATE: In last 24 hours I have noticed him sneezing frequently. Perhaps allergies or cold maybe.

I am really worried but I can be a bit neurotic. I mentioned SM to the vet yesterday when taking him to have his lux patellar confirmed but he didn't know what I meant by the acronym and I forgot the full term for it. It was only last night/today when I was reading more about the luxating pattelars that I looked into it more and realised he has so many signs.

I have updated my vet what I meant by SM and why I thought it. I assume he will call later but clearly it will need a specialist.
Key questions I have are:
- Who should speak to? I feel lost and alone on this here in the US. There are seemingly wider and more affordable options back in the UK.

- Do I need an MRI scan? Would there be much benefit doing it now as oppose to waiting, bearing in mind the cost? Or should I just monitor him and see if any signs become more persistent or worrying until I am home?

- Should I consider getting pet insurance before I have him examined for this? I have not mentioned it to my UK vet or had him checked for it in any way.

- Is there anything else I need to do at this stage?

I will stick by him no matter what and make sure that he has the best life possible, whether he has SM or not.
Thank you for any help. This forum has provided so much support to so many people which is admirable.

Zac

MomObvious
12th April 2013, 01:45 AM
Leo is so cute! No wonder you are so in love with him.

I cannot answer all your questions I have not been a cavalier owner long myself and have not seen firsthand any health problems (touch wood) however I CAN tell you we all worry about our cavaliers like you do. Its kind of like living with a time bomb, I personally knew all about these issues and choose a cavalier anyway. Its a balance of worry and enjoy. Honestly, what you describe could be symptoms of anything from normal puppy, to too much bathing, to SM/CM, to glue ear or even Fly Catcher Syndrome........you need a vet who knows and understands these conditions tho.

Oh and YES I think almost every pet owner should have pet insurance, unless you have an endless bank account or something. I do think you might pay more and/or the knee problem might never be covered or limited coverage but either way get a policy ASAP.

A few ways to find a vet who is better able to care for a cavalier would be to reach out to the regional club of ACKCS http://www.ackcsc.org/ here's a link I know there is a chapter in a big city like Chicago. Also there is a rescue group that operates just in the Chicago area, I am pretty sure they can refer you to a great vet, here is their link https://www.gccavalierrescue.org/. If that doesn't help and you cannot find a SM knowledgeable vet try contacting a neurologist and ask them. Lucky for you there are 2 in the Chicago area here's a link to them http://www.chicagoveterinaryemergency.com I cannot think of any member of this forum who is from Chicago but maybe there is one.


I do hope I have pointed you in the right direction. But I also do want to offer some plain old support:lpy: You are NOT alone...and this forum is here to listen to all cavalier stories and help, laugh, enjoy, worry and understand. Please let us know how you and Leo are doing. Keeping in touch and feeling like other cavalier lovers understand should be very helpful.

ZacAndLeo
12th April 2013, 04:09 PM
Leo is so cute! No wonder you are so in love with him.

I cannot answer all your questions I have not been a cavalier owner long myself and have not seen firsthand any health problems (touch wood) however I CAN tell you we all worry about our cavaliers like you do. Its kind of like living with a time bomb, I personally knew all about these issues and choose a cavalier anyway. Its a balance of worry and enjoy. Honestly, what you describe could be symptoms of anything from normal puppy, to too much bathing, to SM/CM, to glue ear or even Fly Catcher Syndrome........you need a vet who knows and understands these conditions tho.

Oh and YES I think almost every pet owner should have pet insurance, unless you have an endless bank account or something. I do think you might pay more and/or the knee problem might never be covered or limited coverage but either way get a policy ASAP.

A few ways to find a vet who is better able to care for a cavalier would be to reach out to the regional club of ACKCS http://www.ackcsc.org/ here's a link I know there is a chapter in a big city like Chicago. Also there is a rescue group that operates just in the Chicago area, I am pretty sure they can refer you to a great vet, here is their link https://www.gccavalierrescue.org/. If that doesn't help and you cannot find a SM knowledgeable vet try contacting a neurologist and ask them. Lucky for you there are 2 in the Chicago area here's a link to them http://www.chicagoveterinaryemergency.com I cannot think of any member of this forum who is from Chicago but maybe there is one.


I do hope I have pointed you in the right direction. But I also do want to offer some plain old support:lpy: You are NOT alone...and this forum is here to listen to all cavalier stories and help, laugh, enjoy, worry and understand. Please let us know how you and Leo are doing. Keeping in touch and feeling like other cavalier lovers understand should be very helpful.

Thank you so much, Melissa for the thoughtful and valuable response. I am going to investigate these links further today.

Best wishes,
Zac

Kate H
12th April 2013, 05:17 PM
Pet insurance in the US may not be much help, as both the patellas and the possibility of SM could be considered pre-existing conditions and therefore will not be paid for. But if you are going back to the UK in a few months, I would take out UK insurance as soon as possible.

With a dog showing possible symptoms, an alternative to an MRI that some vets find helpful is to put the dog on the main drug used to control CM/SM pain, gabapentin. If it makes an almost immediate difference to the possible symptoms, then there is a good chance that you are dealing with CM/SM. Or even without an MRI, a visit to a neurologist if you can afford it would be helpful, because a neuro experienced with the disease can tell a great deal from the possible symptoms even without an MRI.

I think we all get a bit paranoid about our dogs, but at the same time what seem to be symptoms of SM can be other things, just as what seem to be other problems such as allergies can in fact be SM. It's a very tricky disease! Try and find a vet with experience of CM/SM, think about saving your pennies (cents? dimes?) for an appointment with a neuro - but above all enjoy your Cavalier, they are enchanting at 8 months, all legs and eyes!

Kate, Oliver and Aled

ZacAndLeo
12th April 2013, 05:36 PM
Pet insurance in the US may not be much help, as both the patellas and the possibility of SM could be considered pre-existing conditions and therefore will not be paid for. But if you are going back to the UK in a few months, I would take out UK insurance as soon as possible.

With a dog showing possible symptoms, an alternative to an MRI that some vets find helpful is to put the dog on the main drug used to control CM/SM pain, gabapentin. If it makes an almost immediate difference to the possible symptoms, then there is a good chance that you are dealing with CM/SM. Or even without an MRI, a visit to a neurologist if you can afford it would be helpful, because a neuro experienced with the disease can tell a great deal from the possible symptoms even without an MRI.

I think we all get a bit paranoid about our dogs, but at the same time what seem to be symptoms of SM can be other things, just as what seem to be other problems such as allergies can in fact be SM. It's a very tricky disease! Try and find a vet with experience of CM/SM, think about saving your pennies (cents? dimes?) for an appointment with a neuro - but above all enjoy your Cavalier, they are enchanting at 8 months, all legs and eyes!

Kate, Oliver and Aled

Thank you Kate for the considerate reply.

I will definitely take him to a Neuro at some point. Just monitoring him now to see if I should take him here or at home. I would much prefer to do it back at home really.

My vet has said he knows a few Neuros in Chicago. I would happy to pay for a consulttion but an MRI at $2k when I can get one for £300 in the UK would be wasteful unless essential.

Thanks very much for the tip re; gabapentin - I will consider that if symptoms persist. Obviously I will research dosage etc.

He seems a bit better today and the frequent sneezing has made me think there is a possibility it is something else.

Cavlier's are just the best. There are four on my street here! I really feel like building a loving friendship with a dog is one of the great joys in life!!

Thanks agai

joandesan
12th April 2013, 06:20 PM
I have a tendency to worry too! A couple of thoughts...if you trust your breeder and he/she confirms that they have never bred a pup with SM that is a good thing. Some times itching can be an allergic reaction to food, or dry skin. After a bath, my CKC always nuzzles his head into me -- it's like he is hiding because he doesn't want to be seen all wet. Tail chasing is a normal puppy thing, and dogs do make noises sometimes in their sleep (Bosco snores!). So, before I paid for an MRI (Yes-- very expensive in the US), I would take a deep breath and wait and see. Hope this helps with your anxiety a bit. Please keep us posted.

ZacAndLeo
12th April 2013, 06:46 PM
Thank you for sharing Jo. It's very helpful to hear similar situations.

Karlin
12th April 2013, 07:21 PM
You've had some good advice -- I actually would not be that concerned about anything you mention EXCEPT the air scratching which doesn't really occur with any other condition.

Sadly there is absolutely no way any breeder has not bred a dog with SM -- every breeder who has MRId has found it in their dogs and it is estimated, on clinical samples of dogs with NO symptoms, that at least 70% have it by over age 6-7. The breeder sounds like she cares but also is terribly underinformed on this condition, for someone who is breeding. . Your experience and concern will hopefully encourage her to learn more.

anniemac
12th April 2013, 08:17 PM
Oh I hate that you feel alone here in the US. I will tell you that I am neurotic and have people tell that too me but that's ok because I don't care. Elton is the extremely healthy and acts like a puppy even at 6 1/2. We all worry about our babies. I will say that having a cavalier with CM/SM did make me see some things that are symptoms of CM or SM and I would focus on that when I think there are other issues going on with my adopted cavalier Elton. Elton, however, never have a "pained" look in his eyes. He didn't act or seem like he was in pain. This is a HUGE difference than Ella but Leo IS a puppy so I am not sure if it's the same.

He DID have an MRI scan and even though he doesn't have SM he has CM (very rare that they don't). CM alone CAN cause pain and symptoms which I knew but now I feel that I missed the other things that should be ruled out first.

Reading what you said about Leo, I thought this is very similar to Elton (except phantom scratching).

He does have fly catchers which can be related to other things. There are neurologists that feel it is linked to SM. I went to one that didn't and since it isn't constant he felt he did not need to be on any anti seizure medication because there are really strong. He does the body shake. chases his tail sometimes but it's improved but I think he is a very nervous cavalier. He sneezes A LOT! Sneezing is not a symptom (that I know about) which makes me think there might be an allergy issue. Elton has very red eyes which after I was convinced that the scratching, head rubbing, chasing his tail, was all due to his CM, I finally realized it could be allergies or behavior among other things. One time the head rubbing was actually due to an ear infection that I found out later. He definately runs around and rubs his head etc. after baths. I think this is really normal.


Leo is a puppy so most of these things, like karlin said, seem to be not that concerning and if its not excessive then I wouldn't worry it is anything serious. However, Karlin has a point about the phantom scratching. I also feel that it never hurts to have a consultation with a neurologist. I did and I don't regret it because even if it was $70, it gave me some piece of mind. It also saved me the cost of multiple visits to a vet and since your vet is not familiar with the condition, it might be worth it. Also, he/she could prescribe medication if he feels he should without having an MRI. Actually, I feel if things are not extremely excessive, an MRI might be better when his is a bit older when you go back to the UK if there is still an issue.

I recently switched Elton's food and went to a holistic vet and she changed his diet and added some herbs. I am happy to report his fly catching behavior has not happened since and chasing his tail and some other things have improved. I am not saying you have to go that far but maybe you can rule out allergies first?

There are many other cavalier owners here that live in the US and have dealt with this condition. If they haven't, there are many people that are supportive. Keep us updated on Leo.

Love my Cavaliers
12th April 2013, 09:57 PM
My black and tan, Riley sees Dr. Podell, a neurologist at http://www.chicagoveterinaryemergency.com/ in Chicago for her SM. He has been absolutely wonderful to us. He diagnosed her within a minute of hearing her symptoms and looking at her walk and watching her behavior. She has seen him now for over 5 years. He has a cavalier and is very familiar with SM. He may be able to help you with Leo just with a diagnostic physical exam. If you can get a video of his air scratching that would be great. You could talk to him about wanting to wait for an MRI until you get back to the UK, but maybe ask him if he feels Leo might be helped by some medication. I have nothing but good things to say about him. He has done surgery on two of my dogs - one for SM and one for cervical disc decompression. Good luck.

anniemac
12th April 2013, 11:10 PM
My black and tan, Riley sees Dr. Podell, a neurologist at http://www.chicagoveterinaryemergency.com/ in Chicago for her SM. He has been absolutely wonderful to us. He diagnosed her within a minute of hearing her symptoms and looking at her walk and watching her behavior. She has seen him now for over 5 years. He has a cavalier and is very familiar with SM. He may be able to help you with Leo just with a diagnostic physical exam. If you can get a video of his air scratching that would be great. You could talk to him about wanting to wait for an MRI until you get back to the UK, but maybe ask him if he feels Leo might be helped by some medication. I have nothing but good things to say about him. He has done surgery on two of my dogs - one for SM and one for cervical disc decompression. Good luck.

Bev,

I didn't know you lived in Chicago and I didn't know Dr. Podell did Riley's survey.

Love my Cavaliers
13th April 2013, 12:05 AM
We live about 20 miles north of Chicago. Riley gets so excited whenever she sees Dr. Podell - which is good because she sees him every 4-6 months for blood work! He picks her up and holds her and always has cookies. I love one of his techs too. She will always come out and say hi to us even if she's not taking care of Riley that day.

Rdituro
13th April 2013, 01:51 PM
The only way to be sure is to do the MRI. I am in the US but in NY. I just went through all this & my Winston just had the decompression surgery on 4/4. So far he's doing great. I remember freaking out wondering every time he scratched or rubbed his face, "does he have SM"? Even though I dreaded the news at least when I found out it was bad news I could deal with it. Knowing he may have been in pain all that time & he could've at least been on medication was killing me. You will feel better KNOWING what you are dealing with & if it so you can starts meds to relieve pain & then take it from there one day at a time. Good luck & I'm praying for you.

Love my Cavaliers
13th April 2013, 02:31 PM
The only way to be sure is to do the MRI. Absolutely the only way to be sure your dog does or does not have CM/SM is by doing an MRI, but skilled neurologists can tell a lot by a physical exam, especially if you have a video of behaviors that might not be elicited during the exam. Since you say you're going overseas in August, a neurologist may be willing to give Leo medication if he/she feels his behavior warrants medication until you can get back to the UK and get a less expensive MRI. That is something you would have to discuss with the neurologist. Although Rdituro has made an excellent point that just KNOWING what you're dealing with is half the battle. Please let us know what you decide to do.

Karlin
13th April 2013, 02:37 PM
Yes would echo that it may be worth a clinical exam -- but I'd really talk with your vet or try a new one familiar with SM before doing this.

Honestly nearly everything you describe could well be just normal dog behaviour (and in particular, puppy behaviour for some things :) ) -- the only thing that would raise questions for me, is the air scratching. (sneezing has nothing at all to do with SM).

SM air scratching also may, or may not be, what you are seeing -- perhaps that's not what he is doing, in which case, none of these other things would make me think this dog should be seeing a neurologist at least on your description. If you can video that and post here we can have a look -- a lot of us have cavaliers with SM and are familiar with this very distinctive scratch. I also have numerous videos showing this behaviour on www.smcavaliers.com that might be helpful. They also show the kind of intense versions of some of these activities that are done by SM dogs.

I would -- if all seems to point to SM symptoms -- see a neurologist explaining that you just want a clinical exam and opinion but first you ideally need a vet to consider your concerns I think and perhaps give you a referral. Or a vet may be willing to use Clare Rusbridge's treatment algorithm to try some SM meds and see if he improves.

Karlin
13th April 2013, 03:22 PM
I've heard good things too about Dr Podell as a kind person working with dogs and people with SM affected dogs. :) My only caveat with him is that he seems to be amongst the only neurologists finding numerous dogs of various backgrounds that are completely clear of CM -- which seems quite extraordinary given that these are closely related to UK dogs and the BVA panel has yet to find a scanned cavalier it would rate clear of CM, internationally!!

And owners of these dogs have not wished to submit the scans to the BVA. Which is very sad on several levels -- if they are TRULY CM clear then they would of course be immensely important for international research and would help researchers to better understand this horrific disease. If on the other hand, they do have CM, then the breeders owning them and breeding them need to be considering that within their breeding programme, honestly, rather than --as is happening in some cases -- advertising/selling their puppies as coming from CM-clear cavaliers.

Not all neurologists are adept at seeing CM as we have seen with other cases on the board, when a second opinion has been sought :) -- so it isn't a big deal or a criticism of the neurologist. It is just a shame that breeders who claim to be supporting health research only want to help research if they hear what they want to hear, and won't put contentious scans through to the independent panel breeders themselves asked for, for precisely such cases...to ensure accuracy of clear cavaliers! Go figure.

In addition I would think a neurologist would appreciate the feedback of a BVA panel, as correctly identifying and grading CM is itself a skill especially in some cases and some head positions... Well, we can all hope for some changes of mind, and maybe someone at some point will submit those scans and do something truly positive towards health research. :thmbsup:

Love my Cavaliers
13th April 2013, 03:58 PM
I've heard good things too about Dr Podell as a kind person working with dogs and people with SM affected dogs. :) My only caveat with him is that he seems to be amongst the only neurologists finding numerous dogs of various backgrounds that are completely clear of CM -- which seems quite extraordinary given that these are closely related to UK dogs and the BVA panel has yet to find a scanned cavalier it would rate clear of CM, internationally!!

Not to be too defensive, but Dr. Podell has MRI'd all 4 of my dogs and has said all 4 of them have varying degrees of CM. They were all MRI'd for various reasons - only Riley and Oz for suspected SM. I know it's a small sample though and I don't know any other cavalier owners who have seen him. That's unfortunate if what you say is true about his low findings of CM, especially since he is such a caring neurologist and a gifted surgeon, particularly when we all know that CM itself has caused such pain and suffering for so many of our own cavaliers on CavalierTalk.

RodRussell
13th April 2013, 04:16 PM
My black and tan, Riley sees Dr. Podell, a neurologist at http://www.chicagoveterinaryemergency.com/ in Chicago for her SM. He has been absolutely wonderful to us. He diagnosed her within a minute of hearing her symptoms and looking at her walk and watching her behavior. She has seen him now for over 5 years. He has a cavalier and is very familiar with SM. ...

Dr. Podell has served the breed well. Back in around 1998, he figured out that the progressive early hearing loss so many cavaliers experience. He also has focused upon these other genetic problems of the CKCS: epilepsy, PSOM, and episodic falling.

Karlin
13th April 2013, 04:20 PM
It definitely isn't a criticism of the specialist :). Just a caveat on getting a 'clear'. There are several cavaliers now that he has given a 'clear of CM' to -- odd that there would be a cluster of in some cases, unrelated dogs in this one area of the world clear of CM! CM can be hard to diagnose at times -- so it is no criticism of Dr Podell, just a wish that the owners of the clear dogs would submit those scans to the BVA. It may be however that the quality is not the standard that the BVA requires... some centres do not have the latest scan technology as MRIs are pretty expensive machines... but in which case again that would raise questions on accuracy of a no-CM diagnosis. I had the same myself (a CM-clear) in the past from a UK neurologist by the way, and Anne of course had an initial CM-clear too from a good US neurologist -- and someone else here had one from another US radiologist -- the issue is really that it is exasperating when the supposed 'clear' claim is used as a selling point for puppies yet the breeders won't submit the scans to an independent panel to confirm and if they are clear, make DNA available for research. I think professionals would want to have their grading set against a standard (eg the BVA panel) if they are giving recommendations and results to breeders or pet owners.

If I had a clear from any neurologist, I would be submitting it in a nanosecond to the BVA panel as I'd want it verified by the panel, and would love to have a dog that could be so helpful to research! :)

Margaret C
13th April 2013, 05:51 PM
His breeder is AKC registered and I have spoken to her – they said they have never had a Cav with SM nor luxating patellars or heard from a buyer that it developed in one of their puppies. They seem to genuinely care and offered, “I know it’s not want you want to hear but we can give you a replacement free if worst comes to worst.” I didn’t want to hear that tbh and it sent me to tears but I understand they meant good.

Zac

I agree that what your puppy is doing may well be normal behaviour.

It may be your breeder "meant good" but most astute breeders know that buyers bond within hours of taking their new puppy home, so there is usually no way the new owner will return their pet. I would say that breeders depend on that fact when they don't do the health tests that they should on their breeding dogs.

I would have been more impressed if they could have shown you certificates that showed you the parents of your puppy had been screened for SM. Did you see any health certificates at all when you bought your little boy?

In the UK the £300+ scans are to help breeders check whether their cavaliers are suitable for breeding. They provide a mini scan of the head & neck and a consultation with a neurologist is not included. To get a proper diagnosis and a treatment plan you will need to pay for a full MRI scan which will cost £1,500-£2,000.
You would be well advised to take out insurance as soon as you get home.

When you get back to the UK you do also have the option of paying for a neurologist for a physical examination only. If you go that route please make sure you get referred to someone who is really experienced in SM. There are plenty of us on here that can help you.