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Advice re Syringomyelia please

C

Charles and Lyn

Member
Our Rosie is 2 years 3 months old. She is very fit and active and for the hour or so we walk her each day, she runs constantly, chasing anything that moves, leaping over fallen trees etc. with no trouble whatsoever. About 10 days ago for no apparent reason she collapsed yelping in pain and was trembling afterwards. Being aware of SM we have monitored her closely since then, (perhaps too closely). However she does display other signs, which could also be put down to normal behaviour as well as SM, i.e. occasionally air scratching with her hind legs (we don't walk her on a lead), scoots a lot even though we know her anal glands are empty and fine, scratches her ears, nips at her hindquarters, yawns quite a lot and shakes her head quite a lot. She also carpet rubs her head and rubs along the sofas, however this is normally after she's eaten, (another symptom of potentially normal behaviour). None of these does she do in what I would describe as an obsessive way, however there are quite a few potential symptoms. She does not display that she's in any pain, even when we vigorously rub her head, neck and shoulders and the vet has given her a very thorough, hard physical examination twisting and turning practically every part of her, and at no time did she indicate any discomfort, even jumping down from the 3 feet high examination table with no problem. We are aware that dogs can hide the fact they're in pain, and sometimes although pain is the primary clinical symptom, some dogs don't display it. We're also aware that if the symptoms develop in young dogs they are potentially more likely to progress into severe SM.


Our dilemma; Knowing that it can progress quite quickly and can cause irreparable nerve damage, hypothetically assuming she is in the early stages of SM, whilst we don't wish for her to commence medication too early, neither do we wish to leave it until she has sustained nerve damage, adversely affecting her quality of life. The Vet has recommended a Watch and Wait period and whilst cost is not an issue, both my wife and I feel we don't wish to put her through the trauma of an MRI, as from all the reading I've been doing, most cavvies will show as having CM and a clear or adverse MRI scan does not necessarily confirm whether or not she is likely to develop SM in the future.


My question is, could anyone who has had a similar experience give us any advice please? Thanks in advance for any advice you can give.
 
I'm sorry you have this anxiety. The only way you will definitively discover whether or not Rosie has SM is by an MRI. As you say, this will probably show CM anyway - and this alone can of course cause considerable pain, particularly headaches. But it may well also show that Rosie already has a syrinx and therefore has SM. The result of a scan will give your vet valuable information as to what you are dealing with - if CM is causing her present apparent symptoms of pain, the treatment will be a bit different to treating the symptoms created by a syrinx. My Oliver had a small syrinx that never seemed to cause him any problems - he didn't air scratch or head scratch. But his CM gave him severely dilated ventricles that caused severe headaches and light sensitivity. An MRI would show up dilated ventricles and whether the CM is causing herniation at the top of the spinal cord. I was puzzled by your phrase 'the trauma of an MRI', since Oliver had two MRIs and neither of them were in the least traumatic! Assuming Rosie has a strong heart, a general anaesthetic will put her to sleep for the whole process and leave her groggy for a few hours afterwards - from her point of view, no worse than having a dental. It's more likely to be traumatic for you, waiting in the reception area! 2 years and 6 months is often the age at which signs of SM can first show up - this is why breeders are advised not to breed their Cavaliers or use them at stud before they have been MRId at that age.

Or you might want to take Rosie and her possible symptoms to a neurologist who is familiar with CM/SM, who will have the experience to make an informed guess at to what is happening. A real problem with CM/SM is that symptoms can look like other things and other things (disk problems, for example) can look like CM/SM! You don't want to get paranoid about it, but at the same time if Rosie is in pain you want to do something about it. It's tricky!

Kate and Ruby
 
Thanks for your reply and advice Kate. Perhaps I should clarify the trauma thing, what I really meant was I didn't want to put her through any form of procedure particularly one involving general anaesthetic unnecessarily, and because our Vet felt that her symptoms were so slight that she wouldn't necessary recommend it just yet. However, since I posted the first message there's been a slight development. Yesterday we had a normal long walk, with Rosie running constantly as she normally does chasing pheasants etc. At the end of the walk her right eye looked as if she'd damaged it as it was almost closed, (she does run through undergrowth brambles etc. as a typical Spaniel) which we thought was a bit of a coincidence as the same thing had happened a couple of days previously but had cleared up by the next day. During the evening the right eye kept almost closing as if she was struggling to keep it open and when it was open the pupil rolled upwards and outwards. (This eye has always been slightly different, as her right eye socket appears to be larger than the left). During the evening she was also very restless, rubbing both her eyes with her paws and constantly licking her lips, she couldn't settle and kept lying in different places in the lounge. Although she was also happy to run around the lounge chasing her ball. She slept well last night and seemed perfectly normal this morning with nothing untoward going on apart from her right eye twitching first thing, then everything seemed back to normal. After this afternoon's walk where she wasn't quite as energetic as she is normally, her right eye whilst not as bad as the previous times did look as if she was having difficulty keeping it open as if she was very tired. At the moment we're going to see how she is this evening and tomorrow morning, and if after her walk tomorrow the same thing happens, we'll try to get an appointment with our Vet so she can see Rosie after her walk. I'll also speak to her regarding a potential appointment with a neurologist. Thanks once again, Charles
 
Sorry to hear about your little Rosie.....Please don't worry about an MRI scan, my girl Ellie had one in April, and she is eight, with a heart murmur, and yes it did show that she sadly has SM. She recovered from the scan in a couple of hours.
I have to say, your little Rosie does show a lot of the same signs as my Ellie ...It has taken a few months but we finally seem to have got her on the correct treatment. A week ago she had a big OP on her leg, for Patella and a ruptured crutia ligerment, but is doing well.
I do hope your little one hasn't got SM, but if she has you will find the right treatment for her . Best to know, is just my opinion. X
 
Yes fingers and toes crossed...I do know just how you are both feeling, because I felt just the same, but if Rosie does have SM, you will find the right medication for her. .....SM is a condition that can be dealt with....
 
Thanks Ann, that's very reassuring. It's just an unknown situation right now and having read lots about this awful condition, I'm concerned that if she does have it, just how bad it can get for her.
 
Oliver was diagnosed with CM/SM when he was 6 - although with hindsight there had been signs much earlier, such as squinting in strong light and being a restless sleeper - but with medication lived to be 13, and was put to sleep for something completely different. I don't know where you live, but if in the US there is a useful list of neurologists familiar with CM/SM here: http://cavalierhealth.org/neurologists.htm Not all neurologists know much about CM/SM, because their specialism is some other disease (we do tend to forget that there are other neurological diseases besides SM!). In the UK, you could ask around on this forum; the top person is Clare Rusbridge, but there are other experienced people at Glasgow, Edinburgh and Cambridge universities, the Royal Veterinary College, Chestergates near Liverpool, The Willows in the West Midlands, etc.

It is almost impossible to predict how serious SM will get. The degree of pain and disability depends on the size and - particularly - the width of any syrinx, and whereabouts in the spinal cord it starts damaging the nerves. Some dogs, like my Oliver and Aled, will have a small syrinx that causes relatively little harm and is easily controlled with medication. Others will have long or wide syrinxes that can cause so much pain that it is finally uncontrollable, but these are, I would say, a minority. It is completely unpredictable. And it is a progressive disease - Oliver started showing more symptoms in the last year of his life, aged 13! But how quickly and severely it will progress is, frankly, guesswork. Once diagnosed, and the size of syrinx confirmed by MRI, all your neurologist and vet can do is deal with symptoms as they arise - but there are more medical options available these days.

Clare Rusbridge gave a very interesting talk on the latest research findings for CM/SM at a health seminar last year run by the Companion Cavalier Club; this is available on DVD and can be bought from the Cavalier Matters gift shop:http://cavalier-gift-shop.org/companion-cavalier-club/health-seminar-dvd/prod_684.html

All the best

Kate (three out of the six Cavaliers I have owned have had CM/SM!)
 
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