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Ellie's first consult - PSOM symptoms

sandi

sandi

Active member
Hi there,

I have a 8.5 month Black and Tan Cavi, named Ellie, and we are in Canada. 3 weeks ago, she caught kennel cough and has started licking her nose and the air repeatedly. Last week, it went from occasionally to constantly, where the licking led to biting at the air (fly catching). So we decided to consult a neurologist to see if it was something more serious.

The neurologist tested her reflexes and noticed that has delayed placing in her pelvic limbs and reduced menace response
Ellie1.jpg
i n her right eye. And besides the episodes of fly biting, she was also twisting her head back and forth towards her hind legs.

They had concern that she may have symptoms of PSOM or possibly SM. They recommended an MRI to get a proper diagnosis. They also mentioned that if they were unable to find the problem in the MRI, to also do a CSF Tap and Analysis. I've read and tried to research as much as I can on this condition, but have not heard of anyone going further into doing a CSF Tap. If the MRI results show that everything is normal, should I leave it be and continue life as normal? Is a CSF Tap necessary? I want to make sure we do the right thing for Ellie, but money is tight, and MRI's are already so costly. If possible, we want to avoid any unneccessary testing.

Also, any owners here that have similiar experiences with SM, if you could please shed some advice, I would greatly appreciate it!


Thanks!

Sandi
 
Hi Sandi,

I am sorry to hear about your baby.

I did both for Jack- MRI and Spinal tap on the advice of the neuro vet. THe reasoning behind it was the MRI showed a mild malformation and a pre-syrinx and Jack was exhibiting a lot of back leg spasms and having focal siezures involving the back legs only so my vet wanted to rule out any spinal inflammation. I was extremely hesitant to do the spinal tap, as I didnt hear much info out there on CM/SM dogs getting it done. Plus if not done by an experienced vet can result in more problems than you started with.
Anyway, after some serious thought and mainly the trust I had in my neuro vet, I decided to proceed. It was a relatively quick procedure and I took Jack home the same day, he was slightly off for 2 days but then went back to baseline. Turned out he had no spinal inflammation.
I can't tell you whether to do any of the tests, only that I feel for you being in the predicament of whether to or whether not to. It is tough and confusing because there are so many opinions on it. I guess the best thing to do is go with your gut and your level of trust in the vet
Good luck and feel free to ask me any questions about the spinal tap.
 
Thanks for sharing your experience Irene!

I sent you a private message - hope you got it! Just wondering what steps you took after you found out about Jack's results?
 
Update

I've received kind words from a few of you, and I really appreciate all the advice you all shared! It's nice to know I'm not alone in all this :)

I booked an appointment on Weds for an MRI with the neurologist. I will update as we go along, and hopefully we can find out what's wrong.

Thanks again, everyone!

Sandi
 
Good luck on Wednesday. It is nerve wracking waiting for them to come out of the MRI and then waiting to hear the results. And then in your case - waiting to hear if Ellie needs to have the CSF tap also. Riley, my black and tan girl, has SM so I know how agonizing this whole disease is. In her case the results of her MRI were crystal clear for her SM without PSOM. I will be thinking of you tomorrow.
 
Hi all!

Thanks for all your support. It was a long night on Weds.
Turns out the neurologist had a brain surgery in the morning and did not get to Ellie's MRI until the afternoon. When they scanned her.. they did the brain, neck area and even her spine! He called me in the evening to tell me everything was normal, but he said he noticed that she had the chiari malformation which he said was common in most cavaliers. He said that Ellie did not have any large cavities or syrinxes.

He wanted to continue with the spinal tap to make sure there the issues were not in the spine as well. He said he wanted to eliminate the chance of meningitis (sp?), before starting medication for SM. It was confusing trying to understand over the phone conversation.

I took her home late that night, after the anethesia wore off. And that night was the worst night we've had since we first got her. She kept waking up and digging in her crate (her indication that she wanted out or washroom) Double checked to see if she needed to go out for a pee. After that, she kept at it every hour .. we tried ignoring it, but did not get much sleep. Last night was better, she returned to her regular sleeping pattern. I figure Weds night happened because she was out for so long under anesthetic... she woke up with pent up energy??? I hope it's normal..

So I booked another appt to do the spinal tap on Tues. He will also go over the MRI scans that day, so we get more clarification.

What kind of questions should I be prepared to ask? What should I expect when he shows me these images? I read alot and tried to interpret the information at www.cavalierhealth.org, but I am still lost. :-?
If Ellie is diagnosed with CM, does that mean she will eventually get SM? If we start on medication right away, will she get better, or does the condition worsen over time?

Thanks in advance for all your help!

Sandi
 
My black and tan cavalier was diagnosed with CM only, no SM, and according to the neurologist , is unlikely to develop to sm, as he is 4 + now (the cut off age is 4 years), he does a bit of digging sometimes, but no other symptoms, and otherwise a very active dog , the neurologist went on to say she will be very surprised if he develops sm later although not completely ruled out , hence he is not on any medication as he has no sm.
Hope this helps.
Daffymum
 
sandi said:
When they scanned her.. they did the brain, neck area and even her spine! He called me in the evening to tell me everything was normal, but he said he noticed that she had the chiari malformation which he said was common in most cavaliers. He said that Ellie did not have any large cavities or syrinxes.
Click to expand...

That is really good news.

sandi said:
He wanted to continue with the spinal tap to make sure there the issues were not in the spine as well. He said he wanted to eliminate the chance of meningitis (sp?), before starting medication for SM. It was confusing trying to understand over the phone conversation.
Click to expand...

It is logical to look for other explanations for the symptoms if there is no SM, but I cannot understand why Ellie would be given SM medication if she does not have the condition. I wonder if you misunderstood what he said? That is something you may want to clarify.

sandi said:
that night was the worst night we've had since we first got her. She kept waking up and digging in her crate (her indication that she wanted out or washroom) Double checked to see if she needed to go out for a pee. After that, she kept at it every hour .. we tried ignoring it, but did not get much sleep.
Click to expand...

This frantic digging would suggest a pain reaction to me. She may have been suffering from some consequence of the procedure, perhaps from the breathing tube they used while she was unconscious.

sandi said:
What kind of questions should I be prepared to ask? What should I expect when he shows me these images? I read alot and tried to interpret the information at www.cavalierhealth.org, but I am still lost. :-?
Click to expand...

Continue to read as much as possible about SM. Look at the 'stickies' at the top of this thread and follow the links to other websites

Look at Clare Rusbridges website
http://www.veterinary-neurologist.co.uk/

Go to this link for a very good primer on how to read MRI scans
http://www.roycroftinformationcenter.com/Cavalier Infosite/Cavalier InfoCenter Health SM.html

Write down the questions you want to ask and take the list with you

sandi said:
If Ellie is diagnosed with CM, does that mean she will eventually get SM? If we start on medication right away, will she get better, or does the condition worsen over time
Click to expand...

Complicated questions to a very complex condition, and nobody here is a vet. I will answer as best I can, and I am sure others will come in and say if they think I am wrong.

Most cavaliers have chiari like malformation ( CM ) and it probably does predispose them to develop syringomyelia (SM), but there are some older cavaliers that have CM but do not have SM when scanned.

I doubt whether there is any medication that will have an effect on the chiari malformation, as that is a bone defect at the back of the skull. Only an operation would effect a change there.

The knock-on effect of CM on the soft brain tissue can get worse over time. The brain tissue at the back of the head ( the cellebellum ) can be squeezed down to block the hole that allows the brain and the spinal cord to connect ( this blocking is called herniation) This can lead to pockets of fluid ( syrinx ) being formed in the spinal cord (this is the condition called syringomyelia)
The syrinx can destroy the nerve tissue in the spinal cord and cause pain.

Once the nerve damage in the spine takes place it does not recover, but the dog's body can learn to compensate, so symptoms can seem to disappear.
For most dogs with SM the condition will progress.

As far as I know there is no medication that will stop a syrinx forming.
I do give my SM dogs a small dose of Frusemide daily, as there was a suggestion that it may slow the progress of the syrinx, but I don't know if there has been any studies done to prove the theory.

I hope this helps
 
Thanks for all the info!
I think it was hard trying to interpret all the medical terms during that phone coversation. Those links are great - I will use those and keep up with the homework reading before we drop her off on Tuesday.

I will update again with what we find out on Tuesday. We're keeping our hopes up!:l*v:
 
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