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Confused!!

Gem

Well-known member
Heidi has started to show symptoms of SM (she turned 3 today) she is having several scrathcing episodes a day, rubbing her face on the floor and air scratching now both on and off lead. I dont want to sound over dramatic but i am convinced she has it. We have a vet appointment tuesday morning - however she has never once yelped or cried in pain. when she is having an episode you can see it in her eyes as they glaze over and go bloodshot for a few minutes. I really like our vet however am a bit worried about how to approach this with him - im going to print off all the info on here but dont want to be fobed off - is there any advice anyone can give on how they approached their vet. I dont want to sound like i've already made the diagonsis but i would bet my last penny on it - I of course want to get it diagonised and her on treatment asap its just so confusing as there is so much info to understand. Thanks xx
 
The most important issue here is Heidi not your vet. Karlin has given out a link to a list several times of neurologists which specialise in sm. I would choose one, go to your vet and simply tell him (nicely) you want to be referred its not up for discussion. It is important Heidi is diagnosed and treated as quickly as possible as this disease is nasty and painful. My Molly has SM, I can tell by her expression in her eyes how she is feeling, I would follow your gut instinct which is probably right, if you don't you will regret it.
Please let us know how you get on and I wish you all the best.
 
I'm sorry to hear this. :flwr: Leo almost never yelps nor does Lily and both have SM -- once in a while Leo is sensitive on his sides. But the scratching IS a sign of discomfort and potentially also of pain -- they scratch to try and relieve the discomfort. Clare Rusbridge and other neurologists believe the scratching is often a sign of neuropathic pain. Such pain can be extreme but not make you cry out (I know several people with neuropathic pain). Likewise it would not necessarily cause a specific area to be sensitive to the touch. This is a multi-symptom condition and with neuropathic pain, all sorts of add sensations, nausea, headaches and actual pain sensations can occur. Also keep in mind that human Chiari/SM patients say the single most common symptom is severe headaches -- not something that would necessarily make a dog cry out.

If you are seeing a range of symptoms and your vet doesn't take them seriously then I'd contact a neurologist yourself -- not sure where you are based but you can ring the neurologists in the UK listed on www.smcavalier.com or the US/Canadian neurologists there or the more detailed list on www.cavalierhealth.org. Hopefully you will be able to get to the bottom of what is going on and see whether this is SM or not. (y) It is very frustrating and challenging for owners (and vets!) that it is such a complex and confusing condition but as I note on the list of common symptoms on www.smcavalier.com, a dog can exhibit one or several symptoms. Many do not yelp.
 
Thanks Karlin, we are in west midlands uk so will see what the vet says next week, and then ring the neuroligists direclty if needed. obviously getting a diagnosis and the correct treatment for her is vital - just glad we've got insurance
 
I told my vet I wanted Riley to see a neurologist. She complied without a problem and has still been very gracious to me whenever I go in with any of the dogs. She is also very aware of Riley's diagnosis and is cautious when recommending any treatments. She wants to get the o.k. from the neurologist first. So, I had no problems asking to be referred. By the way, Riley never yelped or appeared to be in pain either.
 
So sorry to hear about your concerns :(


I'm afraid that over the years my attitude to vets changed - Your vet is your PARTNER in the care of your dogs - they are also providing a service which YOU pay for.

I would go in and say that you would like a referral for an MRI scan as you are seeing symptoms, present them with the information, including where you would like to go and contact details and ask them to make an appt.

Normally you won't be able to make an appointment directly, it needs to be a referral from your vet
 
I agree with Nicki, if you can work with your vet it will make life a lot easier in the future as you will still need his help. :) Good luck.
 
took Heidi to the vet today - she was great and totally agreed with me. She advised that Heidi should see a neurologist and that there is a new animal hospital opened about 10 minutes away from me, however when I called them they advised they have an MRI scanner but no neurologist until after christmas! what use is that?? :confused:
tonight i've emailed a couple in London (thanks for the links Karlin) it will mean travelling about 3 1/2 hours each way but will be worth it to see someone who knows their stuff.
 
The leading authority would be Clare Rusbridge at Stone Lion in Wimbledon. There may be some others in the area too but I just am not familiar with them or who has a practice. That's great that there will be another MRi scanner nearby as right now they are rare. We only have one or two in all of Ireland! It probably takes some time to get a qualified neurologist as well; there are very few in the UK or even the US.
 
It would be worth trying Chester Gates Referral Hospital, just north of Chester - it's only about an hour and a half by car from where I live in Coventry. Geoff Skerritt is another leading SM researcher, and he has a good team of neurologists there, one of them looks after my Oliver, who has SM. Tel. 01244 853823.

Kate, Oliver and Aled
 
:updte:
Heidi had her MRI scan today and the neurologist has advised that the scan is clear and shows no sign of SM which is obviously great news.
The insurance are going to pay the vet direct so I only had to cover the excess, as the scan was £1511.34 :eek:
Heidi is rather sleepy now bless her but am sure she'll be back to normal by morning.
Thanks for all the advice & support!
 
I am so pleased for you and Heidi. It’s so nice to hear of some good news for a change.
 
:rah: Wonderful news. I am so pleased for you.:rah:

Did they find anything in her ears that would explain the symptoms?

Please would you think about sending the certificate/report to Sarah Blott at the Animal Health Trust, to help with her research.

The address is..................

Dr Sarah Blott
CKCS Health Breeding Programme
Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU

This can also be done electronically: [email protected]

It would also be good to let Heidi's breeder know the good news. People need to know both good and bad results when cavaliers they have bred are scanned.
 
That is excellent news. :jump:

Did they say anything about the Chiari-like malformation? I some dogs this alone causes facial pain and scratching at ears and head and face -- often treatment with a CSF-inhibitor drug helps. Also any sign of PSOM -- as Margaret says -- can also cause these symptoms.

More info:

http://www.veterinary-neurologist.co.uk/part2.htm#21
 
they did mention that Karlin- but advised that they really couldnt find anything wrong with her. Im now wondering if it was me starting to be too cautious and misreading her behaviour. They have still got all copies of her scans as they apparently send the copies off to be studied again - for their own research purposes. I will ask for these back next week and will definatley send them on Margaret.
Unfortunatley as Heidi was a rescue we cant contact her breeder and sadly they wouldnt care less :mad:
Thanks again for all the support!
 
:updte:
just had a call back from the neurologist and am completley stumped...
she has now advised that Heidi's scans have been looked at again by someone else (even after advising she didnt definatley didnt have it) and advised that she does in fact have SM. she was quite vague and said it is only very mild etc etc and suddenly seemed to know very little about SM. I have requested the report sent to me asap as am no longer convinced that they know as much as they claim to. She said she'd check if their allowed to do this - the invoice yesterday was £1511.34 surely im entitled to this by law??
When I get the report/scans back is it possibleto take them to a specialist in SM to getter a better diagnosis
Im just so annoyed at the vet for been so sure then changing her mind???
 
I am so sorry to hear this has happened. Such a disappointment after being told that your little girl was unaffected.

I cannot understand how you could have been given such wrong information. It sounds like you were seen by someone who has no experience in reading a scan for syringomyelia.

Clare Rusbridge does sometimes review scans if there is a CD of the dicom images ( don't ask me what that means ) not just a sheet of film. There is a charge of about £35 + VAT
 
I was advised to have decompression surgery for Riley when she was diagnosed with SM. Since it is such an invasive surgery, I wanted a second opinion. Her neurologist made a CD of the entire MRI (I believe this is what Margaret was referring to) and I was able to take that CD with me to another neurologist. The second neurologist was then able to load the CD into a computer and look at the images. I even asked them to make another copy for me because her breeder wanted a copy also. I don't know if it's different in Europe, but I got my two CDs of the MRI for free. And I do believe you are entitled to them by law.

I would absolutely ask for a CD and send it off to Clare Rusbridge. I'm so sorry you are having to endure this nightmare. Although I did wonder what they were going to attribute Heidi's symptoms to if she didn't have SM. Hopefully you'll be able to get a copy of her scan (not just a medical report) so you can get someone more qualified to look at it and give you some definitive answers.
 
thanks very much :) have just emailed them asking how to get a CD. Im not upset or suprised that Heidi has it as I knew she did,but the woman so definate she didnt - she even made me question myself for over reacting. Will definatley contact Claire to see if she can read it - as am not convinced by anything they have told me. Its just amazing as yesterday the vet seemed so confident and had an answer for all my questions- today she couldnt care less, just advised that we monitor her and if symptoms persist toget her scanned again!!
 
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