Anyway, as far as 'no symptomatic dogs' goes, I bet that most of the dogs mini-scanned and showing SM are actually also showing some (unrecognised) symptoms. Certainly Oliver was at the time of his first scan, though both I and my vet woud have sworn that he was asymptomatic. Does such a thing as a dog with asymptomatic SM actually exist - or do we need to learn a lot more about recognising symptoms of pain?
Oh for a DNA test!
Kate, Oliver and Aled
You are so right on that one Kate. When I did a write up on Rebel's SM symptoms for the vet I went through old photographs I had taken of him and was shocked to find that for at least 2 years he was clearly photophobic, even at the time of his MRI mini scan, also at Chester Gates, where I was told he was asymptomatic. This was quite clear to me when I realised that in all of these pictures he had the same eye very firmly closed when facing normal indoor daylight. The vet agreed with me, although she had no previous experience of dealing with SM. She also noticed that his face was showing signs of great pain, as illustrated on Claire Rusbridge's site. Once the Frusemide relived the pressure I realised she was right.
Yes, I do think that most of us have a lot to learn when it comes to recognising the symptoms of pain. It breaks my heart to think that dear sweet Rebel was experiencing pain without me knowing it and this experience is telling me that there must be many others in a similar position.
I know so many people who in retrospect reaise they were seeing symptoms. They can be quite subtle but I think you do get pretty good at seeing what is and likely isn't SM (same for vets I am sure. Once my vets began to have cavaliers coming in with SM, they got to where they can tell pretty much right away that most likely, they are seeing SM -- but of course screen for other possibilities first. Face rubbing is real 'mixed bag' symptom. For dogs WITH SM, you do see this generally when pain gets very uncomfortable, such as around the time meds start to wear off. But also many dogs, many breeds and mixes, simply like to rub their face, especially right after eating. To me I would be more likely to be concerned about face rubbing if it occurs around when a dog is also scratching a lot, just had a lot of activity/excitement, or has shown some body sensitivity or yelped or shown some other classic SM sign. Face rubbing on a carpet right after a meal -- I'd discount this as a worry IF this is all a dog is doing and the only time it is done. I have seen people elsewhere mistakenly stating that SM scratching is non-contact scratching or only to the ear area and anywhere else, it is unlikely to be SM. This is absolutely untrue (and I fear leading a lot of dogs to not get treatment until months and months later than should have happened). Scratching with SM can be to virtually anywhere, and often is contact scratching. So I think a lot of people including breeders look right at clear SM symptoms and don't see them because they have mistaken ideas about what SM symptoms are.
With Tommy: given that you have had vets check and treat for other conditions yet you feel you are seeing symptoms of SM, I would discuss with your vet and ask for a referral to a neurologist. It would be helpful I think even to have a clinical exam. Symptoms can be similar to allergies but when they keep repeating and also -- as you are -- you start to see signs of pain too -- I would just go to a neurologist. :thmbsup: Let us know how things go. Given his age, I'd ask about trialing him on some of the basic SM medications as a response to those would be an alternative diagnosis. You would be unlikely to have surgery as an option with a 9 year old dog unless quite fit -- hence not sure I'd be considering an MRI.Many useful comments on both sides on getting MRIs, and low cost vs full MRIs. I've posted elsewhere that I think a lot of people will benefit from getting a low cost MRI and then can pay for a consult on top of that for treatment, it needn't be part of the low cost exam. But I would opt for a full scan IF I were thinking of surgery as an option or wanted the full picture.Right now people really need to be informed about the mini scans to know how to take advantage of them -- most pet owners generally won;t know too much about them as they are directed at breeders.
Riley had surgery for severe and advanced SM when she was two months shy of turning six years old. Her neurologist said that he generally won't perform SM surgery on a dog over 7 years old, but would treat them with medication instead. I guess there is always an exception, but that's his rule of thumb.
So, for your 9 year old, you might want to just jump right to the SM meds or have a mini scan so that you know what you're dealing with and then go the med route. Neurologists can also tell a lot just by their clinical exam. Within 30 seconds of examining Riley, he told me he suspected she had SM. Good luck to you and let us know what happens.
I have had a reply from Clare Rusbridge regarding the mini [low cost] scans:
The main reason why a full scan is important (especially in a 9 year old dog) is that you need to rule out other causes of pain especially intervertebral disc disease. If you do a mini scan and the dog has severe SM then you have an answer but maybe not the full picture – if you do not find severe SM then the £200 etc may have been wasted or at worse misleading.
Also one of the reasons that we try to avoid having pets come on the low cost days is that they have no contact with neurologist – and as you know the dogs need treatment and the owners need support/information. So if the mini-scan option is taken then I think it is important they then book an appointment with a neurologist after they receive the result.
If the dog already has a diagnosis of severe SM then repeat MRI may not actually make a difference to the clinical management – if funds are limited then this is why it may be better to spend money on medication.
That's very helpful -- thanks for that! :) IT's very kind of Clare Rusbridge to reply, and helpful for people to get the view of a leading neurologist in the area of CM/SM.