Gus is 11 yrs old....when he was 2yrs old he had a strange episode with pain and stiffness in his neck, it happened twice and he seemed in a lot of pain with his neck twisted to one side but each episode only lasted a few minutes or less. The second one was bad and we rushed him to the vets but it had stopped by the time we arrived. Anti-inflammatory's helped and x-rays done showed no problem.It never happened again... He had times over the years where he would get a sore neck/back but never anything as bad again. We discovered that his vaccines when given in his neck area was followed by pain and stiffness in his neck area and when this happened a second time we changed to having them given in his hind area. He was fine for years. Last year aged 10 he had reluctance to walk one day and looked in pain with his back the vet thought disc degeneration coupled with some other back problem and again anti-inflammatory's worked along with a course of cartrophan.
He has been well since except a couple of months ago he started slight head nodding and then it got worse and recently he was doing it more and more. Yesterday we went to the vets armed with video of this nodding. We seen the head vet.
He examined Gus thoroughly, looked at the video, asked a lot of questions as to how Gus is lately, looked over his past files, called in a colleague and they both went to the side to talk, I was getting worried especially by the look on my vets face, then he said they think it is SM...
I was shocked to say the least. I would never have thought especially not Gus. My vet thinks the nodding is pain episodes caused by SM, we thought mild seizures but the vet doesn't think so although he said there may be a little disorientation because of pain. He has known Gus and Pippin since puppies and DJ since I've had him and is a good vet.
He has advised not having MRI as it is too expensive and will only tell us what is wrong but we will still have to treat it with medication as Gus is 11 so surgery would not be something I would put him through. He doesn't want to put him on steroids for now and has given us a weeks supply of diazepam to see if it helps relax the muscles and stop the nodding, and we will proceed from there depending on how Gus is.The vet spent a lot of time moving Gus' neck and checking for ease of movement. Gus didn't seem to mind too much but the vet felt his neck muscles were very tense and the diazepam is to see if the muscles will relax and if so whether the nodding eases of not. He is only on half a 5mg twice daily and started them monday night, yesterday he didn't seem to be nodding as much. We also have metacam for his bad days and are to call the vet on Mon to talk about how he Gus is doing.
Gus is well in himself, eating, going for short walks,he loves his food especially a treat and will steal if he can he loves sleeping on my lap and will insist the younger dogs move to let him up as he is number one, he jumps on chairs (although nods a lot just before jumping or attempting to jump). He doesn't over scratch, but hates any kind of collar, always has and would scratch light one's off, so we don't use one. He always makes a strange 'coughing/hacking' sound after getting a drink, but it doesn't seem to be his throat that's the problem he kind of looks like he's unhinging his jaw!
Lately he runs to bed when he sees the grooming brushes come out, Licks his front paws, sometimes seems to stare into space but it doesn't last long, likes a good roll on his back but doing it more frequently, and now and again, rubs his face with his paw. one thing he has always done since the age of 2, after the strange neck incidents, and I forgot to mention it because it was just his 'thing', and a locum vet told us years ago that most dogs don't like to be lifted and passed it off...If you lift Gus from his middle he will scream almost as if you'd given him electric shock, we never ever lift him this way and always tell new visitors to our home, vets etc. not to, we always lift Gus with one hand under his rear and one under his chest and he doesn't even flinch. -we don't always be lifting him it's usually when he climbed on a chair to steal our food- now I'm putting two and two together and feeling it may be SM and I should have known or at least noticed, but all these things never happened together and only lately all came together
I am wondering has anyone else ever had a dog with SM who didn't have any ongoing symptoms and only really started to show pain/symptoms at such a late age?
Thanks for reading...
Just to add, the vet thinks Gus still does have some disc degeneration but it is stable at the moment and he also said that Gus has a great heart for an 11 year old dog and it would be unusual in his practice to find a heart as good in an old cavalier, which is good but a pity if he does have sm...
So sorry to read this about Gus. I'm not much help in this area, but I was wondering if you were seeing a neurologist who may be better able to come up with a medication plan? I also know from reading here that Claire Rushbridge had a treatment protocol on her website that you could print off and show your vet. It was good that you got video of Gus to show the vets.
It is great news that at 11 years old, Gus still has good heart. Let us know how he gets on.
My Oliver was diagnosed with CM/SM at the age of 6 but with hindsight he had been showing symptoms ever since I had him at a year old - squinting in strong sun or fluorescent light, restless sleeping, occasional episodes of scratching that seemed to be worse in the summer, an odd episode of temporary loss of use of his hind legs for a couple of hours - a lot of little things that no-one ever put together. Sadly, it sounds as if your vet is right, As Joyce says, a neurologist would be able to make a better diagnosis of symptoms and suggest a treatment plan (a consultant rather than your GP vet, so to speak). If you're not going to scan (and I agree - Oliver is only having a general anaesthetic if his life is threatened!), putting Gus on a course of gabapentin could confirm the diagnosis, because if his pain is neurological other painkillers may not be very effective, whereas gabapentin specifically targets the neurological pain caused by CM/SM. Karlin will be able to recommend a neurologist who is expert with CM/SM, and if your vet (who sounds very competent) hasn't seen Clare Rusbridge's treatment plan, you can download it at www.veterinary-neurologist.co.uk
Oliver's symptoms are slowly getting worse, but are more or less under control with medication and he lives a pretty normal life, enjoying long walks, still going everywhere with me, and generally being a wicked old man! I hope Gus's symptoms will be as well controlled and he will be with you a few more years yet, enjoying his old age.
Kate, Oliver and Aled
You know that's the thing with this condition....How do we know? If some research is correct a lot more cavaliers are effected then we even know I read like 70% (or something don't quote me)..... I think that's why we as cavalier pet owners are going to get to the point where we want our dogs scanned just because..........I know that is not the answer but still. No loving owner wants their dog to be in pain and not know it.
From what you describe Gus is not in a lot of pain but some. I agree about not scanning him but maybe a neurologist appointment is needed, after all he/she would be expert advice. That's what I would do anyway.
I think you actually have been having some classic symptoms of SM over his lifetime, I am afraid. The curved neck (scoliosis) is a very typical early symptom and pretty much only related to early-onset SM in this breed -- and then often goes away as the dog eventually adjusts to the pain level. The on and off sensitivity and pain at his neck over the years, and the difficulty after vaccinations, would be quite typical of SM pain as well. So would the dislike and scratching at any collar; the screaming when being lifted.
The good thing is you are now able to take action and help him get a lot more comfortable. :flwr:
I would definitely have your vet use Clare Rusbridge's treatment protocol and get him on cimetidine and gabapentin (perhaps omeprazole rather than, or in addition to, cimetidine). He would be far more comfortable. At his age I would not put him through an MRI but ask your vet if you can trial some meds. I don't think I would bother with the diazepam (see below).
The head nodding, as a general breed issue, is something some of us were recently discussing with Dr Rusbridge, coincidentally enough! She thinks this behaviour is most likely not anything to do with SM, but there's a very high incidence of this odd behaviour in the breed (yet another thing :( ) -- sometimes to the extent that the dog regularly falls. Researchers are not sure of the cause and hope to do more investigation into what causes this. My SM clear cavalier Jaspar does this but only very slightly -- generally when he is sitting up; he will look as if he is dozing off but it's a kind of head shaking/nodding. My Lucy did this to a mild degree as well. Generally not anything you need to treat if mild, but when it is really disabling for cavaliers (eg they are collapsing with it) steroids seem to sometimes help.
That said -- it could have other causes and your vet should do a proper investigation.
I would think Gus would be a lot better with traditional SM meds treatment asap. If your vet is reluctant to do this you could go down to Cork to talk to Jacques Penderis or the neurologist at UCD but I think a lot of vets would pretty much agree this is indeed almost certainly SM and be willing to trial some SM meds.
Thanks for that Karlin. Gus was nodding again today so I will be speaking to the vet this evening or tomorrow. You mention some dogs falling. Gus has fallen/tripped over, a few times in the last few weeks, not while nodding more when running (mostly for dinner) but when he nods he seems to sometimes almost lose balance, so the vet thought at first EF but after examining him and questioning me ruled that out.
My vet seems very well informed on SM and was asking me how much I knew about it and got quite annoyed about the high level of it in cavaliers and spoke to me and my husband at length about what is being done (or what he hopes will be done to try stream it out).
He mentioned the programme and follow up programme that we all watched and was mad about people breeding from dogs known to have SM. I am sure he must be familiar with who Clare Rusbridge is and won't have any problem with trialling meds. I will mention the treatment protocol and ask if he can check it out or show it to him when I go to him next.
I suppose the signs were there but because Gus wasn't seriously affected and with his disc problems and his 8yrs of seeming ok it went undiagnosed. I worry that he will get worse and be in pain. A little part of me worries that he would end up somewhere down the line having to be pts and that would be a shame as he has a perfect heart and I always thought he would be one to live to a ripe old age and slip off some night in his sleep. But that's just me thinking the worst, hopefully it will not progress too much.
I wouldn't worry about it (if this is SM?) progressing too much, given his age; more to get medications right so that he doesn't go into the occasional pain sessions and perhaps this will also improve his balance. :)
Your vet could perhaps contact Clare through her website and ask her about this kind of nodding off.
The instability on his feet could be SM related and may not be connected at all to the nodding. Limb weakness/imbalance is another typical sign of SM.
It's great that your vet is up on these things. :D In Ireland, the CKCS Club has done basically zilch in terms of public or breeder education on SM. :( They have another 'meet the breed' type day coming up -- I wonder if they will offer prospective dog owners any information at all on MVD, SM etc?
Your vet may on going through Clare's material, feel comfortable working with that or may feel he wants to consult a neurologist. Sins recently posted the contact info for seeing Jacques Penderis in Ireland I believe -- he is on Cork every 2 weeks I think. I went to UCD for Jaspar's PSOM -- but didn't get much sense of their approach to/knowledge of SM.
Steroids are actually the very last thing Clare suggests using for SM -- only ever if nothing else is working. You may find the gabapentin helps with the limb issues. At the same time -- if he has had progressive SM since quite young and slowly had limbs affected, this may not be something that can be reversed or managed by medications.
Leo has always had poor balance if he is standing on a lap, say; but not collapsing.
I'm interested in what you say about head nodding, Karlin. Oliver does it quite a lot, but licks his lips at the same time so I've always assumed it was a symptom of pain/a headache. He never did it in his younger days, and it has got worse as his general CM/SM health has started gradually deteriorating - evidence that it is a progressive disease, because he's now nearly 12. His headaches are pretty well controlled with his new drug, but he's back on gabapentin for his very wobbly back legs and has pronounced scoliosis in his spine. One of his first symptoms at the age of 8 was frequent stumbling on his right front leg, for example when going up kerbs, but that stopped once he was on gabapentin, although he still doesn't have much nerve sensation in that leg. So with luck gabapentin may help Gus's stumbling as well.
Kate, Oliver and Aled
I vaguely remember the neurologist at the University College Dublin vet school also told me they see that nodding regularly in cavaliers, when Jaspar was there for a myringotomy.