Help with symptoms
First off, I live in a country where there are no veterinary neurologists and there is only one clinic in the country which has an MRI machine, but none of the vets are familiar with SM.
A few days ago, my dog suddenly stopped wanting to stand on her hind legs, and could not jump off the bed/sofa, and has very much difficulty getting upstairs. Usually, she can jump on and off and run upstairs at lightning speed.
She looks to be in pain (eyes, and ears hanging low), and refused food the first day. Brought her to the vet, who checked her temp, legs, spine, heart, lungs and he says everything seems normal. It was a very busy day at the clinic, and they didnt have time to do an xray, so told me to go back another day.
I keep thinking it might be SM and would much prefer them doing an MRI (so that we can also see if there are any problems with her spine), but am not sure if they would know how to do it correctly so the syrinx(es) would be visible. The vet also seemed reluctant to do an MRI in the absence of other symptoms.
My dog scratches her ears at night and in the morning--not too excessively, but enough that her ear fringes mats very frequently. She has no ear infections for sure.
am not sure what to do at this point. Has anyone seen this kind of symptoms in an affected dog? I have a video of her having trouble walking upstairs. Please PM me if you would like to see it.
vet sent us home with antibiotics and Rimadyl. I noticed that she seems to be in less pain after I give her the rimadyl. She can walk upstairs better, and at least she eats and plays, but she is still not right, if you know what I mean? She is not back to normal.
This is a tough one. The things you describe are definitely potential SM signs, but could easily also be something else, like disk disease. My SM-clear, very mild CM girl (on MRI at 9!) had just these symptoms and they were a disk problem which painkillers and strict crate rest for several weeks, resolved.
However that scratching you are seeing could indeed indicate CM/SM; these are the times when scratching is most obvious and scratching enough to cause regular matting in a well-groomed dog, is a lot of scratching. I'd be concerned about that as a separate indication if there is no other cause for scratching.
BUT... again, the pain symptoms you see and sudden onset may well be due to a disk issue and not SM, even if there is some mild or moderately symptomatic SM present. Or it could all be SM-related.
Rimadyl could indeed help with CM/SM pain as well as a disk problem or other pain source. But if not enough I'd certainly be seeing something more substantial.
It is best practice to rule out other potential causes and in your shoes I'd start with an xray. That said an xray may not show existing disk disease or other disk problems, which would show on an MRI.
Do you have the info from Dr Clare Rusbridge's site? http://www.veterinary-neurologist.co.uk/Syringomyelia/. That might be a start to share with your vet and read yourself, and consider all the options. There is advice for vets/radiologists for positioning for SM MRIs as well. If you wanted you could opt for an MRI as it would also diagnose disk disease if that is the cause of her pain. Clare or one of the other neurologists or centres doing MRIs (www.cavalierhealth.org has a list of many) would I am sure offer advice to your vets as well.
Meanwhile I'd block the stairs and not allow her to jump on furniture -- I think her movement is best if greatly curtailed and managed so she cannot accidentally cause herself further severe pain.
Thanks for replying, Karlin. Yes, it sounds like it could be a spinal injury, but I am thinking that we could kill two birds with one stone by doing a MRI and looking at the head, neck, and entire spine at once.
I've read through Clare Rusbridge 's site, and downloaded the pdf she has on the protocol for positioning. Should I insist on an MRI? I haven't asked about cost, but am hoping it won't be too prohibitive.
I don't think the vet has seen a severely affected cavalier, and so doesn't think much of my dog's symptoms. I might have to be very insistent on the MRI if I want one done.
Do you know if Dr Rusbridge does consults for overseas patients?
I'm contemplating buying cimetidine and gabapentin to see if they help with the pain, since the Rimadyl seems to only be lessening but not eradicating the pain.
For my two cents worth, I would go with the MRI. Her symptoms sound just like Oliver's when his disc disease was acting up. He has had two surgeries on his discs - cervical and thoracic/lumbar. The x-rays did not show the extent of the damage. and he was always a trooper on physical exams , sometimes not even making a whimper and even jumping when he hadn't jumped or even moved at home for days. That's what adrenaline will do for them when you take them to the vets!!! Rimadyl and metacam did little to nothing for his symptoms - prednisone helped a lot. He had very mild CM on MRI so all his symptoms were related to his disc problems. He is a much happier dog since his last surgery - no more pain!!! I hope you can get to the bottom of what's causing your girl's discomfort.
I don't have any advice just wanted to send a (gentle) hug to your furbaby. I must be SO hard to know they are in pain and not know why or how you can help them.
My only opinion is if you are willing to insist on an MRI why not see what a x-ray shows first? If vets in your area do not know anything about SM, can they treat disc problems? Most vets/doctors diagnose by process of elimination anyway (oh and educated guesses).
I hope you can get your sweetie feeling better as quickly as possible.
Thanks for the replies, really appreciate it!
I'm beginning to think it's a spinal injury--I was cleaning her legs just now, and I don't know what I pressed or touched, but she suddenly screamed and jumped away, and didn't want me to touch her. That coupled with the sudden onset makes me think there must be some disc injury. I'm going to bring her to the vet's again tomorrow and maybe insist on an MRI, and will get them to read Clare Rusbridge's protocol first.
The vets are experienced in treating disc problems, just not SM. I'm gonna have to get them to read the treatment protocol for SM as well, because I can't get cimetidine or gabapentin without a prescription. I'll update again when I know more. Please keep your fingers crossed!
Best of luck and let us know how things go. I do think it is worth starting out with a conservative approach and if the pain remains, then perhaps you will need to opt for an MRI. There are many good comments on the thread with various perspectives. If pain is down on the legs like this, that again can be consistent with SM pain... just very hard to tell.
If cost and expertise is an issue, I'd certainly also see if you can trial something like gabapentin/cimetidine for a few weeks and see if you get an improvement without going for an MRI, after approaching this first as a possible disk injury perhaps.
Anyway your vets will be in a better position to think through options with you, once they have read Clare's material I think. Many of us work with vets who work with Clare's advice via her documents, and successfully manage our SM dogs in an informed way.
MRIs are ideal, but realistically they are also very costly for diagnosis and my own feeling is that knowing the extent of the problem and confirming SM, especially in an older dog that is not going to be put forward for surgery, would not matter that much as opposed to trialing and finding adequate pain treatment from a known and tested approach such as Clare's algorithm. It is very much a matter of weighing up the possibilities and approaches to find the best route for the owner and dog.
Incidence of SM is very high in the breed and all indications are that most of us -- probably 70% plus --have an SM dog by the time a cavalier is older than 6. That means suspicious systems have a very high likelihood of being CM/SM but at the same time, pain could be caused by something else even IF a dog tests with CM/SM, as CM/SM often causes few or no symptoms. Makes it all very challenging sometimes... :(