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Syringomyelia in 8 week old puppy

Judy, you do need a referral to see a neurologist, not because of what the insurance company wants, but because that is the way you go to see specialists. Most people don;t just directly ring a specialist, they need a referral. A neurologist will want a vet to have cleared the dog for other possibilities first -- not least, so that a visit does not waste the owner's time and money. In a real emergency or if the vet is not willing to do a referral, then I recommend to call directly because many vets will not believe the sytmposm can be SM which is very rare normally.

Also, vets and neurologists don't ever treat dogs for SM without having MRIs except under very special circumstances. Vets will generally NOT treat a dog unless a neurologist has diagnosed SM and the only way to do that except in a severely symptomatic dog is via an MRI. A dog that has early onset SM, some severe symptoms, and clear progression at a young age will have to have an MRI unless the owners opt to just give hospice care to the dog for as long as it might live. There are sadly very few options for this condition and for a young dog with rapidly progressing symptoms, decompression surgery is likely the only medium to long term survival option.

It is also very hard to tell what an insurance company will do. Some will not treat for major probelms until 6 months after enrollment or so; some might feel claiming within days raises suspicions and will go back to talk to the vet. Scratching IS a symptom of SM and thus COULD be taking to indicate a pre-existing condition. Companies also have the right to change what they will cover at any time so that needs to be kept in mind, too. Many of us fear that insurance will no longer cover SM before long because it will be seen as too expensive and too common in the breed.

++++++

Shay, Rory's mom has gone thru the whole decompression surgery with her dog Rory. There are some long threads with images of Rory in the health section if you do a search. Also Rory is doing really well a year now after his surgery! I am sure Rory's mom will happily tell you more either here or if you PM her for advice.

Back to Lily: I would really try not to have her exposed to a lot of activity like playing with children. Just try to keep her as quiet and low key as you can until you can get a proper assessment. Every time her CSF speeds up (as it does with play or excitement) that can further progress the condition. Try to avoid everysituation in which you need to handle her ina way that causes yelping/pain. The fact that she doesn;t yelp while scratching isn;t relevant -- a lot of dogs scratch, and/or show signs of pain. They don;t necessarily go together because the scratching is believed to be a response to skin crawling sensations while the pain is associated with pressure on nerve endings that the dog experiences as pain, or pressure from the CSF's constricted flow, which causes headaches and pain of many types in humans.

It may be helpful to read this, which describes what humans feel:

http://www.asap4sm.com/syringomyelia.html

And also this:

http://www.conquerchiari.org/subs%20only/Volume%202/Issue%202(5)/Wide%20Range%20Symptoms%202(5).asp
 
Shay......did you go with the double illness ? That gives you 6000.00 per category instead of 3000.00 . I have Petcare insurance on 4 of mine and I just have regular illness coverage to keep the cost down ...BUT ........if I ever suspect something major .......I'm switching to double illness .

I think as long as your vet hasnt diagnosed or said SM in his notes ( call and get them to fax a copy to you ) you will be OK with Petcare Insurance.
 
Shay ..........I also wanted to mention that it is VERY common for puppies .....esp Cavaliers to Yipe when picked up ! Colby did this and still does it if I pick him up the wrong way. I was concerned at first too and posted and lots of people said their babies did the same thing !! That made me feel better !

Also ....... If they arent used to wearing a collar they will scratch at their neck for WEEKS ! Colby did this too .

Its natural for all of us to be paranoid about SM bc of all of the info thats out there .........but many times its not the case . But only a MRI will say for sure . Good Luck !!
 
Any *indication* of a pre-existing condition, whether diagnosed or not, can be and usually is grounds for refusal of an insurance payment. That's just the way insurance companies work. A vet would never be expected to be able to make a diagnosis of SM so for a vet to actually name it would be extremely unlikely -- only a neuro can make that diagnosis. However if an owner raised the issue of likely symptoms and a vet also recalls having noted those symptoms, they will almost certainly be taken as indicating a pre-existing condition. With luck, they will still pay out or this won't be noticed by the insurance company, but I would not count on it.

Having spent a full day two weeks ago with the leading neurologists and vets working on this condition, as well UK club health committee members, breeders and pet owners of affected dogs, I simply have to emphasise that it is NOT normal for puppies to yelp when picked up. I've handled lots and lots of puppies through general rescue and grown up with a few and spend lots of time with trainers and pet owners. I also have a clear/clear dog who never yelped as a puppy or overreacted to a collar or harness. If a puppy is yelping consistently -- eg more than when a person realises they have done something to handle the pup incorrectly/pinch it -- this should be a *concern* and I strongly recommend people have any continued incidences of this checked out. Few puppies should keep scratching at collars for weeks when introduced to them unless something is really annoying them about the collar -- most puppies accept a collar within a week or two and adult dogs as well. Again, in this breed, on and off scratching combined with unexplained yelping when handling a dog has GOT to be seen as a concern.

I would have a vet thoroughly check any dog that is yelping when handled -- and with this breed, consider a basic neurologist exam where they will handle the dog and look for pain spots/limb weakness etc, but not MRI. Just as a note on how unusual it is for a dog t yelp -- Jaspar, a clear/clear dog, never does and I carry him all the time at agility while waiting for him to do his runs, and carry him quite a lot generally. Leo, who HAS moderate SM, almost never yelps (once every two-three months?). I carry Leo around a lot too. So for a dog to yelp for no reason when picked up and carried -- that would be a concern worth seeing a vet for.

I also have to reiterate that sadly, SM is NOT RARE in cavaliers. Every study so far shows at least 50 % of cavaliers likely have syrinxes by the time they are mature adults, possibly as many as 70%, and over 90% have the malformation which on its own can cause symptoms. Most dogs will not be severe cases or severely symptomatic but likewise this is a painful condition even when dogs do not show outward pain and there are medications to relieve pain for dogs that are mildy symptomatic. Generally clear unexplainable signs of pain like yelping are considered more serious than some other signs like scratching unless the scratching begins to reach severe evels as it was in Leo's video or the video of the cavalier who was pts (clip 2 on my website).

Thsi is a condition that has been known about for a LONG time in the breed -- old time breeders will recall talking about 'the scratching disease' in cavaliers, which back then, tended to never manfest as much more than persistent scratching. many recall seeing this inthe show ring over many years. Something has now changed causing earlier onset and more sever forms of this condition -- and, because of MRIs, vets now understand WHAT this is (if not why it is happening, how it is inherited, etc). Every researcher so far has been shocked at the high level of incidence in MRI'd samples -- so we as owners and devotees of this breed have to realise this isn't about other people's dogs but abput OUR cavaliers. the chance that anyone has a 'normal' cavalier -- clear of both SM and CM -- is extremely small.

That doesn't mean people need to panic about SM, especially as only rarely is it severely symptomatic but that they need to be well aware of symptoms, just as we need to be with MVD, so that we can be sure we keep out dogs as comfortable as possible if they are showing signs of discomfort. I have spoken to one of the leading human neurosurgeons for this condition and he says even a mild malformation tends to cause huge headaches and pain for those who are symptomatic. Most likely this is the case with the dogs as well.

Some key scratching symptoms that are rare for any other reason but common for SM:

1) air scratching
2) stopping and scratching at head and ears when excited
3) discomfort on the lead and collar, perhaps on a harness too

And also:

4) yelping when picked up, touched in some places, all with no other apparent reason and vet cannot find any other reason

More severe symptoms would be scoliosis (twisted spine), head tilt, limb weakness (trembling, falling over, odd walk).
 
Thanks everyone for your concern and information. I don't want to be a ninny and over react, but I just can not get passed the symptoms. Last night she slept with us and she yelped 3 times when I moved the pillow where she had her little head. To me, this is not normal. This morning she is fine, but yelped when my step daughter picked her up. My husbands kid's are teenagers, and they just love her and she loves them. They will be going home tomorrow, so it will be easier to keep her a little more still. I have been a nervous wreck the whole time they have been here. Poor kids. I have asked the kids not to pick her up, and not to play with her in a way that gets her overly excited. What is so sad is that she wants to play with them as she is a puppy, and can't understand why she can't play and run, which she does unless I put her in her crate. She is completely a normal puppy with the exception of the yelping and scratching. We have been picking her up under her tummy, and she doesn't react to this. If you pick her up further towards her front paws under her arms is what causes the yelping. It has been hard to monitor this and I'm afraid I have been rude to some family when they have picked her up like this. I have asked them not to pick her up, and of course they don't understand the situation, and some just ignore you and pick her up anyway. It makes me so mad. Lily will run to them and jump up and down so they naturally want to pick her up. It is so frustrating. I go back and forth that I am overreacting to watching her like a hawk. I will feel much better when I get her to the Vet and know something one way or the other. I guess the not knowing is the worse. I don't think that her Vet put anything in her chart about the scratching. I just mentioned it to him and he really didn't comment at all. I will get them to fax me a copy of what they sent to PetCare. Regardless of what PetCare will pay, we will get her treatment. It would be financially a strain especially right before Christmas. We paid $1800.00 for Lily and have probably spent another $500 or $600 on doggy stuff, food and shots so far. I will not let her suffer or be in pain, we will do the best for her that we can do. She deserves nothing less. She is just our baby and we love her to pieces. I just have to not cry around her because it upsets her. She wants to comfort me.
 
Good luck with it all {{{{{{{{Shay}}}}}}}} Hope Lily is OK & that it's not SM. I think if it is though I would definitely see if you've got a 'Lemon Law' where you live.
 
I know many of us with diagnosed dogs actually felt much better getting the disgnosis than not knowing. So your feelings are normal. If she does have SM, tenderness is more common around the front legs and shoulders because syrinxes form in the neck area first and the pressure points tend to affect nerves going to front leg, sides, etc. Generally you don't want to pick up dogs from the front legs (as you might with a cat) as they don't have a cat's flexibility and this can be really uncomfortable anyway as their whole body weight is then levered off their front legs. A good way to pick up a dog is just what you are doing -- from the belly, underneath, and supporting the front and back of the body equally. I tend to carry my dogs kind of like a football, with my hand supporting their chest, then braced against my body with my elbow supporting their hindquarters. Or I hold them with two arms, equally supporting front and hindquarters. If she is having pain by getting accidentally moved at night she'd likely be better in a crate next to your bed. Those crate pads that have the kind of rolled edge are good for SM dogs as they like to keep their heads elevated higher and they can rest them on the rolled edge.

Shay, if she has SM you are catching it very early when you have the most options. So you are fortunate in that. I'd see if you vet will get you a prescription for gabapentin as soon as you bring her in if he is willing -- this is very good on pain and the scratching. Leo's frantic scratching has stopped and even if we miss a pill or two he is fine now.

One thing you might consider -- though it would involve travel, it may still be cheaper -- is talking to LIVS (www.livs.org) to Dr Marino -- they are doing low cost screenings for cavaliers and also do the most advanced form of the surgery (however, I do not know if the MRI they do on the low cost screening would be adequate for a full diagnosis; it is intended more for breeders to screen breeding stock). They are one of the most experienced centres for doing surgery for SM, and have done it on chihuahuas and yorkies, so dogs that are very small. They are in Long Island though. They charge $500 per dog for three or more for breeders; don't know what they would charge for single dogs or if it would be adequate. However it is one idea.

I do know someone got an MRI in Alabama where the price was quite good -- probably at Auburn -- but that was a while ago.
 
Thanks Karlin....Today Lily is fine and not so much scratching. I don't know if Long Island will be an option for us at this time. My Vet is a professor at Auburn and is very involved with the School of Veterinary Medicine, however, not that familiar with SM. I mentioned this to him when I first got her when we brought her in right after we picked her up. He was telling me what a great job they are doing in Europe breeding out the MVD, and in his opinion we could do a much better job in the US. I asked him about SM at the time, but he wasn't that afmiliar. I know that I will have no problem getting a referral from my Vets. I have used them for 13 years for my Lhasa and they are the best in the city. All 3 are very active at Auburn. They were going to send my Lhasa to Auburn when they just didn't know what was wrong with her, but the last test finally came back with a definitive diagnosis. I have family who have brought their dogs to Auburn and they have had great success. Auburn is really a great Vet school. I just hope they are familiar with SM.

Maxx's Mummy....I had another member e-mail me about lemon laws, but it appears that Alabama does not have one for dogs. If she has SM I will definitely pursue this matter further. Thanks!
 
Shay - just know that you are in our thoughts. I've been through some rough times with mine (Jake had squamous cell carcinoma) and it was very rough not knowing. Once we got the diagnose and surgery was recommened it felt so much better that we were doing something. We had a wonderful outcome (the complete opposite of what I expected...I thought for sure I was going to lose him at 2 years old). I know what you mean about looking at her and crying. I did this for a week. Every time I looked at that sweet boy's face and thought I was going to lose him I would break down. So, that is completely normal.

As far as what Karlin said about picking them up....I am so relieved now that both of mine are big enough that people don't pick them up anymore! I can't tell you how many times someone tried to pick them up as puppies by their front (like you would a baby). Neither of mine tolerated this and would shriek. The only way you can pick mine up is to scoop their body and support their front. They still will yelp if picked up wrong.

Hang in there....we're pulling for you!
 
Karlin said:
Judy, you do need a referral to see a neurologist, not because of what the insurance company wants, but because that is the way you go to see specialists. Most people don;t just directly ring a specialist, they need a referral.
Click to expand...

Yes, that's true, people will turn to their regular vet for referrals, and hopefully regular vets will make appropriate referrals. i was mainly talking about the lack of insurance policy limitations--but my impression has been that it would not be a problem to self-refer to a specialist, if you needed to, for whatever reason. In fact when Zack had that wrong diagnosis of enlarged heart and i was trying to prove to Petcare that he didn't have it, i called one of the best vet cardiologists around here, Stephen Ettinger's office, and they were more than ready to have me come right in and have an echocardiogram for $500. There was no problem taking him to a skin specialist last summer either.

A neurologist will want a vet to have cleared the dog for other possibilities first -- not least, so that a visit does not waste the owner's time and money. In a real emergency or if the vet is not willing to do a referral, then I recommend to call directly because many vets will not believe the sytmposm can be SM which is very rare normally.
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Also, i guess because of the rarity, normally, so many vets seem so unfamiliar with it, and have surprising misconceptions.

Because treating SM can be so expensive and can become a financial hardship if not covered by insurance, trying to work things so that it does get covered is going to be a high priority for many people. From what Shay said in a later post, it sounds like her vet has not notated scratching--he probably encounters countless new puppy owners who report scratching. So hopefully she will get through the 30 day period without a pre-existing condition so that it will be easier to give Lily the best care in the long run. :xfngr:

I have to question whether a report of scratching in a young puppy could be linked to SM by the insurance company if the vet didn't find it to be abnormal in any way and didn't even write it down, much less treat it. But as you say, theoretically they can call the vet and ask for more information about the history if they want. Scratching is so nonspecific and common, it seems like they shouldn't be able to attribute it to SM, but i suppose they can if they want. I will be paying very close attention to what happens with Lily and Petcare.

Also, vets and neurologists don't ever treat dogs for SM without having MRIs except under very special circumstances.
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i didn't know that. i follow some net discussions by people with SM dogs and had the impression that there are a number of people who could not readily afford MRIs, but who's dogs were still being treated for the symptoms, so i thought that, while not definitively diagnosed, SM was like a working diagnosis for which the medications were given. Is this not very common? Do most dogs get MRI in order to be treated?

....Companies also have the right to change what they will cover at any time so that needs to be kept in mind, too. Many of us fear that insurance will no longer cover SM before long because it will be seen as too expensive and too common in the breed.
Click to expand...

that is scary. If i pay my premiums and uphold my end of the bargain, i expect the insurance company to fulfill their contract. If they can capriciously deny coverage despite it being within what they've promised to cover, that is very scary to think about. It's also scary that SM severe enough to require expensive treatment is expected to increase to a point where insurance companies would not cover it. Petcare does have certain breeds with certain conditions that are so common and so expensive, they exclude them. But apparently their actuaries haven't considered MVD and SM in cavaliers to be something they need to exclude. That things are going in that direction with SM in cavaliers is very sad.
 
Shay, I don't have any words of wisdom or advice for you. I did want to let you know, though, that my heart and thoughts are with you. :xfngr:
 
Thanks everyone for your concern for our Lily.....My step kids and Mother-in-Law have gone home this morning, and Lily is zonked out in her crate. I think I can now get her settled into our little routine. She is doing so good with her potty training, and only had a couple of accidents while my company was here. She is sleeping through the night now, and not having to go out until about 7:00 AM. cl*p . The scratchimg has not been so bad the last 2 days, which is encouraging, but when I take her out, and bring her in and remove her leach she gives a couple of hind leg scratches. So we will wait and see. My house is so peaceful right now, the silence is bliss :lol: but Lily seemed a little depressed when they left :( she was going through the house looking for everyone.
 
The neuro whose name I gave you is definitely familiar with SM and has treated at least one dog with good reports -- that's why he's highlighted on the neuro list. :) So you will be in good hands at the point you may need to talk to him.
 
Thanks Karlin.......I can't wait to get her to the Vet. I am counting the days. She was better the last couple of days, but last night she yelped a couple of times while laying down. Not screams, just little yelps. She is not scratching when she yelps. She is nibbling her paws more this morning, and scratching a little. The weird thing is she does none of this while on her leach. It is always after I bring her in from outside. The yelping is just random. Can't attribute it to anything, except when she is picked up the wrong way. The other yelps have just been for no resaon. She doesn't seem to be in pain except for the little yelps. Otherwise, she seems extremely happy and playful. Just so frustrating She slept for several hours yesterday after my company left. She needed the rest. We are back in our routine now. She is going to the door now when she has to potty. I am so proud of her. She has learned a couple of tricks. My husband has taught her to sit, and I have taught her to speak when she gets a treat. She is so happy with herself when she does this. She is such a pleaser, and very smart. I know all Mom's say this about their babies, but I just have to brag a little.
 
So sorry to read of your concerns, Shay.

I have two affected dogs, Rupert was diagnosed from symptoms only and is mildly affected...TedBear was diagnosed by MRI last April and is moderate to severly affected.

It is better to know for sure, I know in someways there is always a part of you that would rather not know, but once it was confirmed I felt more able to manage the condition.

Please keep us posted, sending lots of positive thoughts.
 
Thanks for your concern, and I am so sorry your babies are affected. Just when I think that maybe just maybe, that I am wrong, something happens to make me sway back to thinking that SM is what she has. Her scratching this week has been relatively mild, and just a couple of yelps, but could attribute that to hubby picking her up the wrong way. Tonight hubby had her out for a walk, and I was siting on the side deck. I could see my neighbors talking to her, next thing I here a yelp. I figured they had tried to pick her up. When he got back, I asked him why she yelped, and he said my neighbor was just petting her. This is very strange, because non of her yelps have been when we are just petting her. I have gone over this dog with a fine tooth comb. I have patted, petted, scratched, combed, and rubbed every inch of her little body. She does not flinch, or yelp as if in pain when I do this.. She will sometime start kicking her back leg when I scratch her tummy, but every dog I have ever had has done this. The scracting she does is never in one spot. Sometimes her neck, rarely her head and ears, mostly her side close to her belly. She scratches on both sides of her body. I am now hoping it is just allergies, and I am wrong about the SM. She plays like mad and never seems to be hurting. She has run into walls while playing, and this does not cause her to yelp. So confusing. Just can't wait for 12/13 so I can start getting her checked out when the pet insurance kicks in.
 
Shay, there is no clear pattern to SM. You need to remember that pain is not caused by any real damage to the bodily areas that can be sensitive, but is neural damage. Hence the pain may never, ever be associated to limbs, head etc. The single most common type of pain humans with SM experience is excruciating headaches, and this is likely true for dogs as well, and is probably the cause of yelping 'for no reason' (though there is of course a reason). The head is only the most common area for dogs to scratch but sides are also common as is trying to snap at hindquarters. As I note in the symptoms document, as does Dr Clare Rusbridge, symptoms are highly variable and while there are a set of *common* symptoms some dogs show none of them or some or all (Dr Dewey has found less than half of the SM dogs he seesn, many of them severe, scratch at all). The fact that she has been air scratching and yelping would have to be considered two key concerns, regardless of whether she is showing other signs of pain. Please keep in mind that the yelping IS a sign of pain, especially when it is as gfrequent as you are reporting, and you do need to find out what it is. None of this may be related to SM but the fact that she is yelping like this is definitely a cause for concern and should be the first priority when talking to you vet. Yelping would not be related to allergies but could be related to PSOM (though this is unlikely if she isn;t also scratching a lot at head/ears) or a disk problem for example.

I'd try to get 1) video of her behaviours; 2) keep a diary so you know how often, on any given day, she may have a scratching session and for how long; and how many times she might yelp; 3) track air scratching separately from any 'regular style' scratching.

You need to be tracking this because it is very easy to not notice things are worsening -- or, conversely, to not realise there probably isn't anything to worry about if we have become overly attentive to behaviours.

I didn't notice how much worse Leo had become because I'd grown used to his 'occasional' scratching (which had long since gone beyond 'occasinal' but as I lived with him I'd just got used to the slow increase). I also had somehow managed to not notice how much hair he had started to scratch out. And really, until I made the video now on my SM website, I hadn't realised how prolonged and intense those sessions were. I was taken aback by my own video as I watched it, and realised he needed stronger medication at that point. So it really is such a good idea to keep a symptoms diary as this will be helpful to you, to your vet, and if needed, to a neurologist.

I know you will feel much better once you are able to proceed with checking all of this out properly; only a short time now and you will be able to.
 
I just wanted to clarify that when I said that its common for puppies to yipe when picked up it is when they are picked up more in the front by their legs..........not well supported under the tummy as they should be picked up . Colby never yipes when picked up correctly.

Shaye, did you get the double illness plan with Petcare ?
 
I found this with both of mine- yelping when picked up under the arms. Now I make sure that my hand is lower down and as soon as I can I support their bums. With Holly sometimes the yelp is because I've picked her up too fast and pulled her hair- with such a profuse coat, it's easy to do!
 
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