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Bentley has an appt: UPDATED w/PSOM info 3/22

I'm glad your appointment went well, Barb. Spencer was MRI'd in February and diagnosed with CM or Chiari-like malformation. Most of the time I'm really glad I did it since it did answer a lot of questions that deep down I already knew the answer to. There are some days when I think we shouldn't have done it because I catch myself watching him like a hawk and measuring every little thing he does. I need to remember that he's a happy little dog who for the time being thinks nothing is wrong with himself. I need to let him live and enjoy every day I have with him.

I hope you're able to get in the PSOM study. One of the new vets at our general vet practice just came from OSU. She raves about the entire Clinical Services department and particularly the strides they're making in neurology. Give Bentley a big hug from me.
 
Do the MRI and know just what you are dealing with.
At least that way you will resolve your own worries and will be able to give the right treatment to help him out.
For myself the worry before knowing is worse than actually finding out. The rest afterwards I can cope with.

Alison.
 
For myself the worry before knowing is worse than actually finding out. The rest afterwards I can cope with.

I completely agree with this. I was far more upset before I knew what was going on than after, as I now could make decisions rather than fear possibilities. I sometimes worry about what might happen... but what I learned from the months before I had the MRIs was: you can waste enormous time and energy worrying pointlessly about all the wrong things (I though Jaspar had SM. He doesn't and is totally clear. I never imagined Leo did. I foolishly wasted time getting upset over what Jaspar was experiencing when all along it was Leo. And Leo was perfectly happy, and undoubtedly was better off being treated like a normal dog and allowed to lead a normal dog's life).

There are plenty of things to work for and care about that are a lot more constructive and rewarding than worrying about what may never happen. So I do my best not to worry but always am reviewing possibilities so that I have a range of game plans and I hope, never have to make sudden, unexpected decisions for Leo. I do what I can to stay on top of research and thinking, keep Leo happy and healthy, and support those who are doing the research that will give this breed a future. (y)
 
Karlin said:
For myself the worry before knowing is worse than actually finding out. The rest afterwards I can cope with.

I completely agree with this. I was far more upset before I knew what was going on than after, as I now could make decisions rather than fear possibilities. I sometimes worry about what might happen... but what I learned from the months before I had the MRIs was: you can waste enormous time and energy worrying pointlessly about all the wrong things (I though Jaspar had SM. He doesn't and is totally clear. I never imagined Leo did. I foolishly wasted time getting upset over what Jaspar was experiencing when all along it was Leo. And Leo was perfectly happy, and undoubtedly was better off being treated like a normal dog and allowed to lead a normal dog's life).

There are plenty of things to work for and care about that are a lot more constructive and rewarding than worrying about what may never happen. So I do my best not to worry but always am reviewing possibilities so that I have a range of game plans and I hope, never have to make sudden, unexpected decisions for Leo. I do what I can to stay on top of research and thinking, keep Leo happy and healthy, and support those who are doing the research that will give this breed a future. (y)

Alison and Karlin; truer words were never spoken! I know I'm in a state of worrying over Bentley, and I have a wonderful :roll: imagination. I was so nervous today before this vet appt, which was totally silly. I think I will do my best to get him included in this study. If that doesn't work I'll have to find the way to afford the MRI.
 
Barb - no special words of advice. I'm thinking of you. And it's really not unexpected for you to feel the way you do. Not knowing really puts our minds into overdrive!! I think you've gotten some good advice. Keep at it....you'll find out what is going on...and you will deal with it. :hug:
 
Cathy T said:
Barb - no special words of advice. I'm thinking of you. And it's really not unexpected for you to feel the way you do. Not knowing really puts our minds into overdrive!! I think you've gotten some good advice. Keep at it....you'll find out what is going on...and you will deal with it. :hug:

Thank you, Cathy. I know myself, and I'm a person who needs to know what is going on. Like Alison said, my imagination gets me in trouble, but once I know what's going on I can make the decisions that need to be made. It's the unknown that drives me batty!
 
Barb...Just know that I am thinking of you and Bentley and hoping for the best possible outcome for Bentley. :hug:
 
I spoke with Dr Cole yesterday, and here's the info on her OSU PSOM study:

First, she is very nice and professional. She asked if Bentley had any of three things:
1. evidence of hearing loss
2. true neurological signs, such as drooling, head tilt, eye blinking, falling, limb weakness
3. air scratching, or persistent scratching at the ears.

Bentley has #3 without a doubt, and I'm thinking he may have some hearing loss. A dog only needs to meet one criteria to enter into the first phase of the study.

The study of the dog takes place over two days. The first day is evaluation day to see if they will proceed with the study. It consists of a general exam by, a neurological exam, a cardio exam and bloodwork. The charges for this are at the owner's expense; $240.00

If the dog passes the initial evaluations, the second day consists of
1. CT scan (Dr Cole said this is the "gold standard" for diagnosing PSOM)
2. an ultrasound of the ears
3. BAER hearing test
4. an impedimence (sp?) audiometry hearing test
5. another ear test where air is puffed against the eardrum

All of the above are done under general anesthesia. They do not look at the CT results until all tests are completed. I believe they try to determine PSOM using the other testing methods BEFORE looking at the CT results, otherwise the study would be colored. After the completion, they study the CT results to determine if the dog does, in fact, have PSOM. I think they compare these results against the other test results to see if they were able to determine PSOM using methods 2-5. The tests on the second day are free of charge.

If the dog is determined to have PSOM, they do the procedure to remove the mucus plug; slit open the eardrum and flush out the plug. They then do another CT to determine if the plug was completely removed. They ask you to stay over the second night, or to leave the dog there, until they are certain there are no complications before the dog travels again.

She told me it was my choice to have Bentley stay at the clinic or in the hotel with me. Since I'm about 3 hrs away, I'll stay in a hotel, and he'll stay with me there. I told her I was interested. She is booked through May, and will be determining June's study dates shortly. She'll be contacting me as soon as the dates are known.

I could kick myself, but I didn't ask her if the SM study is ongoing. I did mention SM, and told her I wasn't sure if the signs he is showing are possibly SM. I am going to put another call in to her today to ask about the SM study.
 
I'm, wondering Barb if those test will determine if he has SM as well? It sounds wonderful if you can find all of that out for such a low fee. I wish we had something like that close to me. I have suspected for some time that Lily has something going on, not sure what. I watched your video and she does exactly what Bentley does, in addition to some other things. It seems to be becoming more frequent, up to many times a day. She is only 7 mos old. My Vet wanted me to wait until she was a little older, and to watch her for more symptoms before he referred my to a neurologist. I will be very interested in Bentley's outcome from this study. I hope you are accepted into the study. Please keep us updated. I am wishing the best possible outcome for Bentley. :flwr:
 
Shay said:
I'm, wondering Barb if those test will determine if he has SM as well? It sounds wonderful if you can find all of that out for such a low fee. I wish we had something like that close to me. I have suspected for some time that Lily has something going on, not sure what. I watched your video and she does exactly what Bentley does, in addition to some other things. It seems to be becoming more frequent, up to many times a day. She is only 7 mos old. My Vet wanted me to wait until she was a little older, and to watch her for more symptoms before he referred my to a neurologist. I will be very interested in Bentley's outcome from this study. I hope you are accepted into the study. Please keep us updated. I am wishing the best possible outcome for Bentley. :flwr:

Thank you, Shay. You're SO nice :flwr:
I've just sent off an email to Dr Cole asking her if the PSOM study can determine if SM exists as well. On the phone yesterday, she did confirm that SM and PSOM can truly mimic one another. I then asked her if the OSU SM study is ongoing, and if, in her opinion, I should approach Bentley problems from both angles. PSOM and SM can and do co-exist. I let you know as soon as I hear back from her.

Give Lily a hug and a kiss on the nose for me, would you?
 
BarbMazz said:
If the dog is determined to have PSOM, they do the procedure to remove the mucus plug; slit open the eardrum and flush out the plug..


...and sometimes this surgery needs to be done more than the once...and even after this the build up can return (relapse), a bit like glue ear in children. It doesn't always have 100% results first time.
If it's only the deafness thats showing with PSOM (Primary secetory otitis media) and nothing else is bothering them then I don't think myself that I would interfere. :flwr:

Thinking of you both Barb, :flwr: hugs for Bentley (((X)))

Alison.
 
Alison_Leighfield said:
BarbMazz said:
If the dog is determined to have PSOM, they do the procedure to remove the mucus plug; slit open the eardrum and flush out the plug..


...and sometimes this surgery needs to be done more than the once...and even after this the build up can return (relapse), a bit like glue ear in children. It doesn't always have 100% results first time.
If it's only the deafness thats showing with PSOM (Primary secetory otitis media) and nothing else is bothering them then I don't think myself that I would interfere. :flwr:

Thinking of you both Barb, :flwr: hugs for Bentley (((X)))

Alison.

Thank you, Alison. Dr Cole explained the reason they do the second CT scan is to determine that the plug is completely removed. She seemed to feel that makes a difference in whether the plug returns or not.

I think I would rather this be PSOM than SM. He is obviously feeling something that's causing the scratching and headshaking. I hope he's not in too much discomfort. :(
 
None of those tests will tell if there is SM I'm afraid. Only an MRI can reveal syrinxes. The neurological exam could verify that there are neurological problems though that lean toward an SM diagnosis, if there's no PSOM.

It is standard for them to need to repeat the procedure at least once on many dogs -- just so you know this is very common. I hadn't heard that a CT scan for the absence of the plug improves the success rate -- but this may be the case or may be something they are trying to verify. I always understood the plug rcan reform for reasons not understood.

That is interesting that they include air scratching as I had understood from other folks that this usually is not seen with PSOM but Dr Cole is definitely the expert on this odd condition, so I will change what I have told people in the past.

I would def. go ahead with this study. OSU is def. doing SM work still as well but I don;t know what phase they are at and oif they are taking new cavaliers into thr study. I think the study went on hold when their neuros all went elsewhere over time and they only just got a new person in recently. The Cavalier Health Trust funds some of the OSU research but hasn;t been very clear in what is going on, who is participating, or what any of the results have been over the past few years. icon_nwunsure
 
Karlin said:
None of those tests will tell if there is SM I'm afraid. Only an MRI can reveal syrinxes. The neurological exam could verify that there are neurological problems though that lean toward an SM diagnosis, if there's no PSOM.

It is standard for them to need to repeat the procedure at least once on many dogs -- just so you know this is very common. I hadn't heard that a CT scan for the absence of the plug improves the success rate -- but this may be the case or may be something they are trying to verify. I always understood the plug rcan reform for reasons not understood.

That is interesting that they include air scratching as I had understood from other folks that this usually is not seen with PSOM but Dr Cole is definitely the expert on this odd condition, so I will change what I have told people in the past.

I would def. go ahead with this study. OSU is def. doing SM work still as well but I don;t know what phase they are at and oif they are taking new cavaliers into thr study. I think the study went on hold when their neuros all went elsewhere over time and they only just got a new person in recently. The Cavalier Health Trust funds some of the OSU research but hasn;t been very clear in what is going on, who is participating, or what any of the results have been over the past few years. icon_nwunsure

Here's my email and the reply I received from Dr Cole this morning re; PSOM/SM correlation:
On 3/22/07 8:46 AM, "[email protected]" <[email protected]> wrote:

>
> Hi, Dr Cole
> We spoke yesterday about my CKCS, Bentley, entering the PSOM study. Thank you
> for the detailed information. It really helps me to know exactly what will be
> happening to my little guy while he's there. I am anxious to determine just
> what's going on with him.
>
> Since SM and PSOM can mimic one another, and can also co-exist, I have a
> question; are you able to determine if SM is also present when you do the PSOM
> study? And, if not, are there any SM studies ongoing at OSU? I'm wondering if
> I need to explore both possibilities? I'd appreciate your opinion.
> Thanks again! Barb

Hi Barb,

If we determine that Bentley does not have PSOM, or if he does have PSOM but
the clinical signs do not improve with the middle ear flush, then we would
consider SM as a cause of the clinical signs. When we do the CT scan, if
there are signs of SM, then the dog does have it....if there are NO signs
noted, that does not mean the dog does not have SM, and an MRI would need to
be done to determine if he had it or not. Right now, we do not have any SM
studies going on here at OSU.....

Hope this helps

Dr. Cole

I am definitely going to do the initial day of the study with Bentley. If he is eligible to continue to the second day then I will definitely do that, too.

Research is certainly tricky, isn't it?!? I can see the researchers must be very, very careful not to jump to any conclusions, and the results can be so foggy! My respect level is definitely rising for the doctors and researchers who struggle to maintain scientific method cleanliness!
 
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