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Update on Bentley's results

BarbMazz

BarbMazz

Well-known member
He's back here at the hotel with me... very, very, very sleepy!

He does NOT have PSOM, but he has some hearing loss... some in the right ear and more in the left ear. He can't hear in the lower decibel ranges, which explains a lot! She had no explanation for what could be causing this hearing loss.

He has mild hydrocephalus on his brain, but no sign of syrinxes... so this is a good thing, I think. She said the results were too vague to say with certainty if he has SM or not, or even whether he has the occipital malformation. I think this is also a good thing? :xfngr: She feels that the hydrocephalus is mild enough not to be concerned about... I'm going to read up on it in any case so I understand what it means.

So, I have some answers but not all, which is better than nothing! As they were doing the study testing she felt that he had PSOM in either one or both ears, and was very surprised when his middle ears were completely clear! She said this is helpful to her research, so I'm glad about that.

OSU has a wonderful facility, and the people working there are very nice, competent, and efficient. I never had to wait even five minutes, and Dr Cole took her time and explained everything very thoroughly to me.

Now, back to hugging Bentley! :luv:
 
:hug:to you and Bentley. I am curious as to whether Dr. Cole thought he might need to have an MRI done now or any other testing or folllow-up to confirm whether he has SM or for any other reason. When she and I spoke on the phone, she told me (which I already knew genreally) that the CT scan she is doing for PSOM might possibly show whether the dog has SM but that it cannot rule it out and if it is highly suspected we might still need to do an MRI (at another time) which would mean a second anesthesia. Just when you get a chance.

Phyllis in WV/USA with Buddy (who is to participate in the PSOM study at OSU later this summer)
 
Barb - sound like you definitely got some answers. Glad he's back with you. You both rest and snuggle with each other.
 
You must feel better having more information, as opposed to wondering and thinking the worst. I hope Bentley feels better too. Sending lots and lots of :hug: your way!

-laura
 
ppotterfield said:
:hug:to you and Bentley. I am curious as to whether Dr. Cole thought he might need to have an MRI done now or any other testing or folllow-up to confirm whether he has SM or for any other reason. When she and I spoke on the phone, she told me (which I already knew genreally) that the CT scan she is doing for PSOM might possibly show whether the dog has SM but that it cannot rule it out and if it is highly suspected we might still need to do an MRI (at another time) which would mean a second anesthesia. Just when you get a chance.

Phyllis in WV/USA with Buddy (who is to participate in the PSOM study at OSU later this summer)
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Hi, Phyllis! and thanks for the much-needed hugs!
Yes, Dr Cole did mention the possibility of an MRI sometime in the future, especially if his scratching and bunny-hopping progress to something more pronounced. I'm also wondering about the neurologist's comments that he has lower cervical spine pain... could that be because of SM? She said the results were too vague to say for certain. Of course, he also has the mild hydrocephaly, too, which I imagine can be a sign of SM. On his side, he's almost four and the scratching has not gotten dramatically worse so far.

Another question I have is if he should be medically treated to relieve whatever is causing him to scratch. He doesn't do it "obsessively", but he does it on a daily basis with some days more than others.. it fluctuates. I don't want him to be uncomfortable... I've experienced nerve pain myself and it is NOT pleasant in any way, shape, or form!

You can be sure that Buddy will be handled very carefully while here. As I've said, everyone at the OSU facility is super! I stayed at the University Plaza hotel which is nice and everyone has treated Bentley very kindly, too.
 
Well that is a mixed bag of results! It is good he doesn't have PSOM; but curious as to what else might be going on. It is frustrating to eliminate some things without getting any clear answers.

I think what she likely meant was that a CT scan itself is too vague to reveal whether syrinxes (and hence SM) exists and won't show the malformation. A skull xray can show the malformation but not syrinxes as it won't see the fluid pockets. Only an MRI would give you the information you might evetually want. Hydrocephalus is sometimes associated with SM as is cervical pain.

From Clare Rusbridge's document on SM:

CT and radiographs have limited value. In severe cases cervical images may suggest widening of the vertebral canal especially in the C2 region and/or scoliosis. Flexed and extended radiographs of neck can be used to rule out vertebral abnormalities such as atlantoaxial subluxation and for an indication of the likelihood of intervertebral disc disease.
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From http://sm.cavaliertalk.com/diagnosing/diagnosing/infosheet.html

I know that Clare sometimes suggests trying a dog like this on frusemide or cimetidine to see if that relieves pain/scratching. If it does she has said elsewhere that this is an indication that you may well be looking at SM, or the malformation (CM) as a cause of pain/discomfort on its own.

From the same document:

If the dog’s history suggests postural pain or discomfort relating to obstruction of CSF flow then a trial of a drug which reducing CSF pressure, e.g. furosemide, cimetidine or omeprazole, is appropriate. This can also be very useful if it is difficult to determine if the cause of discomfort is CM versus, for example, ear disease. CSF pressure reducing drugs may be sufficient to control signs in some dogs, but additional analgesics are likely to be necessary for an individual with a wide syrinx. In this circumstance we suggest that non steroidal anti-inflammatory drugs are the medication of first choice partly because there are several licensed products. However, for dogs with signs of neuropathic pain, i.e. allodynia and scratching behaviour (suspected dysesthesia); a drug which is active in the spinal cord dorsal horn is more likely to be effective. Because gabapentin has established use in veterinary medicine we suggest that this is the drug of first choice but amitriptyline or pregabalin may also be suitable.
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I'd be inclined to talk to your vet about trying cimetidine as it is available over the counter and of that doesn't help, try gabapentin and see if you see the scratching go (if it does it is an indication that you are probably looking at SM or pain from the malformation on its own).

Clare and Penny have told me in the past that the bunny hopping gait and/or air scratching is distinctive pretty much of SM or the malformation. So of you are seeing these signs I'd either go ahead with an MRI to know what you are or are not dealing with, and consider whether surgery is something you'd want to do, or try medicating using Clare's treatment diagram and see if you get a good response. Neurontin won't help discomfort that isn't neurologically based.
 
Thank you, Karlin, your post is very helpful. It definitely was a mixed bag of results. I will be talking with my regular vet next week.

I'm leaning toward asking for the pressure-reducing meds like cimetidine. I use it when he has a colitis episode but I haven't noticed if there is a difference in scratching. Of course, I only give him one or two doses when his stomach is upset. I imagine more effect is seen when a regular dose is given daily.

I would love to have an MRI done. I'll have to see if I can swing it here in the near future.
 
BarbMazz said:
. . . . You can be sure that Buddy will be handled very carefully while here. As I've said, everyone at the OSU facility is super! I stayed at the University Plaza hotel which is nice and everyone has treated Bentley very kindly, too.
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Barb (and Karlin):

Thanks for the additional information. We do not have our exact OSU appointment date yet but it should be in August or September. I have, of course, been second guessing myself about whether to go as we have not had a repeat of the one more serious "yelping" episode and the frequency of the little "yelps" is on average not more than once a day. Then I remind myself that even though it is doubtful Buddy has PSOM and we do not seem to have any other symptoms of SM (other than the yelps), "yelps" for no apparent reason are not normal, that we may get some answers at OSU or at least some direction on where to go next and that we will be helping with Dr. Cole's research. Besides, Buddy loves to travel and we will all get a trip to Columbus for a couple days.

Hope Bentley (and you) have recovered from your trip and are back home safe and sound.
 
ppotterfield said:
Barb (and Karlin):

Thanks for the additional information. We do not have our exact OSU appointment date yet but it should be in August or September. I have, of course, been second guessing myself about whether to go as we have not had a repeat of the one more serious "yelping" episode and the frequency of the little "yelps" is on average not more than once a day. Then I remind myself that even though it is doubtful Buddy has PSOM and we do not seem to have any other symptoms of SM (other than the yelps), "yelps" for no apparent reason are not normal, that we may get some answers at OSU or at least some direction on where to go next and that we will be helping with Dr. Cole's research. Besides, Buddy loves to travel and we will all get a trip to Columbus for a couple days.

Hope Bentley (and you) have recovered from your trip and are back home safe and sound.
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I'm home safe and sound, and mentally very tired! Bentley is his old self this morning... all the ends are working normally.... eating and so on!

I'll be interested to hear if you decide to go, and what Buddy's results will be. I'm definitely glad I made the trip. Dr Cole assured me that we helped with her research, because her guess was that Bentley actually had PSOM from the various tests she did, as did the neurologist. They were both surprised that he didn't!

If you think of it, let me know when your appointment is made so I can send some positive thoughts your way!
 
Glad to hear that you and Bentley are home safe and sound - sorry the results gave you more questions than answers - I guess at least you are a little further on knowing that it's not PSOM {which I believe can also cause scratching}

Please keep us posted on what you decide to do - sending lots of positive thoughts and hugs for you and Bentley.


Phyllis, thinking of you and Buddy too - and wishing you all the best for his appt.
 
Nicki said:
Glad to hear that you and Bentley are home safe and sound - sorry the results gave you more questions than answers - I guess at least you are a little further on knowing that it's not PSOM {which I believe can also cause scratching}

Please keep us posted on what you decide to do - sending lots of positive thoughts and hugs for you and Bentley.


Phyllis, thinking of you and Buddy too - and wishing you all the best for his appt.
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Thanks, Nicki. This is an educational experience for all of us and we will be happy to share what we learn.
 
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