Madison diagnosed through MRI with SM

[Bridam]

I also checked Cavalierhealth.org. and she is the only one listed that is known to have SM experience (noted in red).

http://www.cavalierhealth.org/neurologists.htm#Texas

She would definitely be highly recommended though -- one of a handful in the US with strong SM experience both in practice, as a surgeon and in research.

I'm sold. It's just that my wife is pregnant and I work 70 hrs/week. It will be hard to make five hour trips. Once you get though the initial consultation, how often, on average, are people making return visits? I'm sure it's highly variable but it would be nice to know what we're getting into before we take the plunge.

[ppotterfield]

I do not know for certain, but would anticipate that much of the follow-up care can be handled by a Vet in your area in consultation with the specialist. I would try for a telephone consultation with Dr. Abramson, who might be able to recommend someone in Dallas you could work with, or could give you a pretty good idea of how often you would need to make the drive back and forth from Dallas to Houston. Folks outside Texas (but never Texans) forget how big Texas!

Again, best of luck.

[Bridam]

Thank you all very much. I called Dr. Abramson's office. When she calls me back, we'll see what we can do.

On another note, I really fear that she's starting to progress. She yelped for the first time last night jumping off our couch. And, she stopped wanting to jump on the couch. Small signs, I understand. It could also be that we are now hypersensitive. But, if these things bother me so, I can't imagine watching severe pain episodes.

[Spencer'sMom]

Spencer has CM and sees his neurologist every three months.

[Bridam]

I spoke with Dr. Abramson. She's very nice and I was impressed with her knowledge. She's done both shunt and decompression surgeries and has even combined them. She said that she'd have no problem monitoring Madison over long distance once we come up with a game plan.

I'm sending her the mri tomorrow and will try to make the trip as soon as possible--maybe even MLK day (I get it off). I'll keep you all updated. Again, my sincere thanks for steering me in the right direction.

[ppotterfield]

Glad you got in touch with her. Keep us posted. We will keep you and Madison (and expected human baby) in our prayers.

[Bridam]

Thank you all for your kind words. We have an appointment with Dr. Abramson for next Friday. It gives me some peace of mind to know that we are doing everything we can--although the above post about quick degradation gives me some pause. In the meantime, here is a puppy pic from almost three years ago:

[IMG]http://render-2.snapfish.com/render2/is=Yup6G0G%7C%3Dup6RKKt%3Axxr%3D0-qpDofRt7Pf7mrPfrj7t%3DzrRfDUX%3AeQaQxg%3Dr%3F87KR6 xqpxQQQGx0lnxGPlxQQQG0lnGPlnnnqpfVtB%3F*KUp7BHSHqq y7XH6gX0QQ0e%7CRup6aQQ%7C/of=50,296,442[/IMG]

[Claire L]

Don't have any advice to offer. Just want to let you know that I'll be keeping you all in my thoughts and prayers

[Bridam]

Here is an update after consulting with Dr. Abramson today.

We made our way back and forth to Houston today (about 8 hrs). GCVS is an amazing facility that seems top notch. The feel is more like a hospital than a vet's office--very reassuring.

Dr. Abramson was very nice and extremely knowledgeable. She performed an exam and watched Madison walk up and down the hall. Madison showed normal gait and propioception in all limbs. Reflexes and cranial nerve function were normal. Dr. Abramson noted a right-sided head tilt and pain during cervical palpation, however. Clinically, Dr. Abramson classified Madison as mild at this point with no general pain (this made my wife very happy).

Her view of Madison's MRI confirmed that Madison has severe chiari with hydrocephalus and syrinxes (about 90% of her spinal cord).

We discussed both surgical and medical options. If we go the surgical route, she recommends a combo shunt/decompression surgery: the shunt aimed at reducing the hydrocephalus. In discussing this with her, we learned that she has performed many shunts. Her background was very impressive and she conveyed confidence in her abilities while being very respectful of the delicate nature of the spinal cord.

Medically, she put Madison on Prednisone and took her off the salex (as we've seen no improvement).

My wife and I have a lot to think about and want this to sink in before we make any decisions. Our goal, of course, is to keep Madison from deteriorating. We'll keep you guys updated on what we decide.

Whatever we do, we're very happy that we finally got Madison seen by someone with as much expertise as Dr. Abramson who will be taking over all care for Madison concerning this condition. For pushing us in the right direction, we sincerely thank you all.

[Karlin]

I'm really glad you spoke with her -- it makes a huge difference to talk to a neurologist who is very knowledgeable and experienced in this particular condition I think. I have heard many good things about Dr Abramson over time. I know people do often wonder whether to talk to a neuro etc but I always feel people need as informed a viewpoint as possible to make informed choices. It makes us as owners feel more in control of a potentially difficult situation and more of a participant in the decision process rather than a confused onlooker. I know it really helped me with unnecessary worrying to get an MRI and consult. Before that I didn't know enough about what was going on and you can waste a lot of time worrying pointlessly. I always say, save the worrying for the times you really do need it -- it is so draining and unproductive that I'd rather know what exactly I should be worrying about rather than deplete myself due to lack of the best knowledge I can get. There are always uncertainties with SM but there's a lot we can do as owners to feel we are making the best informed decisions we can and it's funny in a way how just getting a clearer picture of what is going on (eg even just that clinical exam you had where a neuro can assess the actual affects on the dog right now -- something a vet doesn't know how to do and an MRI won't show on its own) really helps.