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Thread: Dilated Spinal Cord

  1. #1
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    Default Dilated Spinal Cord

    [SIZE=3][FONT=Times New Roman]I hope someone can help me, I am desperately trying to find some
    information on my longhaired dachshund. She has had some mild back
    pain since June 2006 (3 episodes). We figured it was the typcial
    dachshund disc problem and treated them as such.

    Last weekend she was fine as always, we were at a match even and she
    was her normal happy skippy self. Monday morning, she had her worst
    pain yet, she could barely roll up from a laying flat position and
    would cry out. She's never been like that before. Ran her to the vet,
    she had a dexasone shot (again thinking this was a disc problem) and
    by afternoon she was much better. Next day she was great. Next day
    she again woke up with a lot of pain. Seemed to be upper lumbar. She
    was quite miserable. I gave her some pred, and tramadol but it didn't
    help a lot. Next day same story. The next day I ran her to a
    neurologist who was prepared to do surgery.

    But after XRays, CT Scan and Myelogram it showed her discs were fine
    but she has what he calls a congenital dilated spinal cord. You can
    see the dye surrounding the spinal cord and within the cord as well.
    This happened from about L2 down, her neck and upper back (cervical
    and thoracic) appear to be unaffected. Unless he just didn't send the
    dye up farther than that I am not sure. In which case I guess it
    could go higher yet? anyway she does not seem to have pain up in her
    neck at all, it seems to be all in her lumbar.

    I have been researching and not finding much but the symptoms I have
    found, she does not have the scratching of her neck, her motor
    functions are all intact, no weakness in any legs or knuckling over.
    She is on day 3 of pred now and is showing improvement in her walking
    and pain (the vet said she'd also be sore a few days from the dye
    from the myelogram so not sure how much of it is that but she is
    improving and feeling better, yet has a ways to go).

    I had googled this the night my little girl spent at the clinic and
    saw the term hydromyelia, so asked him if this could be what she has
    and he said possibly but he didn't know. (is there anything else
    something like this could be besides SM?)

    I am pretty terrified as this little dog is all I have and am
    desperate to find out more, of course hoping for some hope that this
    won't be too terrible for her.

    Can anyone tell me if this sounds like SM or ?? The neurologist said
    he has only seen a handful of dogs with this over the years and he
    didn't have a name for it but said most did well all their lives. The
    pain would probably reoccur but could be managed with steroids. My
    fear is that since this has probably been happening since she was
    almost 6 years old and seems the episodes are increasing and getting
    more severe, does that mean she is on a downhill slope? Or could this
    go dormant for a while? I just really need to know what's going on
    with her and if there is treatment. It scared me when she was on pred
    and tramadol for 2 days and it didn't seem to touch her pain at that
    point.

    I plan to get her results and send them to Dr. Bagley at WSU and
    hopefully have a phone consult. But was hoping to learn here if she
    likely does have this disease and if so, what does the future likely
    hold for her and are there treatments we should be doing now that
    might be able to stop the progression (if that is even what is
    happening).

    Thank you for any insight at all![/FONT][/SIZE]

  2. #2
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    Dacshunds are one of the breeds that are known to get SM and yes, this could be SM going by the symptoms you are seeing (symptoms vary enormously). If the spinal cord is dilated it may be congenital in which case it isn't SM caused by CHiari-like malformation but may be due to improper development of the spinal cord -- eg spinal bifida. This is known in weimeraners and some other breeds. This is a different issue for treatment I think as well. Why does your neurologist think it is congenital and linked to the cord though, and not caused by the Chiari-like malformation in the skull?

    Only an MRI is going to show if there are syrinxes causing the cord to be dilated -- it sounds like this could be the reason though.

    I would NOT do surgery until you have ruled out SM (or ruled it in -- in which case you'd be thinking of decompression surgery). Is there any reason your neurologist has not recommended an MRI? I am not sure there's any point in sending the existing reports to another neurologist without getting an MRI as the neurologist will almost certainly say you will need one to see whether this is SM. But I am a bit surprised your neurologist was saying things like he has hardly seen this but has no name for it when he does... and doesn't know if this could be hydromyelia... just makes me wonder why an MRI isn't being done to determine these things and why the neurologist would not by now have come across SM/hydromyelia etc. Some are less likely to have seen the condition, very true, but noetheless I would think an MRI would have indicated immediately if this was the cause of pain and there IS an established treatment protocol now and has been for a couple of years.

    SM is highly variable in progression so no one can really predict how an individual dog will do, except to say dogs with early onset tend to fare worst. An MRI will indicate the severity of the case though and may help determine whether to opt for surgery or if the dog is a candidate for surgery. I would be looking for a neurologist familiar with SM -- for example Dr Harrington in Washington knows this condition well; Dr Bagley is also listed on cavalierhealth.org as being familiar with the condition.

    There are other medications that can help the pain (but won't resolve the problem) -- such as gabapentin which can really help with pain. NO medications Are known to stop the progression though some neurologists feel frusemide, tagamet or similar can maybe slow progression at least in early stages. These drugs can help with pain as well.

    There's a lot of info on my website here: www.smcavalier.com which is applicable to any breed.

    I'm sorry to hear you have these concerns and certainly hope you can pinpoint the problem one way or another.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    Thank you for replying Karlin. Your site is great, I had already read through it before finding this forum (and scared myself silly). I don't know how the neurologist decided it was congenital. I wish now I had asked but at the time I was in shock, thinking she had a disc problem and was going to have surgery for it, so I was trying to get my head around what he was telling me.

    Are there any reasons for a dilated spinal cord that aren't as scary? Considering she's had a few bouts of pain now since June '06, the last being the most severe so far...scares me. They did not do an MRI on her since they did the 3 tests they did thinking they were locating a slipped disc. I will be calling more neuro's and I'm sure we'll be getting an MRI. I am not sure if the neuro we saw really didn't know the name of this or if he was trying to spare me. He was sounding somewhat optimistic although he did say a disc problem would be better since he could fix that, this he can't fix.

    Good to know there is a pain protocol. And that Dr. Harrington is familair with this. I almost went to him instead of where I did go but I knew the other one from a previous doxie surgery. Now I wish I had gone to Harrington first. So he is really good with this? Do you know anyone personally who has been to him for this?

    Can a dog with symptoms such as mine, live a normal pain free life or will there be more and more pain and symptoms as time goes on no matter what? I just am trying to picture what might be in store for us. I would like to know if dogs can live a happy and comfortable life with this...if there is any hope at all.

    Thank you so much for your help, I am still in shock with all this. It's just me and my little girl here she's all I have and I'm trying not to expect the worst but having a hard time not.

  4. #4
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    Dee Dee I was just reading through this and wanted to mention that to a vet, congenital simply means "born with". This could be because of genes or because of intra-uterine nutrition or environment.

    Sometimes vets will call a condition "acquired", yet it is caused by bad genes. This is because - to a vet - if the condition presents after a pup is born it is then put in the "acquired" category. Therefore conditions names as "acquired" by a vet can be genetic in nature, which is very confusing.

    I hope your pup (and you) are feeling better.

    Arlene and her three.

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    Thanks for that explanation, Arlene.

    On Dr Harrington: yes, I know people who have had him do the decompression.

    Can a dog with symptoms such as mine, live a normal pain free life or will there be more and more pain and symptoms as time goes on no matter what? I just am trying to picture what might be in store for us. I would like to know if dogs can live a happy and comfortable life with this...if there is any hope at all.
    Well, the honest answer is -- no one knows. Every dog is different, all cases progress differently; early onset cases though tend to be the worst and progress fastest. Some go for surgery; some do not opt for the surgery, for many reasons. There is no one 'right' answer. I treat Leo with gabapentin, an effective painkiller as well as Tagamet, which can reduce the pressure of the CSF. Most of us using meds try different ones and different combinations. Most of us have to keep increasing the dose as the dog's SM eventually either progresses or the meds stop being as effective. Leo has been generally stable for a few years now and shows few signs except for scratching. If he declined I'd probably have the surgery. I have always hoped that postponing surgery might bring an improvement in treatment options and that has happened to some extent even in just three-four years. Waiting risks irreversible damage but again, he seems to have very slow progression so I have been comfortable with my choice. Lily my younger cavalier probably also has this and only scratches but seems little bothered by it. I give her Tagamet alone.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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