Suspect SM

[ppotterfield]

I was heartbroken when I found out Tilly had SM - you get a cavi and soon realise they become a pivotal part of your family life - shes my little buddy! But then I took a step back and reassessed the situation - why did we get a doggie in the first place - to enrich our family life. I was fretting about Tilly so much it was slowing enveloping me - and my family. Now that I have decided - keep my girl as pain free as possible, give her an awesome life - live it to the full - and one day at a time - we ALL (including Tilly) seem so much more relaxed and are just loving our time together - however long that may be.

First, Teri, so sorry to hear the severity of the diagnosis. If it was I, I would get a second opinion, before I made a decision, and would discuss with them in detail the prognosis. I know there are no guarantees, but I would want a very frank discussion of pros and cons.

Second, I do not disagree with those who make the decision for surgery, but I do think that there is sometimes, in some circumstances, merit to Ruth's approach, and none of us should think those who thoughtfully choose that approach love their dogs any less than those who choose to have them undergo surgery. Very personal decision based on many varied circumstances.

Hugs to all of you who face these decisions. As long as your decision is based on a combination of knowledge and love, it will be the right one for you, your family and your dog.

[tara]

Teri --I have no words of insight or knowledge on this subject, but just wanted to let you know how very sorry I am that you are facing this with Sadie. It sounds like you are a wonderfully caring mom to her and that whatever you decide will certainly be in Sadie's and your family's best interests.

Again, so sorry that your news was not good. I wish you the best in this difficult time. Thank you for sharing your story with us and please keep us informed on Sadie's progress.

[Karlin]

Thanks for those replies. They explain a range of views really well.

I should add that I have used medications, not surgery on my MRI-diagnosed cavalier. I continue to evaluate where he is and what to do next. I will likely re-MRI him this summer, but he had a very small syrinx on his first MRI. However his symptoms have progressed and the next MRI will help me consider what to do next, but so many different considerations go into each decision. Nothing is easy with CM/SM.

My concern is that people make sure they get a very good analysis of what the MRI shows and what its implications are, and that usually means trying to get a neurologist with lots of experience of this condition, and who is willing to explain why they are making a particular recommendation. There are neuros who lean more to surgery -- especially perhaps neurosurgeons like Dr Marino who naturally will see surgery as a key approach -- and those who are in the middle, and those who are conservative. Those with more experience of the condition in cavaliers will also be revising their recommendations based on experience and evidence.

I'd be a little concerned about a severe MRI and a recommendation to focus on meds only, because I think with such an MRI, the situation could change devastatingly rapidly and people need to understand that such a change -- with no alternatives but to pts -- may be part of their choice (it definitely doesn't mean such a choice is wrong, just that I think people shouldn't be mislead to think they may have lots of time and room to take decisions about surgery if things decline further). I don't have the expertise to make professional recommendations of course, but I do have enough time spent with researchers and at conferences on SM in cavaliers to have a pretty good sense that some leading figures might give an alternative interpretation that is worth considering. It doesn't mean they are right, but in medical issues I like to also have the viewpoint of someone with a lot of knowledge about an area.

I think Ruth's approach is just right, whatever the choice people make. Make the best decisions you can on the information and advice you get and then enjoy each day and don't worry about what might happen until it happens -- but make sure you are well-informed to make decisions if things change.

I waver all the time on surgery or no surgery; it is a hard decision and I like the least intervention possible. Many would have done it already on a dog like Leo. I decided not to to date, because he has few symptoms beyond scratching and very rare yelping if he is touched somewhere sensitive. I do weigh up the rate of his progression. In his case, if he was showing scoliosis and was having problems getting up and down things, I'd probably -- at his current age of nearly 5 -- do the surgery with Clare.

[Margaret C]

I so agree that you should make your decision & then enjoy every moment of their lives.

I now have three dogs with SM, as my mother's affected cavalier has just returned to live with me.

My homebred blenheim, Tommy, was scanned at a low cost centre when he was four. At that time his symptoms were very mild & he would have been a candidate for surgery.

I thought hard about my options & decided that I would not put him through what I felt was a very invasive operation.
I have 10 dogs & I knew I would not be able to keep his environment calm & quiet. Being disabled I would not be able to carry up & down steps if he needed it.

I knew I would not be able to nurse him as he should be nursed, & I also knew that if things went wrong I would always feel it was because I omitted to do something I should have done.

I also accepted that if he did not have the operation, but later deteriorated and needed to be put to sleep, I would have to live with the fact I made the wrong decision.

Tommy is now eight, he scratches & face rubs a little when excited, limps sometimes and is very demanding of attention if I forget his daily rimadyl. I love him & try & make sure he has the best life possible
I don't know if he would have been better with the decompression surgery or not.

I agree with Karlin that you need to speak to a neurosurgeon with experience of SM as your little girl is showing quite severe symptoms.
When you have the full picture you can decide what is right for you, your family & your pet.

Best wishes,

Margaret C

[Teri]

A very big Thank You to all of your for the kindness and support you have shown me through this trying time. Your ideas and varying opinions have really helped me to gain some clarity. It took me a couple days to get out of my fog of confusion and sadness and your posts really helped me. I have a list of questions now to ask our neuro tomorrow, and I am going to request an opinion from Dr Dewey, Marino or Rusbridge. I will be trying to find out how to go about this tomorrow. I have not made a decision about surgery yet. I will reserve my decision for after I receive more information from my neuro and the SM specialists who know this disease better than anyone. In the meantime, we are concentrating on getting her set up with her meds and getting her as comfortable and pain-free as possible. Oh, one thing I was wrong on was that Sadie does not have scoliosis. The neuro examined her and did not see it. So maybe I was seeing something that wasn't really there.

Sadie has recovered from her MRI. She seemed pretty sore the day after the MRI and slept a lot. They must have put her into positions that didn't agree with her. But she's been playing and wagging her tail yesterday and today so she's back to her old self again.

I do have a question for those of you who have had dogs go through surgery, or are familiar with it. What is the recovery like for them? Just wondering what I would be subjecting her to if we did choose surgery. That is something that I will be weighing as well. Its a tough decision because there is the unknown of the disease and the course it will take, the possible pain that can't be taken away. I keep seeing that video of the severe case on Karlin's website and I pray that won't be Sadie one day. That poor baby. And then on the other hand, there is this highly invasive surgery, messing around near her brain and spinal cord which scares me a lot! I would think the recovery would be quite painful from that as well, but I'm not real clear on that.

Thanks everyone! I so appreciate you being here for us!