30th July 2008, 04:51 AM
Wanted to introduce myself/SM
A couple of weeks ago my 3-year-old Watson, the love of my life, started yelping when he got up from lying down and did not want to go up or down our considerable spiral staircase. Once I carried him, he got the idea and started barking for a ride with me whenever I went up or down. After a day of this, I took him to the vet.
My regular vet examined him and got no pain response anywhere. Legs, neck, everything fine. He observed Watson walking and said that looked fine as well. He took x-rays, which showed nothing. He sent me home with a pain medication, tramadol and an article about SM, since he had showed some signs of pain for a couple of days six months ago as well, but that literally disappeared overnight. He said it might be worth looking into an MRI and seeing a neurologist if the pain persisted, but suggested it could also be just a "soft tissue injury" (Watson is still like a puppy when it comes to playing) that would resolve itself. I immediately bought "steps" for him to get on the bed and got out the ones we used when he was a puppy for the sofa.
A day later Watson was really no better, so my vet added Rimadyl. The next day, Watson was immediately 75% better. Maybe more. But not fully Watson again.
So we saw the neurologist, who happens to be one of those listed in red on Cavalier Health, Dr. Sammut in Los Angeles, who sees tons of SM cases in the area. She DID get a pain response in Watson's lower back, but said this could still be a result of SM... or not. She thought the MRI was probably a good idea for back and neck.
(NOTE: Watson has never shown any other SM symptoms that I've read about here and elsewhere, but he does have seasonal itching every year, like a clock, in the warm months. It always goes away by October. I give him an antihistamine and bathe him in a special oatmeal shampoo when he needs it. He does not scratch when he's walking. Based on all this, the doc does not think it's SM itching, and neither do I.)
A couple days later, Watson was no longer yelping at all, but still seemed to rise from lying down very slowly and deliberately. He had also started using the staircase again, without "asking" me for a ride.
Anyway, I decided to do the MRI. Neurologist called this morning and told me 1) that Watson does have a "small" SM "maformation" and a very small syrinx, 2) that Watson has two slightly bulging discs, one near his neck and one on his lower back, 3) that it's very doubtful the bulging discs are related to the SM (I forget her reason, but it made sense), 4) that she suspects the bulging discs are what's causing him his current pain, not the SM.
She added a diuretic, lasix, to the mix of tramadol and rimadyl. And even though Watson is not yelping in pain anymore and seems to want to do anything (even sometimes going around the steps at the sofa and jumping down on his own!), she ordered no stairs, no fetching, no beds/sofa without steps, and very short walks for 3-4 weeks. Then she wants to see him again. Sigh.
I feel lucky that we caught this early (probably wouldn't have if it weren't for the bulging discs, IF they're what's causing the pain), but I'm wondering if there's anything I should know since WE DID catch it early. Should I see about sending his MRI to someone else?
And what does "very small" mean when it comes to SM? What is the rest of his life likely to look like?
I'm also concerned that without his walks and playing fetch, Watson will get heavy, which will be harder on his discs. He's already a couple of pounds over what he should be.
Thanks so much for having this board!
Last edited by boymom; 30th July 2008 at 05:05 AM.
30th July 2008, 06:18 AM
I am sorry you are having these problems and worries with your boy. While I am not going to be any help since I've not dealt with this problem before, I am sure someone will come along who can offer better advice.
I'll be thinking of you and good luck!
30th July 2008, 11:46 AM
It seems like you and your vet are right on the ball! it's excellent that your vet knows about SM and didn't wait around in sending you to a neurologist.
There are many cavaliers that live with mild SM and don't show any symptoms likewise there are others that when mildly affected are in some discomfort from time to time. All will be so different, just as the signs that they display are. Some scratch and others don't and some bunny hop on three legs when walking when excited and another might not. Others yelp which shows us pain but another might have a higher pain tolerance. You will have to watch your own dog and see what is going on, keep a diary and talk with your neurologist/vet about things that are happeneing, and things that help and things that don't.
Your neurologist will be able to talk about any progression, he will be the best person to talk with about meds and any other questions that you might have. Get a list ready for your next visit.
Also when he has been well rested and his disc problem has hopefully settled down some, you might see that it is the discs that are the cause of the discomfort and not the SM, what plans does the vet have for this? just rest and meds and regular follow ups? perhaps when you review at the next visit you could work on a gentle excercise plan together to keep his wait down and adjust his diet as well.
As for now keep him quiet and rested, give the meds chance to do their work and see your neurologist as requested, keep us posted, all the best,
30th July 2008, 05:34 PM
Thank you all. And wouldn't you know Watson's itching has begun in full bloom. Last night the bed was shaking. The twisting and contorting to get the itch can't be good for his back. I haven't given him his itching meds since Sept., and I remember my regular vet telling me I could give it quite a bit more than what it says on the bottle, but I don't remember HOW much. So I'm waiting for a call back on that.
But I'm suddenly thinking - COULD it be SM itching? I called the neuro, and waiting for her return as well. Itching starts in June or July and is always finished by October. I give him hydroxizine (sp?). It's all over his body - neck, back, feet, you name it. And it's nearly constant. It resembles flea itching, but as always, he's had his advantage and the groomer saw no fleas. Sometimes he gets dry patches that are visible.
I hate that he's now taking four meds (rimadyl, tramadol, lasix AND the itchy stuff) and wondering if there's something I should ask my vet about that will kill two birds with one stone, as in a steroid? I know you guys aren't vets, but it's so hard waiting for those calls back!
30th July 2008, 05:58 PM
Dr Sammut is a good neurologist; I know a few people who have gone to her in LA.
A small syrinx can mean huge amounts of pain, small amounts of pain, no pain. The dynamics of pain isn't very well understood with this condition because sometimes very mildly afected dogs are very bad while dogs with massive syrinxes are symptomless or almost so. The issue of pain seems to relate more to width of syrinx than size -- because if it is wider it has more of an effect on sensitive nerve endings in the spinal cord that affects pain experienced in other areas of the body (like ears, head, limbs etc). But it also probably has something to do with the way the CSF circulates in each individual dog so some are worse affected than others.
SM does tend to be progressive so typically, syrinxes will increase in size. I do have lots of the latest research info at www.smcavalier.com and there's more at www.cavalierhealth.org.
Ypu could be seeing a combination of SM pain with disk problems and seasonal allergies. If scratching always goes by season then maybe you are dealing with grass allergies, pollen allergies and so forth. On the other hand weather can also affect how dogs react. Many of us see more scratching during weather changes when pressure changes in the atmosphere.
Maybe you should ask to try gabapentin -- this is the most effective drug most of us have found for scratching. If it helps then you will know it is probably SM scratching as it wouldn't help with allergies.
In memory: Lucy
30th July 2008, 06:13 PM
thank you, Karlin - you've given me some great questions for Dr. Sammut.
One more thing I've just realized: last July, when Watson's itching was getting really bad, and his fur becoming tangled and knotted within days after grooming/bathing, I ended up having him shaved just to make it easier on both of us. Unexpected byproduct: the itching stopped and didn't return until now. For some reason, he was fine the rest of that season.
We have these massive trees lining our street from which sap blows into everything, especially in summer. If you leave your car out overnight, it's filthy and sticky. So, I've always felt comfortable sticking with my assumption that it's the seasons. And I thought maybe that sticky stuff had nowhere to collect when his fur was short.
You're right about keeping a diary.