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Thread: PSOM vs. SM

  1. #1
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    Default PSOM vs. SM

    Hi all, The more I read and learn about both disorders the more I feel obligated to know if Casey is afflicted with either. Because of her deafness, I am inclined to believe her symptoms are related to PSOM rather than SM. But I'll never be able to know until I have an MRI performed, correct? The problem is we live in a fairly rural area with few vets, and NO specialists, so how do I go about finding a good specialist and how much can I expect to pay for an MRI in Florida?

    Are there distinct difference between the sysmptoms of PSOM & SM?`
    Trisha in Southwest Florida
    Cavaliers: Casey, Ollie, & Winston and usually a foster or two! Cats: Pebbles & Benson

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    This explains both conditions:

    http://sm.cavaliertalk.com/diagnosing/psom/psom.html

    Have you spoken to your vet? That's really the first port of call. Deafness is not uncommon in the breed and isn't always related to PSOM. You'd want to be seeing more than deafness to be concerned about SM. If you think you are seeing signs of SM, you need your vet to be testing for other possibilities first anyway.

    Sometimes PSOM can be diagnosed without an MRI. Your vet should be able to refer you to wherever is best.

    Cavalierhealth.org has a list of neurologists.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    Deafness isn't necessarily related to either condition. Geordie has good hearing and he had PSOM; India is deaf and her hearing has not been improved by PSOM surgery.

    In the PSOM study at Ohio State University, they are diagnosed with a CT scan. But then you don't know your dog's SM status at all. Geordie is one rare case where they saw a syrinx in his CT scan because it is up in the C1-C2 area of his spine.

    PSOM symptoms can be very similar to SM. Geordie scratched on his neck/shoulder. He yawned quite a bit when excited, and lip-licked. He also sometimes bent his neck/body to form a slight curve, just a temporary movement while walking. He had a temporary hearing problem which resolved itself before the PSOM study.

    After the PSOM surgery, the yawning stopped completely, and the lip-licking decreased. But he continued to scratch at his neck/shoulder when excited, temporarily form his body into a slight curve when walking, and also now does this quick little body shake that sounds like a peacock ruffling its feathers. We give him his gabapentin every 8 hours, so now we only see symptoms right before he gets his doses and sometimes when he's excited.

    India scratched at her ears and neck before PSOM surgery, and now that has stopped.

    If you cannot get into a PSOM study (which only costs $260), I would go for the MRI. A CT scan for PSOM won't diagnose SM, but the MRI can diagnose both SM and PSOM. If your dog has PSOM, the study covers everything - CT scans, surgery, neuro exam, etc. If all of your dog's symptoms aren't resolved you'll still need to go the neurologist route.
    Last edited by Cathy Moon; 9th August 2008 at 01:41 PM. Reason: added info
    Cathy Moon
    India(tri-F) Geordie(blen-M)Chocolate(b&t-F)Charlie(at the bridge)

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    The indications Casey has, I always thought of as "quirks" but am beginning to think are pain indicators. She scratches her ears quite a bit (and I have taken her in several times to see if she has an infection and it's always "perhaps a minor infection, keep using the drops"). Also, she rubs her face on the ground after pooping, rubs her face on the sofa at times, holds her head level with her back when walking, yawns a lot, does the reverse sneeze occasionally, is generally extremely lazy (her nickname is the bear-skin rug), and in the past year has stopped jumping up on the bed or sofa. This last thing I contributed to her being overweight. After being on a strict diet for some time now, and losing 7 pounds, she now will jump up on the sofa only occasionally and still never the bed. In addition, she is completely deaf. So some of these symptoms could be one or the other or both, or nothing. My vet is very loose, and also a family friend....so I haven't brought this compilation of things to him, as I never thought they amounted to anything until now that I'm learning so much more about the health issues of the breed. Also, since we've been back from vacation I have noticed she is being very careful when she gets up from laying down, and had a hard time walking up & down the steps while we were there (in Florida, steps are nearly nonexistent, so it's been a while since she's had to use them). Perhaps I'm being paranoid, but after reading time and time again that dogs don't just "yelp" when in pain, that there are all of these other pain indicators, I'm worried!
    Trisha in Southwest Florida
    Cavaliers: Casey, Ollie, & Winston and usually a foster or two! Cats: Pebbles & Benson

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    Given her symptoms, I would take the bull by the horns, leave the vet out of it (unless you have insurance or something that requires a referral), and look for specialists.

    I don't know if it's feasible for your situation, but if you have time to travel a bit, why don't you try to have her into the PSOM study at OSU in Columbus OH, then the SM study at UPenn in Philadelphia once the PSOM has been eliminated? Do you have any relatives you could visit nearby?

    Otherwise, if there are any vet schools in Florida you could have her seen by a Dermatologist for PSOM and face rubbing (this could also be a slight skin infection like Geordie once had long ago that caused him to rub his face along the sofa), and a Neurologist for a neuro exam. If her eardrums are bulging, she may have PSOM.

    I've found it is actually far less worrying and far more educational to have my cavaliers checked by specialists at a vet school! If you just go along with your vet when you have all these concerns, you'll be wringing your hands months from now.
    Cathy Moon
    India(tri-F) Geordie(blen-M)Chocolate(b&t-F)Charlie(at the bridge)

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    Cathy- I don't know anyone in the midwest, but if I did I would be there! I think I will pursue trying to find a good vet school within a days drive. Perhaps the Univ of Fla has a program. I don't have insurance, but it would put my mind at ease if I knew one way or the other.
    Trisha in Southwest Florida
    Cavaliers: Casey, Ollie, & Winston and usually a foster or two! Cats: Pebbles & Benson

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    University of Florida does have a vet college:
    http://aavmc.org/students_admissions/vet_schools.htm
    Cathy Moon
    India(tri-F) Geordie(blen-M)Chocolate(b&t-F)Charlie(at the bridge)

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    Quote Originally Posted by chloe92us View Post
    The indications Casey has, I always thought of as "quirks" but am beginning to think are pain indicators. She scratches her ears quite a bit (and I have taken her in several times to see if she has an infection and it's always "perhaps a minor infection, keep using the drops"). Also, she rubs her face on the ground after pooping, rubs her face on the sofa at times, holds her head level with her back when walking, yawns a lot, does the reverse sneeze occasionally, is generally extremely lazy (her nickname is the bear-skin rug), and in the past year has stopped jumping up on the bed or sofa. This last thing I contributed to her being overweight. After being on a strict diet for some time now, and losing 7 pounds, she now will jump up on the sofa only occasionally and still never the bed. In addition, she is completely deaf. So some of these symptoms could be one or the other or both, or nothing. My vet is very loose, and also a family friend....so I haven't brought this compilation of things to him, as I never thought they amounted to anything until now that I'm learning so much more about the health issues of the breed. Also, since we've been back from vacation I have noticed she is being very careful when she gets up from laying down, and had a hard time walking up & down the steps while we were there (in Florida, steps are nearly nonexistent, so it's been a while since she's had to use them). Perhaps I'm being paranoid, but after reading time and time again that dogs don't just "yelp" when in pain, that there are all of these other pain indicators, I'm worried!
    These symptoms could be due to other issues than SM and/or PSOM. The reverse sneeze is one of the most widespread things that Cavaliers have in common. It often is attributed to the shape of their heads and is due to soft palate being too long for the mouth, resulting in the tip of the soft palate protruding into the front of the airway and getting sucked into the laryngeal opening where it may obstruct the normal passage of air into the trachea. See http://cavalierhealth.org/brachycephalic.htm for more details.

    Not getting on the bed or sofa could be due to the excess weight or a structural problem, like a bad back or hips. Complete deafness is, unfortunately, more and more common in Cavaliers. It may be progressive hearing loss due to degeneration of the hearing nerve. At the risk of engaging in some shameless promotion, I suggest that you see more about progressive hearing loss in Cavaliers at http://cavalierhealth.org/deafness.htm

    Most neurologists will tell you that an MRI should be a last resort, and that, unless the dog is in such extreme pain that delay would be unwise, all other possible causes of the behaviors should be considered and eliminated before resorting to the MRI. It usually is expensive, and it requires full anesthesia.

  9. #9
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    Thanks Rod. Please read my other post, "took casey to the vet to rule out everything else". She is not overweight anymore, and all x-rays have shown no orthopedic problems.
    Trisha in Southwest Florida
    Cavaliers: Casey, Ollie, & Winston and usually a foster or two! Cats: Pebbles & Benson

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