Our beautiful Ruby has just been diagnosed as having SM - devastated.

[dizzy]

On Wednesday our beautiful little Ruby - 16 months - was diagnosed as having a SM - 3mm 'bulge' and 1 syrinxes.(apparently an unusual one as it is lore to left of spinal column rather than central) We are devastated. We return to the neurologist at the beginning of December and I am already thinking up questions to ask him. Up until Wednesday her only sign of something not right was after scratching her ear she had a moment of weakness in her right eye and seemed a little frightened for no more than 5 mins. Our vet said she could have made herself dizzy by scratching her ear. We decided to rule out the worst case and had her MRI'd - Now we find we have ruled it in. Since then I seem to be looking for symptoms when infact she doesn't really display any. She never yelps or winces in pain. She loves having her neck massaged. She does scratch occasionally - maybe 3 times a day or maybe only 1. If I simulate scratching her neck for her she does air scratch but apparently this is the 'Scratch reflex' and is normal in dogs. Anyway I suppose I just want reassurance that others have been where I am. SHe has been put on a low dose of diuretic for life. Anyone out there able to relate to our story or offer words of hope? Thank you x

[Karlin]

Welcome to the forum and so sorry you have had this upsetting diagnosis.

It is good that you are already aware of what is going on as that gives you more options to think about in terms of treatments over time and also means you can monitor her more carefully and react more quickly, as needed.

Have you spoken to the neurologist at all or just your vet? I think you will find speaking to the neurologist will give you a lot more information. On the eye movements -- I would doubt this could be from becoming dizzy due to scratching -- I've never heard of this before -- but nystagmus, or problems with eye movements, are a known symptom of SM in humans and dogs so be sure to discuss this with the neurologist if you haven't (I am sure you probably have) and if she appeared frightened then it was probably related to some pain or lack of coordination connected to that I'd think?

Also I think the rubbing on the neck may be causing the scratching, myself -- those reflex scratches (which most dogs will do ) usually are more due to rubbing bellies or the sides of most dogs, not the top of the neck if that is where you are rubbing. But air scratching in cavaliers really means scratching when upright, not when you stimulate it, so you probably aren't seeing actual air scratching, but maybe a discomfort reaction due to rubbing that area. I really would try to avoid putting any pressure on the neck if you can -- move her to a harness for example so a collar isn't pulling at the neck; most dogs with SM are generally far more comfortable on a harness. I wouldn't rub at that area or anywhere around the spine if there's any question of a reaction.

There are videos of dogs with SM on www.smcavalier.com that might be helpful to you. The one of Chester in particular might help put symptoms in some context.

Scratching three times a day (more than once daily, actually), if they are SM scratches, is actually a fair amount of scratching according to the pain assessment diagram used by several of the neurologists to give a pain score to dogs (view it here). Some neurologists feel scratching is a far less worrying symptom and may just indicate some minor discomfort but others say it does indicate actual damage to an area of the spinal cord and can mean anything from minor discomfort to real pain, so it is good to keep an eye on it. If the diuretic doesn't stop the scratching, most neurologists will then recommend trying gabapentin (neurontin) as the next step.

Did your vet or the neurologist say a lopsided syrinx was abnormal? My understanding is that these are more common that syrinxes right in the center of the spine as more dogs scratch or have symptoms on one side only, but maybe it is the case more that while lopsided syrinxes are less common, they are more commonly associated with pain and symptoms. I do know they tend to be a bit more problematical because they start to press on the side of the spinal cord where they are larger, and this is what starts symptoms, whereas those in the centre take far longer to start pressing on the nerve endings at the top or side of the spinal cord. Dogs then have symptoms primarily on the side where the syrinx is pressing -- eg the dog will scratch to that side or develop areas of pain on that side.

There's a lot of info on my site www.smcavalier.com and you might be interested in the presentations in the London 2006 area of the research section where there's a presentation on syrinxes and pain. This is in paper five and there are links to the abstract and slides from that presentation.

This is from that paper:

There is a very strong association between maximum syrinx width and pain:

* Asymmetry of syrinx is only found in the dorsal half of the spinal cord, and is associated with pain. 79% of dogs with pain had such a syrinx.
* syrinx length is also associated with pain.

Results – dorsal asymmetry:
* Syrinx asymmetry only found dorsal half spinal cord
* Dogs in pain more likely to have dorsally asymmetrical syrinx
15/19 (79%) - dogs with pain
16/33 (49%) - dogs without pain (p=0.0419)
* Mean length of asymmetrical syrinx
5.15cm - dogs with pain
2.8cm - dogs without pain (p=0.0039)

You can see that in this study, more dogs had assymetrical syrinxes than symmetrical (31 of 52 dogs). These are my notes from that international conference and I am afraid they are not highly detailed but they were checked by the various speakers for accuracy.

Have you let her breeder know about this diagnosis? This is important information for breeders to help their breeding programmes. Also, is this a KC registered dog? If so the scan results would be very valuable to Dr Sarah Blott's work on the condition; I can send you some further information on this privately.

[*Pauline*]

Yes I second what Karlin said about the harness and not to use a collar. I was told Dylan can never wear a collar again. I won't actually even stroke his neck or back now.

It sounds like you have a lot of questions and I'm sure all of them can be answered here. It's good to keep in touch with your neurologist too.

[Love my Cavaliers]

And I will third what Karlin said about collars. Riley's neurologist said she was never to have a collar on again. Riley has severe SM and had surgery in June. Oz has the malformation but no syrinxes and I was told to use a harness on him also - no collars. And I am so sorry you are going through this. The time period following diagnosis is just a heartbreaking time. Everyone on this board will help you get through it though. Good luck at your next appointment.

[*Pauline*]

Yes that's true Bev, it is a very sad time after finding out. You are not alone in feeling this and we will be here for you

[pippa]

Thinking of you.

[dizzy]

Thank you so much for your informative reply Karlin. And thank you all for your caring words. Ruby has always worn a fleece lined harness - never a collar. Also, the area I rub gently where she then starts to mimick scratching with her leg is her left flank not her neck - sorry if I mislead. She has never yelped or winced and I thank God that so far she has not given any sign of being in pain. She is scratching a bit more on her left side ( the area particularly that was shaved on Wednesday for her MRI) so hopefully it's just that - will monitor though) The neurologist was Martin Deutschland at Chestergates hospital - lovely Man and so caring. I probably mis understood what he said about her lopsided Syrinxe although he definitely said they were excited by what they saw as it was quite uncommon.... will check that out next visit. I would welcome suggested questions to ask him as I just listened on Wednesday. With regard to breeder - I think it's a case of burying her head in the sand. I told her about Ruby and she said - ' none of her dogs so far have screened positive to SM' very hard to believe that. Two friends bought Ruby cavs from her too - same age as Ruby but cousins. You can imagine how they are feeling now. Anyway - thanks again. Love Dawn x

[dizzy]

Sorry meant to add Ruby is not KC registered. Her breeder seemed really good. Saw Ruby's mum and Auntie - clean breeding area - pups in house mixing with family and family pet Rottweiller! Lots of info given with Ruby which our vet was impressed with. Clear heart check with breeders vet and then subsequently ours. All checked out well - however now she seems quite defensive.... Mmmm

[Karlin]

Dawn, I am sure you are right that you heard him correctly -- whatever he saw, he felt was unusual and I'd guess there's probably more than just the fact that the syrinx was lopsided alone but some additional things that surprised him. I've met Martin as well, and heard him give a talk and he is doing research in this area so he would know what he is talking about. All my dogs have been MRId at Chestergates, too!

Just on collars -- my SM dogs both wear collars for their identification but they both have moderate symptoms. So they are fine wearing them but I don't ever walk them using collars. Dr Clare Rusbridge has noted there are some SM dogs that, because of the position of their syrinx, are more comfortable walked on a collar than a harness, but just wearing a collar can be aggravating to some SM dogs too.

[brotymo]

so sorry to hear of your Ruby's diagnosis. You will find lots of support and information here.