Omeprazole is one of the CSF inhibitors. It may be though that another would work better, or adding something else would work better.

I don't think you should be angry at vets for missing this diagnosis. This is like blaming a GP for missing SM in a human. They do not have the training in neurological conditions and most are clearly unaware of the prevalance of this health problem in cavaliers. However, I am sick and tired of some breeders arguing endlessly that vets 'overdiagnose' this as a 'bucket diagnosis' for almost anything involving scratching or pain -- in fact, as any discussion with people who actually have cavaliers with SM can confirm (how many people owning SM cavaliers do these breeders, with their vested interest in selling puppies, actually talk to? I know quite a few breeders however who REFUSE to reply to their pet owners though when they contact them with news that one of the cavaliers of their breeding has SM . Indeed I have a whole list of those), the exact opposite is true and the vast majority of cavaliers are not diagnosed for many, many months to years as vets simply do not spot the problem. Symptoms are very similar to chronic problems like allergies and for most vets who are unaware of SM in the breed, this is what they will diagnose. The drugs given for allergies will also help the pain and other symptoms. So the problem can easily remain hidden. And remember cavaliers are only one breed of many hundreds of breeds and mixes and dogs only one type of animal the average vet sees.

I don't think it is anyone's business who is unfamiliar with this condition to tell owners what decision they should make regarding care. First off, it isn't their dog. Second, many people view their pets as less a part of the family, and will pts rather than pursue more costly or involved treatments. That is their choice, but it isn't everyone's choice, especially when more advanced care is available. Third, the statistics for relief through surgery are actually quite decent, and many dogs are back up and around within a couple of days -- if anything the hard part is restraining their activities (which is really important). While the surgery is in a riskier area than say a patella surgery, the morbidity rate has been extremely low. Finally everyone has their own reasons for making care choices that can relate to the dog or their own philosophies or perspective. Some do surgery when I personally wouldn't. Some don;t do it when I personally would. But everyone has the right to make that decision for their own personal situation.

I just encourage people to read widely, be as informed as possible, but realise there is no right or even 'better' answer. There's only the decision you make after deciding what is right in your own case. I'd just not ask for others' opinions if they are upsetting.