Thought it might be time to share with all of you that our Buddy a/k/a BudBud was diagnosed with SM in June. He is four years old.
In September 2007 Bud-Bud was diagnosed with PSOM as part of Dr. Lynette Cole's study at Ohio State University and had a Myringotomy to remove the mucous plugs from his middle ears. At that time, based on the CT Scan, there were no syrinxes so no SM diagnosis was made. We knew the CT Scan could not rule out SM, but since his symptoms had been mild, and could have been signs of either PSOM or SM, we decided to just see how he did after the ear flushing. For about 18 months he did really well, was essentially back to being our happy BudBud, enjoying his games of fetch and make-shift agility, always ready for a walk, sneaking in and sleeping with his Clumber sister (Hadley), begging for food with pleading dark brown eyes. Then, about six months ago I noticed that the little, isolated yelps had come back, not often, but more than I would want to hear. He was doing more face/ear rubbing than I would consider normal and he just seemed sad. At the same time we had a new Clumber puppy (Katy) in the house and at first I thought BudBud was just stressed from getting used to Katy. But it soon became clear that as much as I wanted that to be the cause (because I knew she would eventually win him over), it was in fact something more -- a recurrence of the PSOM or the appearance of SM, or possibly both.
I had stayed in touch with Dr. Cole so I emailed her. She agreed we needed to get some tests done and together we decided that rather than do another CT Scan which might just tell us about PSOM, we would go ahead and do an MRI, which could tell us about PSOM and about SM. The MRI was done at OSU in June and yes, BudBud's middle ears were again plugged with mucous -- the PSOM had come back. In addition, three syrinxes were seen and we now also had a diagnosis of SM. Not what I would call the best case scenario.
In July, BudBud had a second Myringotomy and a consult with a neurologist about the SM. On clinical examination the neurologist found mild cervical pain, proprioceptive deficits in all four limb without ataxia and slightly hyperactive patellar reflexes bilaterally. Post-Myringotomy, he was put on Prednisone, 10 mg. twice a day for two week, then 10 mg. every other day for a week and finally 5 mg. every other day for a week. We are just about to finish with the Prednisone.
BudBud is much better since the Myringotomy. He is smiling more often -- like he just feels better. In almost four weeks I have seen only two face/ear rubbing episodes and in the same time period have heard only two or three of his little yelps. We now need to figure out whether it was removing the mucous from the middle ear (and relieving any associated pressure or pain) that has caused him to feel better or whether it was Prednisone or a combination of the two. The neurologist suggested Prednisone long-term for the SM, based largely on the diagnosis of proprioceptive deficits, if I understand correctly. I have questioned keeping him on a steroid without trying other options first, including, for example, Prilosec and Gabapentin (although he may not need a chronic pain medication yet). (It is so easy to say a dog is not in pain, but how do we know? So many dogs are stoic!).
Yesterday we were at OSU for a check-up and a discussion of what to do next. For now, once BudBud completes the last of the stepped-down doses of Prednisone, we will not give him anything and simply watch and see whether the sad demeanor, the face/ear rubbing and/or the little yelps come back towards the level they were before the Myringotomy (in which case they would appear to be more related to the SM and the Prednisone was apparently working) or whether he continues to do much better (in which case they would appear to be more related to the PSOM and improved post-surgery and he may not need to take anything right now or perhaps just Prilosec). We will then revisit the treatment options.
I have a few questions for Karlin and others who might know or lead me to the answers. I will put those in a separate post.
Not sure if my story is helpful to anyone else, but it does help me to tell it -- and I know you all understand. I am worried about the future but for now we are very lucky -- BudBud's symptoms are minimal, I learned enough from this forum and my own reading to follow-up nevertheless, we have resources to address his health issues and we still have our BudBud to love and make us smile every day. Some folks are not so blessed.
Thanks to those of you with whom I have shared private emails or posts for being there and thanks to all of you for listening and sharing information, your worries and concerns and your love of your dogs and of this breed which I hope it is not too late to save.