This is a complex topic.
Actually, I have many of the existing SM videos together in one place (not many more are on YouTube for example), and permission to use some other bits that I haven't yet added, and of the several that I have, only one shows a dog that is severely ill and writhing. The others make a very clear point that these are dogs managed through medications. That really sad video was NOT made by the PDE team by the way, it was shot by the dog's owner when trying to capture on video a then misunderstood problem.
The videos are the most viewed part of my SM site so actually I don't think people get a skewed version of the problems from videos. PDE showed the same bad case video I have but also a pet cavalier who scratches on the lead all the time -- pretty much the norm for many of us with affected dogs. My longest video shows a pet owner doing all sorts of normal activities with her elderly, affected dog, and explaining his issues quite clearly.
If anything, the problem is that I think many owners of dogs with symptoms, far from worrying overly that they have an early death sentence (which statistically I'm afraid is the case for many diagnosed dogs with a serious degree of SM, regardless of treatment) assume the dogs experience little pain unless they are highly symptomatic whereas humans with SM will state this isn't true. So I think there's a real problem with undertreatment of those dogs that do get diagnosed, and they continue in pain. And there's a big problem with owners/vets not realising the dog has SM and treating for nonexistent conditions instead.
If dogs have a tiny syrinx at an older age then yes, most of those probably have a reasonable chance of a decent lifespan and mild symptoms at worse. But not that many scan with only a tiny syrinx, when they do have one; and very often, those keep growing. Larger syrinxes, and asymmetrical (more common) almost always correlate with pain, as one study shows. Dogs adjust to tolerating increased levels of pain so lack of outward signs also does not indicate a dog is not suffering if it has a syrinx.
Results:
* 55 of 74 CKCS had syringomyelia
35% SM were painful
27% SM had scratching behaviour
* Comparison pain SM and no pain SM
No correlation sex or age
Strong association with maximum syrinx width (p<0.0001)
Dogs in pain - mean maximum width 0.58cm
Dogs without pain - mean maximum width 0.32cm
95% of CKCS with SM greater/equal to 0.64cm were painful
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)
Clare Rusbridge noted that in a small study, about half of dogs that have had surgery gradually decline though most were still alive at the time of the study, and about half treated with medication alone were euthenised early, eventually.
So: though I have long argued that there are many outcomes of a diagnosis, and many dogs will do well or OK on medications at least for a time, and sometimes for many years, the problem is that no one can predict how any one dog will do. The general understanding is that dogs with symptoms under age 4 are early onset cases that tend to get worse. Of those, some may decline quickly and others more slowly. Those that go on medication tend to need increased levels of medication over time to manage pain. Those showing noticeable signs and early pain do not usually have a good prognosis and their best chance is probably surgery or else need to be viewed as palliative care cases.
Personally, I think too many are mistakenly led to believe that medications will manage their dog really well and perhaps will halt progression where the reality is far more likely to be the opposite -- and that all needs to be weighed up in a realistic way when making treatment choices. And: I think despite some believing vets misdiagnose all the time as SM because they hear about it constantly, that most vets and owners still have never heard of SM and as Sins and Maya note, don't realise what is going on so it can be a while before the dogs get the help they need. All of us with affected dogs play a waiting game where as Margaret has so rightly noted, you can never fully enjoy your dog in a relaxed way as you always are aware they have this condition and never know what may happen next. You learn to take things day by day and do the best you can by your dog, whatever treatment approach is taken. :flwr: But certainly there are choices that can enable management of the condition, sometimes for a full lifespan.
This 6 year old has since been euthanased.
