Blondie diagnosis; SURGERY?? Help!!!

Hello. I was here a few days ago and introduced myself as new to the forum. My doggie 3 and a half and dear little girl just had her MRI and tests done at LIVS.
She was showing air guitar scratching, face rubbing and shaking a few weeks prior of the diagnosis. I diagnosed her myself, since I knew about the disease, and skipped all normal vets and went straight to the neurology department.
The verdict; my little girl has moderate brain compression and a large syrinx, 80 percent of the spinal cord is filled with fluid, however DR Marino said that their is little permanent damage so far. Not ONLY does my little girl has SM, they also discovered PSOM while at it. They drained the PSOM while she was under anesthesia.
I am shocked, but also happy about the non-permanence of the damage.
Dr. Marino recommends surgery with titanium implant. He says that with meds only, the disease will progress and evertually meds wont work anymore. He says I am looking at a two year life span. However, because of the PSOM, I am confused about what clinical symptoms where actually PSOM and actually SM. What if most of the discomfort was caused by the PSOM? Even though she has a large syrinx, is it possible for a dog to have no pain? Anyways, please give me your advice. Also your experience with surgery? It would be sooo much appreciated. I am facing a hard decision.

Blondiemonster said:

... The verdict; my little girl has moderate brain compression and a large syrinx, 80 percent of the spinal cord is filled with fluid, however DR Marino said that their is little permanent damage so far. Not ONLY does my little girl has SM, they also discovered PSOM while at it. They drained the PSOM while she was under anesthesia.
I am shocked, but also happy about the non-permanence of the damage.
... However, because of the PSOM, I am confused about what clinical symptoms where actually PSOM and actually SM. What if most of the discomfort was caused by the PSOM? Even though she has a large syrinx, is it possible for a dog to have no pain? Anyways, please give me your advice. Also your experience with surgery? It would be sooo much appreciated. I am facing a hard decision.

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I think you were very wise to go straight to the specialist. With those symptoms, starting with a general practice vet is just a waste of time and money.

Take what I have to write here for what it's worth. All I know about SM is what I've read and heard. There are several others here with first hand experiences with just meds and with surgery. BUT: SM is progressive, and I am sure it did not start out at 80%. So, that percentage probably will go higher. That seems to be a very high starting point for decision making between just meds and surgery. There really isn't much farther to go to reach the max.

It is true that maybe the PSOM has caused some of the symptoms, but when a syrinx envelops 80% or more of the spinal column, you might find more than just pain in the offing. It could lead to progressive weakness of the hind legs, scoliosis, and even paralysis. That may be what Dr. Marino means by two more years.

If it was my dog and I could afford it financially, I would go for the surgery. But, I agree with you that you should seek advice from other owners who have faced the decision, and maybe even another neurosurgeon, just to give you a sense that you've done all you can do.

I am so sorry to hear your news. The decision about whether to have surgery or try to treat with medications is a difficult and personal one. With a young dog, symptoms as severe as your Blondie's, little permanent damage yet but apparently large syrinxes, surgery may well be the best choice. It is not, however, the only choice. Make certain you understand the risks of the surgery and discuss with the specialists possible outcomes if you elect to first try six months or so medications.

As for your concern about PSOM and SM, I had the same issue. My BudBud has been diagnosed with both. Fortunately, his sympotms are minimal but we did delay meidcations for his SM for about six weeks after his PSOM surgery before we started him on medications for SM to see if he showed any continued symptoms. He did and he in on Gabapentin and Prilosec.

I wish you the best of luck.

Surgery is such a personal decision and unfortunately only you (and your partner if you have one) can make that decision based on the information that you have been given by one of the leading SM surgeons. But remember - he is a surgeon, and surgeons typically recommend surgery. That being said, I have an SM dog, Riley, who had decompression surgery with the titanium implant 2+ years ago and she is doing phenomenally well. Like your baby girl, her syrinx almost totally enveloped her spinal cord and she had a very large cerebellar cyst, both of which were causing her severe balance problems. She did not however have PSOM. Gabapentin and prednisone given to her during the six week period between diagnosis and surgery did nothing to relieve her symptoms. I opted for surgery as her neurologist told me it would give her the best chance of a quality life. I had a second opinion (luckily there are two neurologists close to me with SM experience) and was told the exact same thing. Her recovery was difficult as we couldn't seem to find the right medication for her - until we went to prednisone 5 mg/day. That is all she is on right now plus Denamarin to protect her liver and she is like a new dog.

I have absolutely NO regrets about doing the surgery. Every day I have with her now is a bonus day. She is a happy dog. She runs, she loves taking walks, she loves snuggling with my other dogs, she hunts chipmunks and birds in the yard. She will always be affected by the SM and her vestibular problems. She can't jump well (I bought doggy stairs that she uses - it's really cute), she doesn't play with the other dogs, she still gets off balance every once in a while, she can knock herself over if she does the whole body shake - but on the other hand, she stands on her hind legs to beg for food really well!!

While I never forget that she has SM, I treat her more like a normal dog now. I am not hypervigilant anymore for any little thing that would indicate that her SM was worsening. She is my sweet little girl and she is a happy girl and that is what matters to me. Please PM me if you would like to talk more about my experience with Riley's surgery.

I am so glad you went on this forum because everyone here can give great support and advice. I know we have been emailing each other and I told you about ella, but remember each dog is different. Take comfort in riley and others that have gone through this tough thing. The neurologist you are going to is one of the best in the us and he is an expert and he does have his opinions. I would like to take in mind that even though you will probably go through surgery with blondie, there are many other dogs on this forum that have gone through similar things and have very good hearts. Anyone who has this experience knows how tough it can be at first so please keep in touch because there are a lot of people that can help. Please keep us updatedicon_welcomeicon_welcome

Hello. Thank you all for sharing your experiences with me. I am glad I found this forum.
I talked to Dr. Marino today and he basically recommended not waiting with the surgery.
He even said he wouldn't even give her two years till paralysis without surgery.
Someone told me about getting a second opinion. Maybe that is wise. But is there really another way with an 80 percent syrinx? Anybody on here heard of a case with such a syrinx that is looking positive on just meds? If so, I'd love to hear it... I feel like id really be walking a fine thin line and dangerzone. Due to practicalities (my bf has a car and travel with it for work a lot) Id have to decide on weither to schedule the surgery for THIS monday, or te week after. If not then, I have to wait till september.
Nobody wants to see their baby go through this, and i have such a rough time making this decision.
I know it's a serious surgery.