Diagnosing SM

Brian's recent experience with Rosie has reminded me of something that I think is important. Brian isn't the only Cavalier owner on this forum who has seen what seem to be symptoms of SM and thought the worst - and then discovered that their dog hasn't got SM at all. It's easy to get paranoid about SM, focus on every scratch and whimper and convince yourself that disaster has struck. Yes, everyone needs to be alert and well-informed and not let vets fob them off with endless treatment for allergies. But don't put yourself through a hell of worry and speculation when there is a simple way of finding out one way or the other - which is to get your Cavalier scanned. A low-cost min-scan (at least in the UK) will pick up whether your dog has SM at all; if the symptoms seem to warrant it, a full scan will then reveal the extent of the problem. If your dog has a pedigree, you can make a valuable contribution to research at the same time. If the scan reveals SM, you can get started on treatment straight away and save your Cavalier from unnecessary pain. If the scan shows that your Cavalier is free of SM, you can breathe a sigh of relief and stop worrying (at least about SM - there's always something to worry about with dogs!). Until we have a DNA test, scanning is all we've got, but it's there to help us and our Cavaliers, one way or the other.

Kate, Oliver and Aled

An excellent post Kate, thank you very much for writing.

I can only echo what Kate has written - it is so much better to know than to have the agony of not knowing - meanwhile your Cavalier is only going to suffer, there's no benefit to waiting.

Couldnt agree more!

When Leo showed signs of SM I felt sick at the thought of it. But I knew I wanted him scanned so we could start the appropriate treatment if need be.

It's a horrible feeling, waiting to be told but like Brian Im so glad I did. I decided it would be so much worse to bury my head in the sand and convince myself his symptoms were something else.

However it's also worth remembering that all dogs scratch, rub their heads at times and roll on their backs. You have to keep a realistic perspective on things, but like some one else said "you know your dog"

Kate, well said that is so true.

When my vet said that Minnie's problems were not SM related I decided to get a low cost scan done as I wanted to know for sure whether it was just a lower back problem (as diagnosed by my vet) or SM. I just wished I had had it done sooner.

I am in the same boat as other who worry. Chloe is only twelve weeks old and today she yelped out in the middle of chasing the other dogs, and started limping on her right leg. Even knowing yesterday she wiped out playing and I think she hurt her leg then. But my first thought when she was standing in the middle of the floor crying for no reason was worst. And it is hard not to notice every scratch, because it is on the back of your mind.

She is walking fine on her leg now, but I am taking her
in with me to work Monday to do xrays and have the
vet check her leg out.

I know puppies itch as a normal thing, and I plan to have Chloe get a MRI when she gets older, but right now I am just being a paranoid puppy mom (and she is way too young for my likeing to have anesthetic unless is it a emergency)

Sherri

Yes, very true: it is really important to consider a scan if nothing else is indicated for pain problems or scratching, and actually an MRI is the only definitive way of analysing disk disease as well -- problems do not always show on xray. Also important to keep in mind that many other things can cause problems and these should be eliminated first. especially in puppies, who can scratch for all sports of reasons!

That said: Rosie has both CM and a herniated cerebellum. These alone are enough to cause all the symptoms seen and while CM is generally 'better' than having a syrinx, Sm can develop at any time in a dog with CM and I am aware of current statistics from a very large sample of dogs (800) in which the likelihood of *asymptomatic* dogs getting SM is close to 70% by age 6+. I stress, that is for dogs *without any clinical symptoms, as cleared by a neurologist*. CM with symptoms generally requires the same meds as SM. As there are also signs of disk disease in Rosie, this alone could be causing symptoms, or it could be the CM, or it could be both. But CM with herniation means the skull is too small for her brain and her brain is being forced out into the spinal canal through the opening in the skull. In humans this alone generally causes far more problems then the addition of a syrinx. Both CM and SM remain mysteries in many ways, which doesn't help with understanding how best to treat! But CM can be just as worrisome a diagnosis as SM for many dogs and is the precondition for SM, especially if there is also herniation of the cerebellum.

Chestergates unlike many centres, does tend to place lesser emphasis on CM -- they don't actually indicate it on the scanning certificates they hand out. CM is formally noted in the grading certificates for breeders.

Unfortunately it probably is not going to be very easy to distinguish which accounts for the pain. Gabapentin will help disk pain as well as CM/SM pain. Both disk pain and CM/SM pain can recur. My Lucy has had two bouts of disk pain but nothing now for a couple of years. She does not have SM and little CM, no herniation.

I entirely agree, Karlin, about the problems caused by CM. Oliver seems so far to have no problems from his small syrinx - only from the dilated ventricles caused by his CM and herniation, which affect his eyes in strong sunlight, and also give him headaches at other times (which so far seem mild and respond well to an additional dose of gabapentin when required).

Kate, Oliver and Aled (who have all just enjoyed a few days of camping and walking in the Cotswolds)

While Brian was in the process of deciding whether to get Rosie an MRI, it made me think of our India.

She isn't showing signs of SM (signs like Geordie's) but she has a sensitive area on her left side when being picked up, and has had a few occurrences over the years of what was diagnosed by the vet as soft tissue injuries around her left shoulder/leg. With rest and NSAID, the problem has resolved itself, but then has recurred months or years later, and x-rays have never shown anything.

She still plays every day and loves to walk, but I need to know...

We've decided to have her MRI'd in December/January with Christmas bonus money; we reached the point that we want to know her status to set our minds at rest.