Results 1 to 10 of 24

Thread: PSOM Question

Hybrid View

  1. #1
    Join Date
    Mar 2005
    Location
    Atlanta, GA
    Posts
    774
    Post Thanks / Like

    Default PSOM Question

    Hypothetical question:

    If one were doing a screening MRI on a dog with no symptoms, and PSOM is found - what is the proper course of action? I had assumed that one would want a myringotomy and flush done even if PSOM was just an incidental finding, but I'm now reading that nothing should be done if there are no symptoms.

    Feedback please?

    Pat
    Pat B
    Atlanta, GA

  2. #2
    Join Date
    May 2006
    Location
    Orlando, Florida USA
    Posts
    1,234
    Post Thanks / Like
    Blog Entries
    1

    Default

    Quote Originally Posted by Pat View Post
    Hypothetical question:

    If one were doing a screening MRI on a dog with no symptoms, and PSOM is found - what is the proper course of action? I had assumed that one would want a myringotomy and flush done even if PSOM was just an incidental finding, but I'm now reading that nothing should be done if there are no symptoms.

    Feedback please?
    I must have missed the suggestion that nothing be done about PSOM. It is progressive, so if there are no symptoms (of psom) and the tympanic membrane is not yet bulging, you could wait until it does bulge, but if you do nothing, ulitmately the the tympanic membrane may rupture and a hearing loss likely would be assured.
    Rod Russell

  3. #3
    Join Date
    Jul 2010
    Location
    nyc
    Posts
    636
    Post Thanks / Like

    Default

    Hello. My blondie had her ears flushed twice. I would say if the psom is not symptomatic flush it, because the dog is under anesthesia already, and its not worth it to wait until it gets worse and then have to do anesthesia again. Its a minor procedure. In dogs with sm its hard to say what's caused by what when psom is also present. My blondie seems happier now her ears r flushed again, the psom came back after 6 months, full force. There was tons of "goo" coming out of her ears even for days after the eardrum was "cut". Quite a bit of fluid.. We are considering eartubes @ ohio state if symptoms return. Every time her SM seems aggrevated by psom returning. She stopped doing airguitar scratching since her ears have been flushed for instance. I do believe the psom was clearly visivle on both mri's she has had.
    Mom of Blondie aka The Monster, my furry daughter and loyal friend!!!!!!!!

  4. #4
    Join Date
    Nov 2008
    Location
    Surrey
    Posts
    1,826
    Post Thanks / Like

    Default

    Dougall was diagnosed with psom two years ago. We have scanned each year. The latest mri scan revealed "There is still a middle ear effusion of the right ear; however the left ear appears to have sponaneously cleared which is most unusual ".

    We are closely monitoring him.


    This is worth taking a look at too....(NAC is often used as a cough medicine because it breaks up the disulfide bonds in the mucus and thus liquefies it, making it easier to cough up. It is also this action of breaking disulfide bonds that makes it useful in thinnning the abnormally thick mucus or Cystic Fibrosis patients)

    http://www.cavaliertalk.com/forums/s...highlight=psom
    Last edited by Tania; 20th February 2011 at 04:54 PM.
    Tania and The Three Cavaliers!
    Dotty!- A Sweet Little Tri
    Molly - Pretty Tri Dougall - Gorgeous Blenheim

  5. #5
    Join Date
    Mar 2005
    Location
    Atlanta, GA
    Posts
    774
    Post Thanks / Like

    Default

    "PSOM does show up on MRI but the ear can also be examined with a special scope under general anaesthesia. The mucous plug can be flushed from the ear but often this procedure must be repeated more than once to be successful. Neurologists who regularly do MRIs on cavaliers say some degree of PSOM is often present. Many neurologists and vets advise leaving the condition unless it is causing distress or severe deafness, as the flushing procedure is invasive, requires anaesthesia, and has some potential though rare complications. Be sure to ask your vet or neurologist to talk through these aspects of treating PSOM."

    The above is from this site. I had assumed that if PSOM was an incidental finding on an MRI, you should go ahead and do a myringotomy since the dog is already under anesthesia. But reading the above made me ponder the question. I am wondering if it might be like anal gland expression - I've not had a Cavalier that required regular emptying of anal glands, and I was chatting with a groomer friend yesterday about that since another friend commented she has to have her two Cavaliers' anal glands expressed every couple of weeks. The groomer commented that sometimes if "you never get started emptying glands, you never have a problem."

    That leads me to wonder - if you have an older Cavalier where PSOM is an incidental finding on an MRI done for breed research purposes (no symptoms) and you flush the ear - are you setting yourself up to have to have repeat MRIs and myringotomies because you have intervened? In other words - do you "leave well enough alone"?

    Pat

    Not sure that the cases of Blondie and Dougall can be used as illustrations - weren't these dogs MRI'd to get a diagnosis because of symptoms rather than for purposes of a research study?
    Last edited by Pat; 20th February 2011 at 05:58 PM.
    Pat B
    Atlanta, GA

  6. #6
    Join Date
    Nov 2008
    Location
    Surrey
    Posts
    1,826
    Post Thanks / Like

    Default

    [QUOTE]
    Quote Originally Posted by Pat;381597
    Not sure that the cases of Blondie and Dougall can be used as illustrations - weren't these dogs MRI'd to get a diagnosis because of symptoms rather than for purposes of a research study?[/QUOTE

    Agree Dougall is unusual and I would not suggest for one moment this is normal. We scanned Dougall because Molly had been diagnosed with sm.

    If it had not been for Molly, Dougall would not have been scanned. We assumed he was a quiet dog and later a quiet dog with back problems.


    Dougall has not showed any symptoms, his first scan revealed cm and not psom. His 2nd scan revealed psom. His 3rd scan revealed psom in one year and had vanished from the other. Dougall has never displayed typical psom symptoms.

    That leads me to wonder - if you have an older Cavalier where PSOM is an incidental finding on an MRI done for breed research purposes (no symptoms) and you flush the ear - are you setting yourself up to have to have repeat MRIs and myringotomies because you have intervened? In other words - do you "leave well enough alone"?

    Maybe you are right !
    Last edited by Tania; 20th February 2011 at 06:36 PM.
    Tania and The Three Cavaliers!
    Dotty!- A Sweet Little Tri
    Molly - Pretty Tri Dougall - Gorgeous Blenheim

Tags for this Thread

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •