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Thread: Reality Check

  1. #1
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    Default Reality Check

    Luka's discharge paperwork came and it basically states the following:

    Luka's first syrinx spans C1-C7 the entire cervical spine, there is one in the top middle thoracic cord, the is one at the spine, and 3 small dialations at the top of the lumbar spine. There is a dilation of the ventricles, mild crowding of the cerebellum and a slight medullary kink.

    Those of you who have had experience with this disease, I am thinking that with this extensive damage to his spinal cord it is not a benefit to do surgery because even if they shunt the two large areas he will still have to take an extensive drug regiment.

    Also Dr Kline says that he could still have a few years, those of you who have gone through this what should I expect- what is a reasonable lifespan for Luka?

    I don't think accupuncture would be benefitial to him because there is so much damage to the entire spine.

    Thank you.

  2. #2
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    I'm so sorry. Did your neurologist advise against surgery? Riley's syrinx was very wide and covered her entire spine and was complicated by a very large cerebellar cyst, which they thought they would have to shunt. Two neurologists thought her best chances for a longer healthier life were through surgery, which she had three years ago.

    I was just wondering if your neuro gave you any advice - pro or con surgery. You can always take the MRI disc for a second opinion - or even send it to Clare Rusbridge. For a fee, i think she will do a consultation.

    Riley is still on prednisone and will be for life, but that's o.k. with me. She's happy and running around, still damaged, but a happy girl nonetheless.
    Bev
    Oliver (blenheim, born 3/2001), Riley (black & tan, born 8/2002,), Madison (ruby, born 9/2003), and Oz (tri-color, born 7/2007)

  3. #3
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    Default Not really.

    Quote Originally Posted by Love my Cavaliers View Post
    I'm so sorry. Did your neurologist advise against surgery? Riley's syrinx was very wide and covered her entire spine and was complicated by a very large cerebellar cyst, which they thought they would have to shunt. Two neurologists thought her best chances for a longer healthier life were through surgery, which she had three years ago.

    I was just wondering if your neuro gave you any advice - pro or con surgery. You can always take the MRI disc for a second opinion - or even send it to Clare Rusbridge. For a fee, i think she will do a consultation.

    Riley is still on prednisone and will be for life, but that's o.k. with me. She's happy and running around, still damaged, but a happy girl nonetheless.
    She really didn't advocate for it and I understand why because you cannot shunt the entire spinal cord, and his cervical syrinx spans from C1-C7, which is the entire cervical curvature. The next is the most top of the thoracic curvature, and the dialations inside his spinal cord that have nowhere to go but bigger. They won't shrink.

    At this point I think we are just managing his pain.

    Thanks though it helps.

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    I'm confused when you talk about surgery because you talk about shunt surgery rather than FMD - decompression surgery. Have you specifically discussed FMD surgery with Dr. Kline? I'm not advocating for or against surgery, just trying to make sure that you understand and have considered and discussed all of the options.

    FMD I believe would aim to prevent any increase in the size and/or number of syrinxs (what is the plural of syrinx anyway?) and might also help with controlling the dilated ventricles, etc., since the CSF would be able to flow more freely after the surgery. My understanding is that neurologists are more in favor of surgery with a case like Luka's - younger dog with extensive damage - and less inclined in an older dog with less damage where the damage might be much more slowly progressive and the situation more easily managed by medication. With a younger dog with a lot of damage and symptoms, the aim of surgery is to prevent further deterioration and allow medical management for a much longer period of time versus waiting until the damage is such that it simply can't be medically managed. (As you said, there is nowhere to go but bigger....)

    Regarding acupuncture, my understanding is that it might help with pain management despite the extensive damage as it somehow works on the "pain nerve centers" (I just made that term up!) rather than actually doing anything to directly help or improve whatever damage is causing the pain. I have used a certified a/c veterinarian for three of my Cavaliers over the years - they were all geriatric and two of them had significant disk disease and one had DM (degenerative myelopathy). The two with disk disease were helped tremendously as evidenced by lessened pain and much greater mobility. The one with DM was not helped at all by a/c. In each case, I gave an 8 week trial of a/c, and I continued with the two that were helped and was able to space out the visits longer. I finally stopped it with the DM girl but I was happy to give it a chance. It's something that you might want to consider a trial to see if there are results.

    Just some thoughts - others might elaborate to validate or discredit these ideas!

    Pat
    Pat B
    Atlanta, GA

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    Default

    I'm a little confused also. I don't know that much about shunts as fmd surgery but deciding on surgery has several factors. Some neurologists may see an mri image and decide but imo, it should be age, progression, reaction to medication, severity, symptoms.

    I want to say that maybe if there has been damage done to the spinal cord, surgery will not reverse it but it can help with progression. Some neurologists will talk about surgery reducing size of syrinx etc. I think that's stretching it but it hopefully reduce pain and also progression. Maybe you should get a second opinion. I know you mentioned supplements for sm treatment so surgery is a complete extreme. Acupuncture is not intended to treat SM but can be used to treat pain. Ella had surgery, took several medications but I also sometimes would have her get acupuncture. However, I would never recommend alternative therapy as a treatment just as an addition.

    Sent from my Droid using Tapatalk
    Anne Proud mother of Elton 5 and Angel Ella

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    I am reading it again and you said with surgery still need to take drugs. That may be the case but still something many who have surgery do. Ella did not have a long syrinx but a short wide one located near the base of her skull and she took medication after surgery. Not sure how that relates but I do hope you get things managable. Thinking of you

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    Anne Proud mother of Elton 5 and Angel Ella

  7. #7
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    Default I mean Decompression

    Quote Originally Posted by Pat View Post
    I'm confused when you talk about surgery because you talk about shunt surgery rather than FMD - decompression surgery. Have you specifically discussed FMD surgery with Dr. Kline? I'm not advocating for or against surgery, just trying to make sure that you understand and have considered and discussed all of the options.

    FMD I believe would aim to prevent any increase in the size and/or number of syrinxs (what is the plural of syrinx anyway?) and might also help with controlling the dilated ventricles, etc., since the CSF would be able to flow more freely after the surgery. My understanding is that neurologists are more in favor of surgery with a case like Luka's - younger dog with extensive damage - and less inclined in an older dog with less damage where the damage might be much more slowly progressive and the situation more easily managed by medication. With a younger dog with a lot of damage and symptoms, the aim of surgery is to prevent further deterioration and allow medical management for a much longer period of time versus waiting until the damage is such that it simply can't be medically managed. (As you said, there is nowhere to go but bigger....)

    Regarding acupuncture, my understanding is that it might help with pain management despite the extensive damage as it somehow works on the "pain nerve centers" (I just made that term up!) rather than actually doing anything to directly help or improve whatever damage is causing the pain. I have used a certified a/c veterinarian for three of my Cavaliers over the years - they were all geriatric and two of them had significant disk disease and one had DM (degenerative myelopathy). The two with disk disease were helped tremendously as evidenced by lessened pain and much greater mobility. The one with DM was not helped at all by a/c. In each case, I gave an 8 week trial of a/c, and I continued with the two that were helped and was able to space out the visits longer. I finally stopped it with the DM girl but I was happy to give it a chance. It's something that you might want to consider a trial to see if there are results.

    Just some thoughts - others might elaborate to validate or discredit these ideas!

    Pat
    I meant decompression. Emotional distress doesn't make me think clearly.

  8. #8
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    Default My concern is that

    Quote Originally Posted by anniemac View Post
    I am reading it again and you said with surgery still need to take drugs. That may be the case but still something many who have surgery do. Ella did not have a long syrinx but a short wide one located near the base of her skull and she took medication after surgery. Not sure how that relates but I do hope you get things managable. Thinking of you

    Sent from my Droid using Tapatalk
    The Syringes (plural of Syrinx) are large the large one runs the entire cervical curvature. In human terms it's the ENTIRE neck area, and there is another Syrinx right below so I don't know where they would stretch it too?

    I need to read more about decompression, because with his extensive damage realistically I don't see many options.

    We were just diagnosed on Friday and I am defin. playing catch up. From what I am lead to understand and I don't know about canine anatomy but I do know about human anatomy. FMD, removes bone, for one bone tissue is somewhat regenerative, is that the same case in Canines?

    So at this point I need more information, especially from owners whose loved ones have have multiple Syringes, and their experience. I don't want to put Luka through a painful procedure that may not even help.

  9. #9
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    Quote Originally Posted by goda View Post
    I meant decompression. Emotional distress doesn't make me think clearly.
    Perfectly understandable! But know that decompression isn't intended to "shunt the entire spinal cord" or the "two large areas" - it is intended to correct the underlying physical condition that caused the syrinxes in the first place. The aim is to prevent any further damage (more and/or larger syrinxes) in order to hopefully keep the symptoms from getting worse. That is why meds are still generally given - to control the pain from the existing damage.

    Anne reminded me of a second point - are the syrinxes long and narrow or long and wide? The width seems to be an important factor in the amount of symptoms from what I've read here.

    Pat
    Pat B
    Atlanta, GA

  10. #10
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    Quote Originally Posted by Pat View Post
    Perfectly understandable! But know that decompression isn't intended to "shunt the entire spinal cord" or the "two large areas" - it is intended to correct the underlying physical condition that caused the syrinxes in the first place. The aim is to prevent any further damage (more and/or larger syrinxes) in order to hopefully keep the symptoms from getting worse. That is why meds are still generally given - to control the pain from the existing damage.

    Anne reminded me of a second point - are the syrinxes long and narrow or long and wide? The width seems to be an important factor in the amount of symptoms from what I've read here.

    Pat
    They are mailing me the MRI photos which I am hoping to post, from what I remember the first one is wide and long, the next one is long, and the rest are wide.

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