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Results are back .... pretty severe malformation and syrinx

You all have brought up some things that I learned today in talking to the assistant to the neurologist who may do the surgery... they were very surprised we were prescribed prednisone without anything for the GI. And very surprised no proton inhibitor, which could help both situations. I do have a call in to the prescribing vet on call (Dr. Bergman) and did not get a response today. But do not plan to add prednisone at this time until I talk to him personally about this. I may well defer to the neuro in Florida who likely will do the surgery as he seems to have a protocol that is more consistent with what I have been reading. One thing he also recommends is adding one thing at a time... starting with gabapentin and then omaprasole or cimetidine. I was very impressed with his office today... fast response, very thorough, asked alot of questions and let me ask alot... a world of difference already! :p

I'm so glad you were pleased with the office. It seems quite a few people have said good things about them. I'm sure talking to someone directly made you feel better.

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As far as the safety of omeprazole. I too was concerned after reading it could cause stomach cancer with prolonged use, however my neuro stated that was tested on rodents and has never been shown in dogs. He reports having many dogs in his practice on it for years with no adverse response. I also read this passage from Clare Rusbridge's website regarding Omeprazole:
- "This is also an antiacid and in laboratory rodents long term therapy has been reported to result in changes to the stomach lining. However this effect has not been reported in dogs. Reported adverse effects include nausea, diarrhoea, constipation and skin rashes"

If anyone has any recent studies regarding the dangers of omeprazole in dogs please forward them to me so I can bring them to my neuro. Jack has been on it for a year and a half along with Gabapentin and keppra, He gets bloodwork every 6 months and so far all has been good with his renal and liver functions.:xfngr:

Gracie's Mom so glad you found a vet who listens and is attentive, makes life a little easier when dealing with such a major illness.
 
Debra,

Just back from holiday and catching up with the news. I am so sorry it is SM.

You are really impressive in the way you are tackling this and you are getting some wonderful advice and support on this thread.

Sometimes I feel really proud to belong to this forum.



Hugs to you and Gracie :hug:
 
Well... Gracie doing good on meds

Started omaprazole yesterday for first time since gabapentin went very well. No side effects that I can see. Gracie's poop just slightly softer, but not diarrhea for sure. Other than that, omaprazole seems to be very beneficial. Yesterday was our best day in weeks! She ran through the house at 9:30 pm with her usual zoomies that had been gone for 2 weeks or so. However, I never heard from the neuro clinic that did the MRI at all. So I let Dr. Schubert advise me on adding the omeprazole.

Anniemac and RodRussell may be interested in what Dr. Olby told my vet by phone. Glad I did not wait for her to come back from maternity leave! Here is a quick summary:
"She did research on this about 6-8 years ago and she found that ~99% of the Cavs that came into the study had MRI lesions/narrowing/scarring. But only ~20% of them had any clinical signs. Almost all of those 20% showed scratching as a sign. But NCSU only recommends surgery if there are more serious clinical signs, such as pain - only a handful got surgery. Mostly because even with different types of surgery, the scratching does NOT resolve.
If the symptoms are severe enough for surgery, she recommends the duragen to attempt to limit scar tissue.
If the symptoms are NOT severe enough for surgery, she recommends omeprazole, gabapentin, pred etc"

Now this is shocking to me because if you wait until a dog is in major pain instead of having the surgery to keep them from having such pain... why bother??? :confused: Surgery is not about totally resolving the scratching... it is also about preventing more serious complications when you have major malformation and notable syrinx. Some are lucky that meds can help them for a long time, but Gracie's odds are not great. Soooooo glad I did not go there.
 
Now this is shocking to me because if you wait until a dog is in major pain instead of having the surgery to keep them from having such pain... why bother??? :confused: Surgery is not about totally resolving the scratching... it is also about preventing more serious complications when you have major malformation and notable syrinx. Some are lucky that meds can help them for a long time, but Gracie's odds are not great. Soooooo glad I did not go there.

Well different neurologists are going to have different opinions about surgery but this comment goes hand in hand about what someone told me that happened to them when they went to NC State. The technician or neurology student said they would only recommend a MRI, if their Cavalier was being vocal or in obvious pain. I told her that if she sees symptoms and is worried, "waiting for them to be showing outward pain by yelping" is not the way to go. She got an MRI elsewhere and her cavalier is being medically managed.

I am familiar with the study she is talking about that was done in 2006 since I know two cavaliers in the study (you have met one of course they no longer were bred etc). This is from Rod's website. http://cavalierhealth.org/syringomyelia.htm

"4June 2007: Development of Clinical Signs and CSF Flow: Dr. Natasha J. Olby, board certified veterinary neurologist, and Dr. Sofia Cerda-Gonzalez, both at North Carolina State University's College of Veterinary Medicine's Department of Clinical Sciences, reported in June 2006 that they and team members at IAMS Pet Imaging Center, Raleigh, NC. are in the process of conducting a three year study to determine whether abnormalities of the caudal fossa and cervical spine predict future development of clinical signs of SM.
The NC State/IAMS Pet Imaging Center team also has been studying the dynamics of cerebrospinal fluid flow in Cavalier King Charles Spaniels, and the extent to which head positions of the dogs affect the flow patterns. They reported in June 2006 finding that turbulent flow occurs in dogs with SM and can be found within syrinxes, and that CSF flow velocity may be higher within the dorsal subarachnoid space of affected dogs. They stated that additional studies are needed to determine whether their findings are significant. For more information, go to http://www.cvm.ncsu.edu/docs/neuro_studies.html or contact Dr. Cerda-Gonzalez at [email protected]"

What is this, "she recommends the duragen to attempt to limit scar tissue"

Debra,

I'm very impressed with all the information you are learning and taking the initiative to call several places and even others on forum. Gracie is in the best hands!
 
Hey anniemac...

I think you are right that this is NC State's take on it. And just not where I want to be. It appears that what she calls duragen is same thing as using mesh or swine tissue to control scar tissue from surgery. I think her term implies swine tissue only, but not sure.
 
I am a bit obsessive about research....he he!!

Well I have been since January 2010 and read stuff all the time but you seem to know more and picked up so much in such a short period of time. I guess my brain isn't that functional. Anyway, we can chat later.
 
I don't think so!!!

Well I have been since January 2010 and read stuff all the time but you seem to know more and picked up so much in such a short period of time. I guess my brain isn't that functional. Anyway, we can chat later.
Just kinda figured out if the swine tissue application is called duraplasty...then duragen is related to it. Just confirmed in some article on human surgery that is completely full of medical jargon. You and I had to get going on research. We had no choice...
 
Well I was wrong!!,

Well I have been since January 2010 and read stuff all the time but you seem to know more and picked up so much in such a short period of time. I guess my brain isn't that functional. Anyway, we can chat later.
It is not the swine tissue barrier for scar tissue... It is the material that dissolves over time. Dr. Schubert did use this for a while, but may have been another company that made it. Here is link for Duragen:http://integralife.com/Neurosurgeon...x&ProductLineName=Duraplasty&ProductLineID=28
 
Interesting thing with Gracie's eyes

I think that Zumie brought up a question in another thread about watering, red eyes related to SM or CM. Since we have had Gracie on meds for 4 days, her eyes are not tearing nearly as much and the whites are whiter. I used to have to wipe her eyes fairly frequently, but just once or twice a day now. What could be the connection...or coincidence???
 
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