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

[GraciesMom]

I knew in my heart it was SM but was shocked how bad. It is shocking that Gracie has not been screaming all day long! Gracie has a fairly substantial malformation and one huge syrinx that runs from skull down much of her spine. It varies in width but is taking up nearly half the spinal canal in places. We start her on meds tomorrow which include: prednisone, tramadol and gabapentin. I do have questions as I do not want to put Gracie through major surgery until I am clear enough on its ability to give her a decent quality of life. First, when a young dog (14 months) has a major compression with a large dominant syrinx, what have we seen in terms of impact of surgery? I would be fine if her current level of scratching and discomfort stayed about the same, but sounds like it may well get worse over time even with meds and surgery?Second, what have those who used a mesh implant found in terms of positive/negative impact? Some are concerned that the implants can lead to infection and not sure they are really that effective in containing the problem. But others feel that it is very effective in terms of limiting formation of more problems?Third, what can we expect as worst side effects of the meds above? I am most concerned about prednisone long term, but not as familiar with the other two. So any experiences with these is appreciated.Lots to decide in the next few days. I know we must decide on surgery soon given severity of situation. I must admit that we may well decide not to have surgery and just give her the best life we can until we know it is time to let her go. The severity of the syrinx is pretty disheartening.

[Love my Cavaliers]

I'm so sorry Debra, but you knew it in your heart. I can only give you my experience with Riley which has been a dream experience. Riley was diagnosed with severe and advanced SM 3+ years ago with a syrinx that covered more than 95% of her spine. After a second opinion, we opted for suregery even thought she was probably at the upper age limit for surgery (she was almost 6). She was treated before surgery with gabapentin and prednisone which had zero effect on her symptoms. In June of 2008 she had decompression surgery with the titanium mesh implant. After surgery, it took several months to hit on the right medication for her which was just 5 mg prednisone a day. She has been on that now for more than 3 years. The only side effects that I have seen are a loss of hair on her belly and her tail and some dry skin. I give her daily salmon oil. She also take a liver supplement daily and has her liver enzymes checked every 4 months.

She has had no problems with the mesh implant. She is a happy dog. She runs, she hunts in my yard, she catches chipmunks, she loves to go on walks. She does have weakness in her rear legs and can't jump well so I have stairs for her to get up on my bed and one of her favorite chairs. Our sofa is low so she can jump onto that. Her vestibular system was damaged before surgery and while the prednisone keeps it in check most of the time, she still has lingering balance issues. Her head tilt is still there, but not as severe as it used to be. She will never be a normal dog, but she is my miracle dog, and I never expected her to be alive and in as good shape as she is today.

For Riley, surgery was the right and only decision for a longer and better quality life. That doesn't mean it is right or wrong for Gracie or for any other dog. I've got to run, but I'll write more if you have more questions that I can answer later. Best of luck to you. Gracie will get the best care because you are her mom.

[waldor]

I am so sorry that the diagnosis is what you feared. At least now you know, and can move forward with meds and proper care. Have you told her breeder? (I can't remember if she was a rescue or what)

[Sydneys Mom]

I'm so sorry you got this diagnosis. I have no experience with SM so I can't offer any advice. I'm crying as I type this knowing that you and Gracie are suffering. Whatever decision you decide to make on the treatment will be the right one. Sydney and I are sending you lots of prayers and hugs. Love you both.

[GraciesMom]

I did tell her breeder... Some good and not some not so good reactions. He knows now that he can't breed her sister. He told that he already had stopped breeding another line 2 years ago. He seemed genuinely upset but he is a JUDGE as well as a breeder and I do not know how much I trust him. He did not offer any help or support with expenses, nor did he offer helping us get another dog in the future. Of course, I would not want one from him anyway. He did say...and I agree... That CM/SM could very well end this breed. Unless breeders take drastic action, I fear it could happen.I appreciate the info from Love My Cavaliers and others as this will help us make a decision on what to do.

[Reptigirl]

I'm sorry to hear those results At least she is getting the treatment she needs. I'm right there with you trying to figure out what is best... surgery or no surgery.

I have no experience with prednisone or tramadol. Mine are managed with either Lyrica or gabapentin + omeprazole. They all seem to be managed fairly well with the exception of the occasional "bad day". I know many members on here do well with prednisone but my neurologist seems to be against it until it is a last resort He is concerned about the long term side effects of taking it.

I know JUST gabapentin + omeprazole have been a miracle drug for poor Blitz. It has given him great relief despite having a syrinx that is so wide it takes up to 90% of his spinal cord in some places.

As far as gabapentin I was not told of any "long term side effects". Sorry I'm not much help but wanted to know we are thinking about you guys! I know how much it sucks.

[Zumie05]

That is so scary seeing how mild to non-existent Gracie's symptoms have been to how large her syrinx is I am so sorry, but at least you know now and are doing all you can to keep her comfortable. Remember Gracie doesn't know anything is wrong, dogs live in the moment.

[Holly]

This sounds so much like my experience with Scarlett... severe malformation and a HUGE syrinx but relatively mild symptoms. I'm sorry to hear this and I know how you feel.... that even though you knew it, it was shocking to hear how bad it actually is and overwhelming when trying to decide what to do. I am curious to hear everyone's opinions on the surgery. Scarlett has been well-managed on her meds and is already almost 5 years old. I decided to manage her medically due, in part, to her age but if she were much younger, I might have thought more seriously about the surgery.

I've had her on Gabapentin, Omeprazole, Previcox and, if needed, Tramadol for about a year and a half. Her bloodwork has always come back perfect. I am not sure about the Pred but that is something we may use in the future.

Good luck! I just went through this same exact scenario 4 days ago. Pat gave me the best advice when she said... Just remember that she is the same girl she was yesterday.

[GraciesMom]

I am really curious now why the neuro prescribed what he did. Why no omeprazole? Why both gabapentin and tramadol if she is not yet in that much pain? They seem to do very similar things. Why a fairly high dosage of predisone? I will ask him but curious as to your thought on this. I hope Pat is here to weigh in.

It is unclear to me Reptigirl if Gracie's young age makes her more of a candidate for successful surgery or not. The neuro said yes and no. Her youth is more likely to make it easier to recover, but he said the potential for ongoing damage from syrinx or scar tissue may be higher due to having this so young. That last part is confusing to me and I need to get clarification.

[Holly]

Our neuro had us do an NSAID (Previcox, Rimadyl etc) along with the Gabapentin. The Omeprazole is thought to reduce the production of CSF, I believe. I would ask him about adding something like that, bc I think it can be preventative.