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Daisy's Appointment At Chestergates "Mr Geoff Skerritt" Mon 22 nd 11.00 AM

Hey brian,

I think PSOM is fairly common 40% I think? Look at rods website www.cavalierhealth.org. I know dr. Rusbridge also mentions it on her site. I asked this question recently about if they do an MRI (which will show PSOM) and it shows both, would they want to treat then?

The person on forum that knows about this is blondiemaster.

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Its so hard because CM/SM can be asymptomatic and do you think its the PSOM causing symptoms or SM. There are different symptoms and I remember there is a blink test for PSOM, (which I will tell off forum) :) but I am praying for you!

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Hi Brian,

PSOM is diagnosed/confirmed by MRI. I have very briefly described in on the Cavalier Matters website.

There is more in depth information on Cavalier Health.


http://www.cavalierhealth.org/psom.htm

It is similar to Glue Ear, a mucus plus that fills the inner ear. Symptoms can be similar to cm/sm - can cause pain to the head and neck and a number of other problems.
 
If Daisy has PSOM, this will be clear on the scan, because they do a picture from the front through the skull, which shows the inside of the ears very clearly. If Daisy has it, Geoff will discuss treatment with you. It sounds, however, as if she may simply have the 'normal' partial deafness that is common in Cavaliers. You can just make allowances for it, or you could ask Chester Gates to give her a BAER test before she has her scan. This will tell you the degree of deafness she has, if indeed she is deaf and not just naughty! It simply involves her sitting on a table wearing comfortable headphones that are plugged into a computer; a noise is sent through the headphones and the computer measures how each ear responds to it. This was how we discovered Oliver is almost totally deaf in one ear. When he had his test (at the same time as his last scan 2 years ago) he was filmed, so you may see him doing his Snoopy as Red Baron imitation on the video that runs in the CG reception!

I think most neurologists take CM as a given in Cavaliers, because almost all of them have it. So the scan will tell you whether the CM is causing any problems, but its main purpose is to discover whether the CM has produced SM; it will tell you (a) whether Daisy has a syrinx, where and how big, (b) how much, if any, herniation there is (the bottom of the brain being pushed down into the spinal cord), and (c) whether her brain ventricles are dilated (enlarged). (b) and (c) can be produced by CM alone, without the presence of a syrinx; and the syrinx itself may or may not be producing symptoms, depending on its size (especially its width). All these factors will affect the amount of pain and discomfort Daisy experiences and what treatments will help. Oliver, for example, has a very small syrinx and moderate herniation, but very enlarged ventricles which cause most of his symptoms (the main one is light phobia and headaches) - so he is on a moderate dose of pain control (gabapentin) but a quite large dose of diuretic (frusemide) to try to reduce the fluid in the ventricles.

Hope this helps,

Kate (and Oliver and Aled on holiday)
 
Yes the MRI would show both...

The neuro showed me where that would show up on Gracie's MRI if she had it. It shows fluids in light colors and bones and other hard matter is black. Very odd to learn to read it myself...but can do it a bit now. Whatever it is, I hope it is very treatable.
 
Rebel was diagnosed but asymptomatic by Geoff Skeritt with CM, a large syrinx between C1 and C5 and curvature of the spine. Two years later some of the classic symptoms appeared overnight, so armed with the pictures from the MRI and Clare Rusbridge's matrix off we went to the local vet. She knew nothing about SM, although having quite a few Cavaliers on the books, so started him on a conservative dose of Frusemide, while she had a week to learn more.

As it worked out, the Frusemide brought about a vast improvement within about a week of treatment starting. About a year later he is a happy and healthy 8 yrs old Cavalier, now relaxed and living his life as it should be. He has regular 3 monthly check ups, the next of which is on the 24th. I am sure he will be fine, but if not, the vet has the matrix to take him another step up the treatment ladder.

If I hadn't taken Rebel for the MRI because the researchers were looking for clear scans from over 6's at the time, I would never have taken Rebel to Chester Gates and my vet would not have had the benefit of his scan pictures to see what was going on. They are the very best, despite the recent adverse publicity and I would not hesitate to return if Rebel deteriorated.
 
Hi

Thanks to all for your kind advice and good wishes ,especially the personal experiances .

We have an hours initial cosultation then I presume the MRI 4-5 hours and after that the diagnosis
and explanation ,what questions should I ask and what do you think Mr Skerritt will ask me.?

Luke will be with me and when Daisy is taken for her MRI rather than wait there like I did with
Rosie I have a dental appointmet at 2.45 ,so that will occupy till my return .
 
Here are my suggestions for what they are worth...

Brian M said:
What questions should I ask and what do you think Mr Skerritt will ask me.?
Click to expand...

We were lucky that we were in and out of there in about 3.5 hours. The MRI did not take as long as I thought but they were not real busy either. General suggestions:
  • Bring videos if you can showing symptoms.
  • Make a list of symptoms and any patterns related to when they are better or worse....he likely will ask about this. Especially note which side seems to be more affected, if any.
  • Note when you first became suspicious it might be neurological.
Other questions he might ask:
  • If you know of any neuro problems in her family history.
  • If she has had anesthesia before and any reactions to it since they will put her under.
  • If she is taking any meds and how much.
Questions you might ask:
  • Is the MRI full length of spine or partial... full is better but partial seems to tell you what you need to know.
  • What are specifics on what they find in MRI, including size and location of any syrinx and severity of any malformatiion in blocking spinal column?
  • Does he recommend surgery fairly soon or later... and what factors does he use to determine when?
  • What specific technique is used if he recommends surgery at any point for PSOM or CM....and would he do it or someone else?
  • For CM surgery, does he just do decompession only or also implant mesh or other material to try to control scar tissue? Ask him to explain why he has chosen this method over others.
  • What is the purpose and side effects of any meds prescribed for her? how long are they effective in the system? do they have a conflict with any other meds she takes? (Note...our initial neuro did not prescribe what has worked best for most dogs with SM...so this is important)
  • When will full impact of meds be felt in her system?
  • How long does any surgery take and typical period of hospitalization?
  • How many such surgeries has he performed? What were the results in terms of dogs that got better, worse or about the same over time? Are most able to reduce or eliminate some meds?
  • How often would she be checked on by staff in the hospital, especially when out of intensive care?
  • How often would you be updated on her status in first few days? When can you first visit her typically?
  • What is the first 2 weeks of recovery like at home?
  • What are signs of major problems once she is home?
If I think of more, I will let you know.
Hope this helps. I went in with a list but forgot some of these. So glad Luke will be with you.
 
Amending the useful list of questions - Daisy won't have anaesthetic because Chester Gates do their scans with a sedative, which means she should come round much quicker. So may be out just as you go to the dentist! Though I'm sure they'll keep her in the recovery kennels until you're back!

Kate, Oliver and Aled
 
That is awesome Kate!

Wish we had had an MRI with just a sedative too! So much easier on their little bodies. Also means she does NOT get a poodle cut save on her front legs too!
 
GraciesMom said:
Wish we had had an MRI with just a sedative too! So much easier on their little bodies. Also means she does NOT get a poodle cut save on her front legs too!
Click to expand...

Me too. I wonder if its cheaper too? But Gracie pulls off the poodle look

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Brian M said:
Hi

Thanks to all for your kind advice and good wishes ,especially the personal experiances .

We have an hours initial cosultation then I presume the MRI 4-5 hours and after that the diagnosis
and explanation ,what questions should I ask and what do you think Mr Skerritt will ask me.?

Luke will be with me and when Daisy is taken for her MRI rather than wait there like I did with
Rosie I have a dental appointmet at 2.45 ,so that will occupy till my return .
Click to expand...

I love how Anne keeps calling me Blondiemaster :) the name is BlondieMonster , thats her nickname . Lol. I wanted to share about PSOM. they discovered it on her MRI and did an immediate myringotomy. It relieved symptoms significantly. She also was diagnosed with Stupid Disease SM. Grrrr. A large syrinx down spine. She had a second MRI aftee 6 months in which the psom had returned. Second myringotomy. We are 6 months past that, but i have a gut feeling the psom is back. I can tell cause the scratchig at her ears is caused by it. (disappears after myringotomy) It complicates the situation for sure. I will be at the neuro in NY in monday for our 3 monthly visit so will be thinking of you since u are going monday too. U wont be alone :). My advice as to draining or no draining if psom is foubd during MRI: If she is symptomatic at all and psom is found on MRI i would persoanlly let them go ahead and drain it. With blondie they did it automatically...
 
Hi

Thanks Kate I totally forgot its a sedative and not an anaesthetic thats a comfort as I am very nervous
about G.A. thats the main reason I am such a fanatic over cleaning their teeth to hopefully prevent any
future dentals apart from the link with bad teeth and heart disease.

I have all the Bassenthwaite vidoes on You Tube which I can access via my iphone to show Mr Skerritt
Daisy in action, but they may not be a true reflection of her so not sure on this.

Just give her a bath with Petzlife Mango shampoo followed by the Mango conditioner then thinned
her hair a bit with a Mars rake followed by the furminator then the soft Mason Pearson brush with a nice
leave in conditioner and she was as good as gold ,no stuggling or scarching at all even when gently
brushed down her reactive side . She's now gently snoring all fluffy and smelly ,poor girl.

When Rosie saw Martin D last Oct he gave her quite a strong physiacal examination will it be similar with
Daisy as I know she definately wont like it and will react ,thanks Ladies.
 
Debra wrote: Wish we had had an MRI with just a sedative too!

Chestergates is one of the few places that does MRI without anaesthetic. People have mixed views about this: the proposed BVA/KC scheme won't accept their scans because they say the quality isn't good enough, but Oliver's scan seems perfectly OK and tells us what we need to know. Oliver is sensitive to sedation, so GA is reserved for life-threatening conditions! That's one of the main reasons I took him to CG - plus that it was done for £120 under the Midland Club scheme for mini-scans! He needed a very small amount of sedation to put him out for his scan. Oliver only had a mini scan of head and shoulders, so Daisy's full scan will take longer to do.

Brian: I would think that they will simply do the scan, with no physical examination first - the scan will tell them what they need to know much better than poking and prodding. When the scan has been done, Geoff Skerritt will put it up on the light box and explain it to you, and then discuss prognosis, symptoms and possible treatments.

Hope the coffee machine in reception is working to keep you both going!

Kate (and Oliver and Aled, who are coming home on Sunday)
 
Brian,

Can't believe Im only just reading this now! So sorry you are going through this. I know exactly how you feel as I had Leo scanned 2 years ago. The wait was agony and both my girls and I were a tearful emotional mess whilst we waited.

Keep strong and know everyone here will be there with you on Monday (in spirit if not in body).

Mel XX
 
Brian just wanted to add that I too will be thinking of you and Daisy tomorrow. The waiting is awful but your doing the right thing, the unknown is even worse.
I will be praying for a good MRI read.

:lotsaluv:
 
Brian

You and Daisy will be in my thoughts tomorrow. I hope and pray that the outcome is a good one.
 
Fingers crossed for Miss Daisy tomorrow. Will be praying for you and your family Brian hope all goes well.
 
Brian, so sorry to read that you have doubts about Daisy`s health. Thinking you and the delighful Daisy tomorrow, hope all goes well.
 
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