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Don't know what to think

I would call the neuro office and tell them your predicament! Like Graciesmom said maybe they can recommend a vet. We had similar troubles and had to switch to several different vets to get a referral. So glad I did! I ended up getting apologies from one of the GP vets. I've always told the vets "It will make me feel better to see a specialist so I know what I'm dealing with". Any vet who does not care what the owner thinks should not be in the profession IMO. After all they are our furry children we are trusting them to care for! Can you imagine the outrage if a human doctor or even worse a pediatrician had similar excuses!!! It would be all over the media! I don't understand how vets can be like this!

I hope you get this all sorted out. Maybe Nicki would have some advise on who to go see?
 
What a mess, just wanted to say I am so sorry you are going through all this. BTW, NSAID's also have long term side effects.......so what the heck is he talking about! Read Pat's post to (I think) Brian about using different fluid reducers that don't have as many or little long term side effects.
 
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Never thought of calling them direct to see if they could advise something. I know Edinburgh does a normal vet practice too, but hopefully I can find something closer.

Cindy thanks, I saw Pat's post when I read Brian's thread earlier.

You'd think the way the vet was going on that I have asked him to operate on her without a general anesthetic or chop a healthy limb off. All I want is a MRI scan, sure I know there can be a risk with a GA, but she'll be checked first to make sure she's fit. He made me out to be a right selfish cow, as if only I will benefit from a scan:mad:

I guess I need to be patient to Monday, I should take a leaf out of my little Princesses book, she's snoozing right now:D
 
Just received a call from the other vets. They have had cavaliers at their practice that suffered from SM. Unfortunately two are away to the bridge, but the fact that they have knowledge of SM is a good start.

I've booked Misty in at 16:50 on Wednesday to be checked over. I did ask his opinion on MRI scans, and he said where the pet is insured or the owner can afford it they advise a referral. He said the more scanned at a teaching hospital like Glasgow the more that can be learnt. He did advise that finding a balance of drugs can be difficult, and depending on the dog may not prolong their life more than a few years. However, not to worry about anything until he's seen Misty in person. He's away to request her records from my current vet.
 
I'm so pleased to read this. Well done for perservering.

I hope that it turns out that there was nothing to worry about, but you do need to know.
 
That's wonderful that you found someone who seems willing to listen to your concerns and work with you. Will keep good thoughts your way that Misty will be OK.
 
Thank you :)

Within 15 minutes of me speaking to the other practice my vet was on the phone asking if there was a problem. I simply said I was unhappy at the lack of help in trying to get a referral, and I felt it best to get a second opinion. He mumbled something about how he had been willing to speak to a neuro this week, and to call him back it I wanted him to do so. Grrr, funny how potentially losing a client or money is finally enough to prove how serious I am.

I'll let you know how it goes on Wednesday:eek:
 
For heaven's sake...

Should not have to come to this!! And he apparently does not know how much medications can help and even surgery can help some dogs too. He should be more informed on the condition. Maybe you should recommend he some education on Cavalier health in general.

Thank you :)

Within 15 minutes of me speaking to the other practice my vet was on the phone asking if there was a problem. I simply said I was unhappy at the lack of help in trying to get a referral, and I felt it best to get a second opinion. He mumbled something about how he had been willing to speak to a neuro this week, and to call him back it I wanted him to do so. Grrr, funny how potentially losing a client or money is finally enough to prove how serious I am.

I'll let you know how it goes on Wednesday:eek:
 
So sorry - I wrote a long reply to this yesterday but have been having Internet connection problems and it lost it :x


So pleased you are finally getting vet support - they are very like a GP/doctor and can't possibly be experts in everything. Something like this really needs a referral to a specialist - you can ask a vet for a referral and they should do that - remember you are the client. For some years now I have treated by vets as partners in the care of my dogs - respectfully of course! Sadly I recently had to change vets but now have a really good relationship with the new practice. If a vet is not prepared to listen or be prepared to read information you take in for them and listen to your concerns and suggestions, then they are not the best partner and as you have had to do in this case, you are best finding a new vet.


Glasgow are absolutely brilliant, the neurologist I saw was Maria Ortego but you can't request to see a specific person, it depends who is available. Maria was very thorough, and had a lovely bedside manner with Kayleigh. When we went back in for the results, my friend came with me - she had not seen an MRI scan like this before, and as Jane expressed interest, Maria took the time to explain it to her, and to compare it with that of an [anonymous] dog sadly diagnosed with severe SM a few days before, pointing out the syrinxes etc.

I was really impressed with all the staff, the cleaners kindly asked us if Kayleigh was ok with the vacuum before switching it on in our vicinity :) [we were there after hours as Maria had been called in for emergency surgery]

Maria has very kindly been answering my questions in e-mails too!

The new hospital is fantastic, it has been very thoughtfully designed to give the most welcoming atmosphere with minimal stress to the animals.

I wish I was a bit nearer as I would meet you there :( please try to take someone with you, it really helps to have someone else to listen and to give support.


There is a cafe area upstairs, with very reasonably priced drink and snack machines [sandwiches, yogurts, even vegan date and nut bars which were yummy!] - and the best coffee I've ever had from a coffee machine!



Often the MRI scan is the day following the consultation, so be prepared for that. The insurance company should be able to do a preauthorisation for you, takes about 48 hours to get a telephone confirmation [they will need to contact your vet], and then a written confirmation. Glasgow ask you to take two insurance claim forms - you have to pay for the consult at the time, but they will claim direct for the MRI if you take in your valid policy.


I do hope the appointment with the other vet goes well, print off the relevant info from http://sm.cavaliertalk.com/, also it helps to take in a history and symptoms you are seeing [you should be able to get your old vets to print off a clinical history, if they won't do this, ask them to fax it through to the new vet]

You will be in our thoughts and we hope for good news
 
I would be very angry, as well, that this vet wasn't taking you seriously. You know your dog better than anyone. I am glad it will all be resolved.

I did want to point out one thing, though, in case it helps a dog suffering with SM pain. MRIs are very expensive, especially here in the US (here in Atlanta it is around $2,000). When I first got Scarlett she was about a year and a half-- her breeder had leukemia and had to place her. I offered to take her in. As time went by, I started to notice some SM-like symptoms (air scratching, limping with her back leg- always the same side, head rubbing). At that point in time, I simply couldn't afford the $2,000 to MRI her but I had done a lot of research and knew what I was seeing. I talked with my vet and we decided to try her on the Gabapentin and see if we saw improvements, as typically, Gabapentin helps SM. As soon as I started her on the meds, things dramatically improved. I did take her in to see the neurologist a few months later for a consult and ohysical exam and brought video with me. The neuro agreed it was most likely SM and added omeprazole to her meds. All of this made a huge difference in her quality of life.

I have since had her MRId and she has a horrible case of SM. Even though I couldn't afford the MRI at first, if I hadn't started her on SM meds, she would have suffered quite a bit. So, sometimes, if you work closely with your vet that you trust, you can try the SM meds to see if they help the symptoms. Of course, an MRI is always the best route, but it isn't always financially possible.
 
How can he be looking to medicate my dog without knowing if she has CM or SM or POSM? God!!! I've never heard of anyone on here being medicated without a MRI scan being done first.

There are many dogs on medication for SM that have not had an MRI, especially here in the States. I'm glad that Holly posted. If you don't have insurance and/or you are not affluent or if you don't live anywhere near a scanning facility, there is always the option of starting a gabapentin trial to watch for changes in symptoms. This is called "empirical" treatment. It's best to do after a neurologist physical exam and history but many don't even have access to a neurologist. I'd always opt to start with gabapentin for a trial rather than NSAIDs as gabapentin is generally safer than NSAIDS, especially for long term use.

Karlin has mentioned before, and I agree, that insurance companies are likely to eliminate MRI scan for SM for Cavaliers in the future when they figure out how this breed problem is affecting their bottom line. I fully expect that to happen. There will be much more empirical treatment at that point, particularly in this economy, as the average person just isn't going to be able to spend $2k on an MRI.

Pat
 
Thank you for posting that Holly and Pat - even a neurologist consult will really help if you can't manage an MRI scan. that is about £165 at Glasgow.

They quoted me £2000 for the scan, but it came in about £1800 - Also paid £100 for pre GA blood tests - essential in older dogs but advisable in younger ones - it also ruled out other issues. Kayleigh had a spinal tap [similar to a lumbar puncture in humans] - this examines the spinal fluid, checks for inflammation etc. They will have a shaved area on the top of the back in the area of the spine, usually towards the tail but sometimes towards the neck area. [not sure why they use different areas unless it's done after the MRI and they are trying to avoid syrinx areas? Pat might know?]

You can see a needle puncture wound but it heals up very quickly and hair re-qrowth is surprisingly fast.



Kayleigh had an ultrasound due to the weak pulse in her femoral artery - nothing was found and this seems to be another Cavalier thing although as long as they do not show symptoms, it's not clinically significant. This was actually much cheaper than expected, came in around £85.


If medication is needed, Glasgow will prescribe that and give you supplies for about a month, you can then obtain further prescriptions from your vet. It is probably cheaper to get them to issue a prescription and buy them elsewhere. Although vets do rely on income from drugs [this helps keep the consultations fees down...] sometimes they do charge what appears to be an excessive amount for drugs. I came to an arrangement with my vets that if they supply the drugs at a reasonable price [ not more than about 30% more] then I will purchase from them. That takes into account the cost of them writing a prescription - you need to factor that in.

Glasgow will discuss progress and future medication changes with your vet if required - they do ask for a follow up in 3-4 weeks by e-mail or 'phone - especially if you are too far away for further consults.
 
Thanks Nicki, I'm glad to hear that Glasgow is so nice. I am a little sad to be in the position to need to change vets, but I do feel it's very much in Misty's best interest. I know I am not an expert by any means, but it did feel as though I knew more about SM that either of the vets at my current practice. And like you say I should not have to be jumping up and down demanding a MRI scan and still getting told it's "pointless". I was hoping the consultation and the MRI would be done in the same day, but not to worry I suppose it's not too bad a journey. The new vets have already called for her history to be faxed over, so hopefully he should be up to speed by tomorrow.

Holly I do understand in those circumstances why and MRI can't always be down, but when I was so intent on getting one down, my vets really have no excuse not to refer Misty.

Pat, I did question the vet about why he wanted to start Misty on Metacam, but he said by starting her on anything else "would be jumping straight" in. She's been on it three days now, no obvious improvement, but I assume it's too soon anyway. Then again given the fact I have nagged, yes nagged, I'll admit it, the vets for months now about her symptoms, I shouldn't be surprised. Up until Friday, when I basically lost my temper, their attitude was very much wait and see.
 
Just to say that I am with AXA and before the scan I had no claims with Harley. They emailed me the Pre Authorisation Form, I printed it out filled it in the vet done the quote and faxed it with Harleys medical history direct to AXA and I had a decision 1 day later where AXA rang me and then my vet to say that it’s ok to go ahead with the scan. I needed to take a normal form to the vets so they could claim it direct. But the scan was done at my vets so I didn’t need a referral. I will need a referral when I see a neurologist so the consultation for that I will need to pay and claim back.
 
Thanks Sabby.

I'm feeling more nervous as the day goes on. I never thought I'd be looking to change vets after six years, it's worrying.

Plus i'll need to get them used to my singing Cavaliers. Murphy and Misty hate waiting at the vets so tend to be very noisy in reception.
 
Thanks Sabby.

I'm feeling more nervous as the day goes on. I never thought I'd be looking to change vets after six years, it's worrying.

Plus i'll need to get them used to my singing Cavaliers. Murphy and Misty hate waiting at the vets so tend to be very noisy in reception.

I had to change Vets recently with Ruby as her vet left our surgery after 4 years of seeing her. I really panicked as I know that there wern't many vets around whom have knowledge of this disease!

I did alot of calling around and found a vet that was already treating 5 Cavaliers with SM so I took the plunge and got an appointment. I wasn't disatsisfied with him by any means - he knew what he was talking about, Ruby liked him- but then she isn't picky!

But the first time I asked for a Presciption for her meds which I get from Boots I was shocked that I had to pay over £15 and it was only for one dispense!

With my first Vet I only pay £9 for 3 repeats (it does 4 dispenses). To pay £15 every time I went to buy her tablets would mean I might as well buy it straight from the vets ( which I think was what they wanted).

But since then I have gone back to my old vets, for a few different reasons.. One of which being that Charlies Cardiologist is based there and secondly she knows the place and feels happy there if she has to stay over for anything. And it is closer to home (which was a god send when she was extremely sick last month)

And hey- If I can give a vet some experience of treating a dog with SM which can help another dog in the future then I'm happy to do that.

The difference is that I already have a Neurologist in Dr Rusbridge whom I trust deeply and that is another reason I feel comfortable enough to be under the care of a not so knowledgeable vet.

The lady I have now has taken so much time to read through the encyclopaedia that is Ruby's life so far and I really appreciate her for that. She trusts my instincts and will pretty much get on board with anything I need. I have told her about Clares website aswell and she is very interested to learn as much as she can!

For that I am very grateful and happy with the desision I have made.
 
:updte:

I've started a new thread in the SM forum as it seems more appropriate. The newest of the bad news is listed there too :(
 
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