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More points raised by PDE2

It could be taken as insulting, but it's probably true as well. Very few neurologists in the US would have extensive experience grading CM in cavaliers; most of these specialists would also be happy to allow input from more experienced colleagues.

I suspect the quality difference is actually in the positioning of the head during the scan, rather than neurologist competency.

Thank you for your explanation. I don't understand why they don't all use the same protocol. At least there would be some consistency in results.
 
It could be taken as insulting, but it's probably true as well. Very few neurologists in the US would have extensive experience grading CM in cavaliers; most of these specialists would also be happy to allow input from more experienced colleagues.

I suspect the quality difference is actually in the positioning of the head during the scan, rather than neurologist competency.

I agree with the above. It really is NOT an issue of competency but lack of knowledge in this particular area. There has been a lot of work to try to standardise readings, and Clare Rusbridge has info up on her website on diagnosing syrinxes and CM. It would help if some of the US neurologists were in closer contact with the principle researchers on this condition. The ones in the US who are giving lots of 'mild CM' and some 'clear of CM' analyses have not been to any of the SM professional events in the UK at which much of this was discussed (I know this because I was there and knew the neurologists present) and, because the US clubs are doing so darn little, there's no discussion between colleagues on standard interpretation as there is in the Uk with the new BVA/KC scheme. This HAS a distinct way to grade CM. As Clare notes in the article I quoted, of 564 MRIs only SIX fit the grade of 1 for "mild CM". Not a single dog was a clear. Almost all of those dogs are breeder dogs, and will be immediately or closely related to all cavaliers in the US. There's just no way there are pockets of mild CM and clear CM dogs in the US when they are so closely connected to all the dogs getting non 'mild' grades.

So neurologists should not be insulted but driven to becoming more informed on the terminology of what is now the STANDARD analysis of CM in the UK, geared specifically for breeders.

To not do so, is totally misleading to many pet and especially breeder owners of cavaliers in the US who are assuming their dogs have a particular grade and may use this for breeding decisions (and in some cases, are telling people they have lots of clear dogs, which is almost guaranteed NOT to be the case and extremely misleading to buyers).


To repeat: there is a STANDARD for grading CM that was drawn up by a panel of neurologists and researchers in consultation with the Kennel Club and which is the centrepiece of the whole grading programme designed to help breeders make the best possible and most informed breeding decisions.

There is NO reason for ANY international neurologist not to be using a standardised analysis and to stop informally using terms like "mild". Until they are using a standard, then terms like "mild" are relatively meaningless if coming from US professionals because their mild is in many cases obviously not the "mild" used for the professional grading scheme and used in published papers.


The reality is that research and definitions in this condition have been almost entirely UK driven, and most published work has come from the UK (with some notable exceptions). What a difference it would make if the US clubs/AKC actually showed some constructive concern about this condition and the needs of breeders, and worked to connect into the existing scheme, and funded US researchers more broadly. There are pockets of research work but absolutely nothing like the BVA/KC scheme and no club or AKC drive to have anything like it. :(
 
Very few neurologists in the US would have extensive experience grading CM in cavaliers; most of these specialists would also be happy to allow input from more experienced colleagues.

I agree with this statement, and this was my experience when I had the MRI done for my then 8 year old boy through Rupert's Fund. I had the MRI done at the University of Georgia with Dr. Simon Platt. He has a good deal of experience as UGA was doing the study for Brussels Griffon, and his interpretation was closely in line with the report I got from Dr. Rusbridge who looked at the CD that I sent to her. But Dr. Rusbridge gave a lot more details on more subtle features of the MRI, and Dr. Platt acknowledged that she is the expert in this area.

Pat
 
I love, love, love Ella and now Elton's neurologist but when he said Elton had "NO CM", I said, "Let me see if Dr. Rusbridge would find this valuable for research even though I don't have his pedigree." I knew there were few that truly had "NO CM". He told me he wanted a radiologist (who Karlin has mentioned knew even less about diagnosing CM I think) and came back saying he does have "mild CM". Since Elton is not going to be used for breeding does it really matter? I would like to know what is causing him to act the way he does (Fly Catchers, etc.) but if medicine helps then so be it.
 
BVA president Carl Padgett gave a speech today at the BVA's annual dinner in London. He stated:

"Last week the BBC screened a follow up to the hard-hitting 2008 documentary Pedigree Dogs Exposed. The programme revealed that much has happened in the last 3-4 years but that there is still a lot more to do to improve the health and welfare of man’s best friend.

"One of the starkest images of the original programme was the Cavalier King Charles spaniel writhing in agony with a condition known as Syringomyelia, where the head is essentially too small for the brain.

"This year the BVA and Kennel Club have launched a screening scheme for this painful condition and later this week we will be educating breeders and potential puppy owners on the benefits of the new scheme at Crufts."

So, it looks like the roll-out will be a Crufts. Text of his full speech is here:
http://www.vetsforum.com/wp-content/uploads/2012/03/London-dinner-speech-2012-CAD-on-headed.pdf
 
There's a health area at Crufts, where people from the Animal Health Trust, Royal Vet College etc are available to give information and answer questions - I would guess they'll make a big thing of the new scheme there. as well as on the KC's own information stand. Incidentally, anyone buying a catalogue or show guide is also going to get a free video of the KC's two new films - one on health and one on puppy farming. With the numbers of general public who go to Crufts (it'll be heaving on Saturday, when we're going!), this may at least do some awareness raising.

Kate, Oliver and Aled
 
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