Understanding a pre-syrix

[karen baker]

Thank you, i,am going to make an appointment for Ruby, after all nothing ventured nothing gained, i,am sure that one of them at my vets has good knowledge of this condition, i,am hoping they are aware of Clare Rusbridge's site, it will make things easier. I feel shes needs to be assessed further. I will let you know how things go. Karen,Ruby and Sadie x

[murphy's mum]

Well, his MRI actually came back pretty good (better than I thought!) but he has what the neuro is calling a pre syrinx in the cervical spine through the C4 and C5.

Can someone help me understand more about a "pre syrinx"? We are putting him on 100mg of Gabapentin three times a day to start, as she is unsure if the pre syrinx is causing pain or not. Any one familiar with this?

Murphy has a pre-syrinx too, although he also has CM, we started on Cimetidine, and have now added 100mg of Gabapentin three times a day as well. Touch wood, Murphy is acting like a puppy again, he's such a pest when he wants to play now, he keeps pawing me until I get down on the floor and tumble about with him. It's good to see how different he is now, and I hope your little guy ends up feeling as good.

Thank you, i,am going to make an appointment for Ruby, after all nothing ventured nothing gained, i,am sure that one of them at my vets has good knowledge of this condition, i,am hoping they are aware of Clare Rusbridge's site, it will make things easier. I feel shes needs to be assessed further. I will let you know how things go. Karen,Ruby and Sadie x

Same for you Karen, I hope you get to see her run again, as I've said seeing Murphy go from looking like a little old man to turning into a puppy again has just been unbelievable. I worried to begin with I was looking for things that wasn't there, and was wasting my time going to see a Neuro, as his symptoms didn't really seem much compared to Misty, but seeing how well he is now, I'm glad I followed my gut and got him scanned

[karen baker]

That would make me so happy!!!! I would love to see her run, i really don,t think that i looked into things enough, and now i realize that there may be options available, plus did,nt see the connections with the way she was behaving, i just thought it was normal for her, she was operated on as a 6month old puppy with bilateral luxating patella,and eye issues as well, and i just thought that maybe it was connected, and had slowed her down, shes always seemed unlucky with health problems, but now i feel that maybe a chat with our vet and discuss a programme for her. Many thanks Karen,Ruby and Sadie x

[Karlin]

Hi BrooklynMom --

I missed on first reading that the diagnosis here is no CM but the existence of a pre-syrinx! This would be almost impossible unless he'd had a severe head injury of some type, at some point. But I just had a good look at the scan and enlarged it on my computer and for what it is worth -- I strongly think the diagnosis is mistaken about CM but that is most likely due to the neurologist not really being that familiar with 'seeing' it -- which unfortunately is not uncommon. To me at least, there looks like there's an indent at the cerebellum which means there is CM. As it is so rare for ANY cavalier not to have CM (so far there has only been one graded on the entire BVA/KC scheme, where a panel, rather than just a single neurologist, examines the scan) it would be very unusual to have such a dog and especially so if there's also a presyrinx.

I do not think anyone who is given a diagnosis of no CM can accept this as definite without submitting their scan to the BVA/KC scheme which has a panel of three neurologists familiar with CM.

There are a couple of neurologists -- who seem to be the only people routinely finding a few dogs for breeders, without CM. Having been told by one of these that one of my own dogs had no CM -- and a couple of years later, finding that CM was there in that old scan and even being able by then to clearly see it myself (!! -- the reason I asked for someone else to look at it) I just think that breeders (and pet owners if they want a definite diagnosis on CM) simply cannot accept a supposed 'clear' on CM without running it past a professional panel (or alternatively, having someone well known for diagnosing it, such as Nick Jeffrey or Clare Rusbridge or one of the other neurologists on the BVA panel, or Dr Marino in the US, examine it).

For breeders, if they accept the 'no CM' diagnosis from a neurologist (especially those who seem to have found such dogs when others do not!) and breed on the basis of that diagnosis, not seeking any confirmation -- then truly they are breeding for themselves (and sadly perhaps a premium they now feel they can charge for their puppies or their stud dogs) and NOT for the future of the breed. Be VERY WARY of breeders claiming they have CM-free dogs!!!

I would say to anyone told by a breeder that their dog is clear of CM -- to aks if they have had a second confirmation of that from a recognised neurologist (in the US, I'd recommend either Nick Jeffrey or Dr Marino at LIVS), or submitted the scans to the BVA/KC scheme. If they have not -- think about it -- why not? Might it be that they don't want their 'diagnosis' challenged? Might it be that they are aware that they are unlikely to get that diagnosis confirmed? Could it be that people who claim to be working for the breed's future, would really make the decision not to contribute what must be critical and deeply valuable information to the formal breeding schemes so other breeders and the breed can benefit?! The latter makes no sense at all -- unless they are well aware that their diagnosis is unlikely to stand.

For the pet owner I think being CM-free is less critical to confirm -- especially in a symptomatic dog that needs some kind of treatment. I think unless the diagnosis has been confirmed by a second opinion then anyone needs to assume their cavalier has CM. And just go ahead and treat the symptoms.

Clare Rusbridge will give second opinions on a scan but unless there's spare cash and a real desire to know this detail, I probably wouldn't bother; I'd treat on the assumption that you are dealing with CM/SM pain.

[Kate H]

Like Karlin, I blinked at the 'no CM' diagnosis. CM alone can cause considerable pain, but whether it's CM or syrinx causing it, it's still pain and you can only treat the symptoms. So I hope you and your vet can get Ruby comfortable again - though finding the right combination of medication for your particular dog can sometimes take several months of trial and error.

Kate, Oliver and Aled

[lovecavaliers]

Interesting thread.
First I wanted to say to BrooklynMom that I was sorry to read about your pup's diagnosis.
My Jack was diagnosed at LIVS in May 2010 with a "pre-syrinx" and mild-mod CM. I have been managing him with medications thus far. He will be 4 years old this week. So far his quality of life is good (knock on wood) while not completely living a "normal" dog life (he cannot tolerate long walks especially if it is warm out). He takes omeprazole, gabapentin and keppra. I have not had him re-scanned therefore I have no idea if this pre-syrinx has developed into a full blown syrinx. At his last yearly neuro exam the doctor said he was exhibiting less pain symptoms during his assessment than the previous year (same medications). I pray he is in my life for many more years.

[BrooklynMom]

Thanks everyone for your thoughts and info!
I might have misheard about no CM...have a call with my neuro in one weeks time so I will ask her that specifically. My whole appointment after the MRI was a bit of a blur with emotions etc. so let me ask again to make sure. We are very lucky with our neuro, she is the leading neurologist in Australia, and the leader in SM with the Brussels Griffon breed...we are very lucky to have her, but like with specialists at times, they speak in speciist talk! So what makes sense to her or is easy to wrap her head around can wash over us. So I have a big list of follow-ups she is SO nice and really easy to talk to, so I will know more next week.

Also, like you all said, her main point was that regardless of the scan, we need to treat the pain and the symptoms - so we are doing that. He seems better on Gabapentin, but sometimes will have break through head rubbing/digging episodes - would this indicate another med is needed or a higher dose of Gabapentin? You can definitely tell when it is wearing off.

I know so much (almost too much!) about SM and CM that it is hard not to get swept away, but I try to always think like him and live day by day And for one, he is certainly much happier on meds! Bless.