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Thistle had several pain episodes this weekend

Soushiruiuma

Well-known member
Since getting Thistle back in November she has not been her usual self, although she hasn't been suffering (outwardly). She would run and play with Guinness but not nearly as much as she used to play, and she has been more distant with me. I was hoping it was just part of readjusting to being back with us after 5 months apart.

Saturday afternoon she sat bolt upright in the middle of napping and just started screaming. That only lasted a few seconds. Then again on Sunday during a nap. She is completely naked while in the house, so no collar or harness to bother her. Last night she had another attack around 1:30 am, this one lasted about 10 minutes, and then she was clearly distraught but not screaming for several hours afterwards. I barely slept at all (she slept about 2-3 hours, and otherwise was so uncomfortable that she was pacing around and barking at things.

I thought to get a video, so I've uploaded it to YouTube. http://www.youtube.com/watch?v=OdV1bjzDCfE
This was the 1:30 fit, the video is only of part of her panicking.

I have contacted a vet here about getting immediate attention for her, but otherwise is there anything I can do to make her more comfortable?

From the vet I asked for a cortisone shot to get her comfortable immediately while starting cimitidine or omeprazole.

The other thing I'm thinking it could be is a disc/spinal injury if someone dropped her or she had a fall while she was out of my care for the last 5 months. So we'll probably start with an X-ray, and a work up before going for an MRI.

Even though I always knew this could happen, it's so upsetting to see my little girl so distressed, and it just came up so quickly. She's been reserved, but not showing pain. I feel so terrible for her.
 
I'm so sorry for her and you too. I know you were without her for a longtime and I'm sure missed her very much. I hope you get this figured out and get Thistle out of pain quickly. Let us know.
 
The video is heartbreaking to watch. My guess would be CM/SM related only because that's not how my Oliver related whenever he's had disc related problems. He just wouldn't move at all. But then again every dog is different. I'm so sorry. I hope you have a good vet. It's so distressing to think that something happened while she was out of your care also. Please let us know what the vet says.
 
We were able to get an appointment, and I'm really happy with the vet I found online.

After getting kissed hello by Thistle (the appropriate way to greet everyone), and watching her walk around happily, she said Thistle seemed perfectly normal. Fortunately I had the video. She gave her a thorough once over for skin irritations etc. Proprioception test (Thistle failed to fix her left side- right side was normal). She felt around, watched Thistle walk some more. She gave her a cortisone shot, which sent Thistle screaming in pain (it's for the best though), and referred us to a neurologist.

The vet has seen syringomyelia before, but said Thistle seems very mild compared to the ones she's seen. She definitely agreed Thistle was in a lot of pain and that should be addressed immediately, and that the pain seems to be neurological.

No pills for now, the shot should keep her comfortable for a while, and hopefully we will be meeting with the neurologist later this week.

We're home now and Thistle's resting, This is the calmest her breathing has been since I started noticing her symptoms.
 
And LoveMyCavs, thanks for the advice. I don't know how disc pain would present differently from syringomyelia, so it's nice to hear from someone with experience.

I am suspecting SM/CM as well, the scratching, trying to run away from the pain...she's really a classic presentation of symptoms.

I'm hoping we're catching this early. Although I don't know how anyone could ignore something so obviously distressing until the disease is more advanced.
 
Oh no; I am so sorry to hear this. You are doing all the right things -- look for some immediate relief (I'd probably ask for low dose steroids and/or some other actual painkiller like tramadol, but your vet may well make that suggestions for the level of pain -- the pain, whatever the cause, is what needs to be addressed); then try to figure out the source by starting with an xray. That might reveal disk problems, but often an MRI is stil needed for a definite disk diagnosis.

I really hope you can quickly get the pain under control, and then you will be able to move forward with far less of the immediate stress of having a painful dog. :( The distress of that definitely makes the situation so much more stressful.
 
Sorry to hear that Thistle is having pain. It does sound like you are taking all the right steps to figure this out. Hopefully, you can get this under control quickly.
 
I have sent the vet a link to Clare Rusbridge's website, and a second link specifically to the the treatment algorithm. Being from the US, I have been conditioned to never ask for pain killers (seriously, I shattered my arm a few years ago, and wouldn't ask for them from the ER doctor for fear of "looking like a druggie"- my brother is a drug addict and will break his hand just to get the painkillers. This was a monthly occurrence for a while).

Europeans don't seem to have that stigma, especially not the low doses a small dog like Thistle would be prescribed, but vets in the US are still only now transitioning to treating pain. I'm to call tomorrow with an update, and at that point I can ask for Tramadol (or something else, not all the drugs are the same here- no Benadryl, for one thing).

It will be essential to keep something in the house for when she's having a hard day though.
 
That video is very distressing to watch. Thistle was in a lot of pain.

I have a Japanese Chin with disk problems and I have also had few SM cavaliers. It looked very like SM pain to me.
 
That video is very distressing to watch. Thistle was in a lot of pain.

I have a Japanese Chin with disk problems and I have also had few SM cavaliers. It looked very like SM pain to me.

This was the first time (this weekend, the 3 rd and worst episode was filmed) she's never done this at all, and for her to be so painful was really unexpected. I was afraid to touch her for fear of making it worse.

She tried to play it off at the vet giving kisses and prancing around, so it was very important that I had the video.

Another question, her proprioception was off on the left side (she also is scratching the left side in the video), her front limb was much worse than the hind. But her pupil dilation is normal in both eyes. Is that typical?

At first blush it seemed odd, but if you think about a syrinx (or even CM) would only affect structures lower than the level of the lesion (similar to paraplegic/quadriplegic injuries). Since the optic and oculomotor nerves arise from the mid-brain they would not be affected. So theoretically only structures from brainstem/cerebellum and back should be affected by CM/SM.
 
Oh gosh, that is heart breaking. I actually had to go to the Vet after hours last week with my old boy due to him crying in pain, so I know how terrible it is to hear them cry. The vet thought my dog was having back pain and so far the meds have worked but I am going to follow up with a neuro. Listening to my old dog for only 30 minutes, I can't imagine having to listen to a dog longer than that. I just don't have the heart. I hope they can find some relief for your girl.

Just curious but why didn't the vet give you pain medication?
 
Oh gosh, that is heart breaking. I actually had to go to the Vet after hours last week with my old boy due to him crying in pain, so I know how terrible it is to hear them cry. The vet thought my dog was having back pain and so far the meds have worked but I am going to follow up with a neuro. Listening to my old dog for only 30 minutes, I can't imagine having to listen to a dog longer than that. I just don't have the heart. I hope they can find some relief for your girl.

Just curious but why didn't the vet give you pain medication?

She didn't give a reason. I should be able to get an appointment with the neurologist tomorrow or Wednesday. She was very clear that she wasn't going to spend any time trying to manage Thistle, when it was obvious she should be handled by a specialist.

The neurologist she usually recommends is on vacation until Feb., so she sent me to another one, rather than wait.

Thistle was only screaming for about 10 minutes, not several hours. She was restless, panting, and obviously uncomfortable all night though.

I only have a bike as transportation here, so an emergency vet visit is quite a hardship. I should know where one is though, I can always call a taxi if need be.

The vet today is 2 communes away, it took me 1.5 hours to bike home from work, get to the metro and get to the right commune, and walk to the clinic. If Thistle was in a state to walk herself it would have been faster, but I carried her in her carrier the whole way.

I have already purchased a stroller, so future trips should be less taxing on me. I'm very petite, so carrying the extra 20 lbs that is dog + carrier makes a significant difference in my speed.
 
I have just watched this video three times through and I am sorry to say that it does look to me as though Thistle is showing symptoms of SM. I only have experience of Rebel suffering from this disease, but the scratching is identical to his, as is the restlessness and trying to find a pain free position. The noises aren't quite the same as Rebel has made when in extreme pain but of course every dog is different and every dog's collection of symptoms is too. Rebel too lost the ability to walk until he had been started on medication for a few days, then it was a very different story.

I am so glad that you have got yourself a stroller to make transporting a sick dog easier. I am petite too, also without transport, so I bless the day somebody at a dog show suggested I purchase the stroller for my epileptic dog. My CC/DE girl also uses it to avoid walking on hard ground, which has eliminated all the infected pads and nail beds she had to cope with before.

I do hope you get definite answers from the neurologist tomorrow, although you may have to wait a while for the MRI scan to be interpreted. The neurologist is likely to prescribe suitable pain relief whatever the diagnosis.

Sending gentle hugs for you and Thistle while I spin the Tibetan Prayer Wheel as I write.
 
I'm so sorry to hear your.ittle one is having pain. I don't think I could personally bear that. :(

You might want to start tracking the barometric pressure for your area. I gather that can have a big effect on dogs with syrinxes, and people on here have been able to predict somewhat when their dog might have a pain episode.
 
Soushiruiuma wrote: 'Since the optic and oculomotor nerves arise from the mid-brain they would not be affected.' Unfortunately it doesn't work like that, because the CM on its own blocks the flow of CSF round the brain and causes it to back up in the ventricles at the front of the skull. This can cause painful headaches and eye problems such as light phobia (which so far Thistle doesn't seem to have - one thing to be thankful for!), entirely independent of the damage lower down being done by the syrinx. Hope your visit to the neurologist sheds a lot of light and gets the pain under control.

Kate, Oliver and Aled
 
Alright step one she is out of pain for now. Thank goodness, I always think getting the issue on video is helpful. I am also glad you like the vet and it seams both you and the vet is doing everything possible for Thistle. I must admit tho I did not watch the video, I just would cry and I have only seen a few pain episodes and I can't be of any help so tho you were so smart to take the video I just can't watch it.
 
UPDATE: We made it through the night, and everyone got to sleep. Thistle was still uncomfortable, and would get up and move around periodically, but only scratched a teeny bit (one or two kicks, occurring about 6 times night). She came over an snuggled quite a bit which was really nice.

She liked to be petted on the right side (the normal side), but would tense up if I touched her left side. She still has a long way to go before she's comfortable. It would have been nice to be able to give a her a dose of tramadol or something to get her pain-free. But it was an improvement nonetheless.

Our neurologist appointment is at 4 pm today.

She's also kind of smelly, but I won't bathe her till she's comfortable.
 
I don't think the neurologist is going to mind that she is smelly, cute out weights smelly every time. I'm so glad you can get her in the see a neurologist so quickly, it still may be after a few tests and the dreaded MRI before you know exactly what is going on but I'm sure getting her out if pain as soon as possible will be a top priority. She is so lucky to have a Mommy whose so on top of her care.
 
I'm so glad there was an improvement last night -- you both needed the rest I am sure! We'll all be thinking of you at 4pm -- you're probably en route right now. No matter the result, I think it is always a relief to know what is going on. You'll also be able to get her on to a pain management programme and then consider what steps will be next -- but she'll be so much more comfortable.

Let us know how the appointment goes. :flwr: Fingers crossed for you.
 
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