After sending Dr Rusbridge videos of Kookie and a detailed list of observed symtoms she viewed his MRI scans and made an evaluation.
I received a very detailed report and a copy is being sent to the vet with treatment recommendations. Thankfully there are no syringes present however Kookie does have symtomatic CM and mild secondary ventricumegaly. Clare has recommended Kookie's gabapentin is increased to 3 times a day, introducing a CSF inhibitor either cimetidine or omeprazole and also starting him on an NSAID.
This is what the report states regarding CM
[SIZE=3]Chiari malformation does appear to cause signs of pain in some dogs, as it does in people (approximately 25% of humans with Chiari malformation exhibit signs of pain). Because the majority of Cavaliers have a Chiari malformation there is the mistaken idea that this is without clinical signs in the dog – however, this is not the case and several of Kookie’s signs are consistent with this condition
She also added the following to the report
[SIZE=3]The other consideration is whether or not Kookie should have surgery (foramen magnum decompression). . Dogs with Chiari-associated pain are probably better candidates for this surgery than dogs with syringomyelia-associated pain because the improvement after the surgery relates to the Chiari malformation whereas the syringomyelia tends to be persistent.
I would like to see how Kookie does with the recommended medication before considering that option.
I would like to thank all of you who have been extremely helpful since I sought advice on this forum.