Page 1 of 2 12 LastLast
Results 1 to 10 of 12

Thread: My Cavalier with PSOM - Confused and need help

  1. #1
    Join Date
    Aug 2013
    Location
    Nottingham. Uk
    Posts
    21
    Post Thanks / Like

    Default My Cavalier with PSOM - Confused and need help

    My 6 year old cavalier has recently had a bad attack of Vestibular Disease. He had all the symptoms, drunken swaying, flickering eyes, unbalanced, dizzy, sickness etc. After 3 weeks he has improved a lot, but still is very unbalanced when he moves or gets up too quick.
    However following this, we noticed his right side of face drooping, his right ear drooping and that his right eyelid wasnt blinking or moving. We've had numerous visits to the vets, and on Monday he had a MRI at the local vet hospital.
    They concluded that he has got fluid/mucus in his middle ear, which shouldnt be there. They said this is probably PSOM (Primary secretory otitis media) Depending on how he progresses in the next week, they will decide if Antibiotics are working or he may need surgery to drain the mucus away fully.

    But my concern is his facial paralysis, the neuroligist said this will probaly never be cured, and on top of this he is limping very bad, air scratching, sometimes bunny hops, scratches at his ears and rubs his head a lot on the floor, the obvious cause of this was Syringomyelia, however he was tested for this whilst unde the MRI and it was all negative, which we was thankful for. However why is he experiencing these symptoms? Is this what the PSOM does to cavaliers?

    I'm totally at a loose end, as no one I know has had any experience with this illness and i've read so much conflicting information on the internet, i'm now totally confused.

    Any help would be appreciated.
    Best wishes
    Gemma and Merlin (Tri Colour Cavalier)

  2. #2
    Join Date
    May 2006
    Location
    Orlando, Florida USA
    Posts
    1,221
    Post Thanks / Like
    Blog Entries
    1

    Default

    Gemma, have you looked at http://www.cavalierhealth.org/psom.htm?
    Rod Russell

  3. #3
    Join Date
    Aug 2013
    Location
    Nottingham. Uk
    Posts
    21
    Post Thanks / Like

    Default

    Hi Rod, thanks for the link, which has proved very interesting reading. Hopefully it is all related to the PSOM, however his symptoms seem very excessive indeed. Only time will tell I suppose. Its just awful seeing him in such a state, especially with this facial paralysis, unable to eat properly etc.

  4. #4
    Join Date
    Aug 2008
    Location
    Coventry UK
    Posts
    1,837
    Post Thanks / Like

    Default

    Gemma, sorry you're having so much worry. Did the MRI show that your dog has Chiari Malformation (very likely, as an estimated 90% of Cavaliers have CM)? And were his ventricles (the cavity at the front of the brain) enlarged? CM alone, even without a syrinx, can cause considerable discomfort and produce many of the symptoms of pain (scratching, rubbing etc) more usually related to SM, especially if the CM slows down the circulation of cerebral spinal fluid round the brain, which then backs up in the ventricles, causing them to become enlarged. Did your neurologist say anything about CM or enlarged ventricles?

    Hope your boy gets sorted out soon,

    Kate, and Cavaliers Oliver and Aled (both with SM)

  5. #5
    Join Date
    Aug 2013
    Location
    Nottingham. Uk
    Posts
    21
    Post Thanks / Like

    Default

    Hi Kate,

    Thanks for your comment on my thread. The neurologist said Merlin has slight Chiari Malformation, but its not severe, he wasnt surprised by it (as like you said its very common in king charles) and that he's not concerned about any treatment for it. However I think this might be why he has the excessive scratching etc.
    He did an MRI and it showed his 2 air sacks at the front of his head, they should both be filled with air to drain the mucus, however one of the sacks was full with debri and thick fluid, they took a sample of the mucus and sent it to the lab (of which I will receive the results today for if its infected or not) he said if it is infected they will start him on antibiotics and if that doesnt work they they will do surgery to cut under his chin, enter the sack and drain the fluid. This is all okay and I sort of understand, but it still doesnt explain the scratching, and now severe limping. (he seems to be limping on both front paws) this has got worse over the last 3 days. I'm totally confused about everything now, and dont know what illness/disease is affecting what parts of his body and causing certain symptoms. He seems to distressed and uncomfortable, never can settle, keeps getting up and moving around it is now reluctant to jump up or go up steps due to this limp with his front paws.

  6. #6
    Join Date
    Aug 2013
    Location
    Nottingham. Uk
    Posts
    21
    Post Thanks / Like

    Default

    Hi Kate,

    Thanks for your comment on my thread. The neurologist said Merlin has slight Chiari Malformation, but its not severe, he wasnt surprised by it (as like you said its very common in king charles) and that he's not concerned about any treatment for it. However I think this might be why he has the excessive scratching etc.
    He did an MRI and it showed his 2 air sacks at the front of his head, they should both be filled with air to drain the mucus, however one of the sacks was full with debri and thick fluid, they took a sample of the mucus and sent it to the lab (of which I will receive the results today for if its infected or not) he said if it is infected they will start him on antibiotics and if that doesnt work they they will do surgery to cut under his chin, enter the sack and drain the fluid. This is all okay and I sort of understand, but it still doesnt explain the scratching, and now severe limping. (he seems to be limping on both front paws) this has got worse over the last 3 days. I'm totally confused about everything now, and dont know what illness/disease is affecting what parts of his body and causing certain symptoms. He seems to distressed and uncomfortable, never can settle, keeps getting up and moving around it is now reluctant to jump up or go up steps due to this limp with his front paws.

  7. #7
    Join Date
    Aug 2008
    Location
    Coventry UK
    Posts
    1,837
    Post Thanks / Like

    Default

    Hi Gemma

    I think that all you can do for Merlin is tackle one thing at a time. If he definitely has PSOM, deal with that and see whether it makes any difference to the scratching, restlessness etc. If it doesn't, go back to your neurologist and talk about some pain relief, because a lot of what Merlin is doing are signs of pain - which may, of course, be caused by the PSOM, but could also - if dealing with the PSOM doesn't make a difference - be caused by the Chiari Malformation. The problem with his ventricles (what you call air sacks) could be causing the scratching as it can be painful.

    It all gets so confusing - both of my boys have other things besides CM/SM and working out which thing is causing what symptoms and what can be done about it sometimes seems to take over my life, especially as Oliver is 12 and some of his problems may just be old age! But try not to worry - though you may find that you have to fight on Merlin's behalf to get the treatment you feel he needs.

    Kate, Oliver and Aled

  8. Thanks RodRussell thanked for this post
  9. #8
    Join Date
    Mar 2005
    Location
    Dublin, Ireland
    Posts
    23,992
    Post Thanks / Like
    Blog Entries
    15

    Default

    Hi Gemma: I'd agree with Kate here and also add: CM can have all the serious symptoms and pain that SM has. Maybe your neurologist is less familiar with this aspect of the condition and is not aware of this. I am not sure where you are located, but you could have your neurologist contact Dr Clare Rusbridge, who is a leading researcher on this condition and has lots of cases of dogs with CM alone having the same issues as dogs with SM. Indeed it might be useful to know that in humans, it is the equivalent of CM that is far more widespread and the better known element of this disease, with SM being one complication following on from the Chiari malformation.

    PSOM could also cause serious pain. Sadly a significant percentage of cavaliers seem to have PSOM (some researchers feel it may be the result of breeding for those 'cute' short noses and big eyes which cause internal structures to be cramped and in some cases to move to a different location in the smaller skull area. PSOM does not seem to bother dogs with more normal0length muzzles and normal-sized eyes). It is believed PSOM probably contributes to the high rate of early onset deafness in the breed though there is also a high degree of genetic deafness as well. The ear flushing procedure for PSOM usually has to be repeated at least once. It is generally not a once-off resolution. I've had it done for one of my cavaliers and it didn't do too much and I didn't feel his symptoms warranted putting him through the procedure again but I also do not feel the facility I took him too really understood that they were supposed to be trying to remove as much of the mucous plug as possible. Others have had a very good result -- see this story on my SMcavaliers.com website: http://sm.cavaliertalk.com/diagnosin...m/trouble.html

    There are recorded instances of dogs with both CM and PSOM having the limping and also, scratching. Actually, scratching and weak limbs are described as some of the more serious complications of PSOM but likewise both could be the case with CM as well.

    Here's one paper describing problems with PSOM:

    Primary secretory otitis media in the Cavalier King Charles spaniel: a review of 61 cases
    Authors: Stern-Bertholtz W.; Sjostrom L.; Wallin Hoekanson N.
    Source: The Journal of Small Animal Practice, Volume 44, Number 6, 30 June 2003, pp. 253-256(4)
    Publisher: BVA Publications

    Abstract:
    Sixty-one episodes of primary secretory otitis media (PSOM) were diagnosed in 43 Cavalier King Charles spaniels over a 10-year period. The principal findings were signs of moderate to severe pain localised to the head or cervical area, and/or neurological signs. Diagnosis was made by examination of the tympanic membrane and middle ear with the aid of an operating microscope under general anaesthesia. A bulging, but intact, tympanic membrane was found in most cases. Following myringotomy, a highly viscous mucus plug was found filling the middle ear. Treatment, consisting of removal of the mucus plug, flushing of the middle ear, and local and systemic medical therapy, had to be repeated between one and five times. The prognosis was good in all cases. PSOM is an important differential diagnosis in Cavalier King Charles spaniels with signs of pain involving the head and neck, and/or neurological signs.
    If you are based in the UK you might consider getting a second opinion from Clare Rusbridge.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  10. #9
    Join Date
    Mar 2005
    Location
    Dublin, Ireland
    Posts
    23,992
    Post Thanks / Like
    Blog Entries
    15

    Default

    Argh -- somehow a second bit got deleted. I was suggesting you have a look at Clare's website on CM/SM and in particular this document describes facial pain as associated with CM but I think Clare would feel that other problems are also seen with CM alone, since the point when this was written:

    http://www.veterinary-neurologist.co...ngoindepth.pdf

    I also was suggesting you (and anyone else with a cavalier! ) download this pdf brochure from Ohio Sate Univ which has a lot of expertise in cavaliers and in particular, research on PSOM:

    http://vet.osu.edu/assets/pdf/hospit...lesSpaniel.pdf

    Of particular interest might be this description of PSOM symptoms which would include limb weakness and head pain (which would often cause scratching):

    e presenting signs of PSOM may include
    pain localized to the head and neck, balance
    problems, drooping of the ear or lip, drooling
    saliva, inability to blink the eye, involuntary
    rapid movement of the eyeball, head tilt
    and/or hearing loss. However, these signs are
    also symptoms of syringomyelia...
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  11. #10
    Join Date
    Aug 2013
    Location
    Nottingham. Uk
    Posts
    21
    Post Thanks / Like

    Default

    Hi all. Thanks for your lovely and kind comments. The fluid results came back and it's not infected. So the neurologist feels no need to put him on antibiotics for the middle ear disease. Instead he thinks all these problems could be from his chiari malformation and has started him on frusemide. 20Mg. Half a tablet per day. He's on a weeks trial to see if we notice any improvement. I still think this middle ear issue should have been addressed further. He does scratch a lot but the main thing is scratching at his ear and shaking his head all the time like his ear is annoying him. He's definitely not got a standard ear infection and had his ears cleaned. But just seems irritable with his ears all the time. I'll see if I can upload a photo of my little man for you to see.

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •