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Thread: Our dog is in agony and we believe its SM....please help!

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    Default Our dog is in agony and we believe its SM....please help!

    Hello all. I am new to the forum but grateful to have a place to turn. I am desperate. Our cavalier, who is not even 2 years old yet is in constant pain. Please help us if you can or offer words of advice. We don't know what to do. Here's our story...

    Basically Shiloh has been in pain since we brought her home at 10 weeks old. But in the beginning the episodes were very mild compared to now, and they happened every now and then. The first sign was constant scooting. Yelping in pain and jumping off the couch and running around screaming while trying to chase her bum. We immediately sought advice from her vet and for the first year we would go back multiple times a month to have her anal glands expressed. "Anal gland this, anal sac that...." Bla bla bla. Here's the problem. After spending hundreds of dollars to get her glands done, multiple times a month, she never had any relief. Not one time has the scooting stopped or slowed as a result of expressing the glands. Over and over and over again. Constant pain, yelping, scooting, squealing. Finally the vet says, "it's allergies. "
    Great. So the entire second year of her life has been spent feeding her strict hypo-allergenic food, absolutely nothing else. Still expressing the glands, still no relief. After spending hundreds of dollars at the vet trying to figure it out, I finally took videos of her behavior and begged the vet to watch them. I pleaded with him to hear me out that SOMEtHING IS WRONG with my dog! Her symptoms have intensified and over the last year she has declined significantly.

    Her quality of life is absolutely heartbreaking. She itches constantly, rubbing herself raw, yet she has no dry skin, yeast, rashes. Nothing whatsoever to suggest allergies. She has always hated going into her harness for walks, has always ducked her head down when people try to pet her, she cries and screams in pain daily, she digs non stop, always fidgets, is never comfortable, won't lie still, and in the most recent months has started biting and licking her paws obsessively. The absolute worst behavior of all, is that she spends about 85% of her life hiding under our bed. We live in a loft and have concrete, cold floors in the bedroom. Whenever I work on my music or choreography in the living room when she's in pain, she will scream and cry until I let her under the bed where it is cold and dark. It is literally the only place she is comfortable. Needless to say, all of this led me to do my own research, and I eventually found out about SM. I insisted the vet listen to me at her last visit and he finally agreed to do a bunch of tests to rule out other things. He finally agreed this is NOT allergies and that something is horribly wrong with my young cavalier. He reluctantly gave a referral to a numerologist, but warned me the cost of trying to get a dx would be astronomical. We are in the U.S. and the only neuro here said the cost would be $2000-$4000 just for the initial scan and consult. We have no money to move forward but are convinced she has SM. She air scratches constantly. My dog is in agony. She currently is on trauma doll but the poor thing gets sick to her stomach with. WHAT do we do!? We are desperate to find help but absolutely do not have the money to do an MRi. The irony is that we bought her as source of therapy for me after I was diagnosed with Lupus, and she has been suffering every day of her life. I'm heartbroken.

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    This is almost certainly SM and this dog desperately needs help. I am so sorry you are facing this with Shiloh especially while you too are dealing with a health issue.

    Have you spoken to the breeder? Any responsible breeder would want to help and also would truly need to know this mating produced such a badly affected dog.

    I would tell your vet to please trial your dog on the meds that treat SM. They can read all about it and use Dr Clare Rusbridge's treatment algorithm here:

    http://www.veterinary-neurologist.co.uk/Syringomyelia/

    Has your vet not even tried ANY pain meds? In such a horrific case I would get her on steroids probably initially just to try and manage this level of pain and then try to see if using cinmetidine and gabapentin 3x will help -- I would think this level of pain would likely mean starting her at close to 100mg 3x of gabapentin.

    You may also face some difficult choices. You simply cannot leave her like she is, in the agony of this condition. It can be one of the most hideously painful diseases known to humans, and she sounds like she is suffering very deeply right now. Many of the dogs with severe SM that cannot respond to medications will need to be euthenised out of love and kindess for the dog, as hard as that may be to consider. But please do immediately try to get her pain addressed on medications.

    Frankly I would go to another vet as well. If the vet had tried googling pain and cavaliers they;d have seen this is a description that exactly fits SM pain. I hate vets who are unwilling to listen to their clients and the fact is you have been right and he has been wrong for two years! I also have never heard of vets charging such prices to do anal glands all the time -- or not just showing you how to do them. But if she has SM, all that squeezing of anal glands may well have caused even more pain. The good thing is you have a good idea now what is going on, and a decent, supportive vet will trial meds without requiring an MRI. A vet should NEVER have left a dog to suffer like this out of their own refusal to learn more about what is sadly a common condition in this breed.

    Not being able to afford an MRI does not mean the dog cannot be trialled on medications by a caring vet and owner. Please do urgently get her seen and get her started on some meds to see if that helps -- and post all the questions you want here.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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    I have no personal experience with SM, just what I've read here on the forum. I do agree 100% with Karlin that your dog needs relief NOW.
    A new vet is definately the way to go. You may even want to try to get just a consult with a neuroligist who should be able to give advice without having a MRI and get you a trial of medication.

    I'm really sorry your little girl is going through this. There are, sadly, many others on the board with more experience with this and I'm sure they will offer advice too! Good luck and let us know how Shiloh is doing.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

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    Thank you so much Karlin and Joyce for the replies. I was so relieved to come home and see that someone had responded so quickly. And I just started crying reading them. I'm just sick over the whole situation and feel so guilty that I haven't been able to help her more. I've always known. Every day I've known deep down, this is not normal. That something is horribly wrong and I'm just heartbroken watching her suffer. So many times over the last year we've wondered if we should put her down bc of the pain she's in. The last visit to the vet was my absolute limit. I'm maxed out. I walked in there and got in the vets face and said, "prove to me that my dog has allergies and then we can talk about changing her food again. Prove it. Run every test you need to. I'm not leaving until you watch these videos. If you can't prove she has allergies then you can go tell your staff to euthanize her right now." That shut him up REAL quick. I guess sometimes you have to be aggressive to get things done. I'm livid just thinking about that visit. He had the audacity to tell me while watching my videos that "all dogs scratch." Then he asked if I could fast forward the video so he could "see" what I was talking about. I said, "excuse me? You mean to tell me you don't have 5 minutes in your schedule to devote to a helpless dog who is suffering? You don't have 5 minutes to give to a client who has given your practice hundreds of dollars over the last 2 years, all while following your expert advice?" Ha. Once again he shut up. I'd rather not have to turn into a psycho lunatic at the vets office. I'd rather have a vet who actually cared about helping animals. Just beside myself thinking about it.

    To answer your questions, she is actually taking tramadol for pain but my iPad auto corrected in my post earlier. Hate auto correct! I had to beg for the pain meds, but they have helped. Once the vet realized I wasn't leaving his office without medication, he gave them to us. He was probably willing to do anything to get the psycho dog owner out of his building. He actually did seem relieved when we told him the meds were helping her. He agreed she needs help from a specialist. The only problem is that she gets very sick to her stomach and has pretty severe diarrhea after taking it for a few days. We try and give it to her only when absolutely needed, so that she can have a break from the diarrhea.

    As far as the "breeder" goes....please, please, please hold judgement against us. We are horrified now that we know where Shiloh really came from. We bought her from a local, family owned pet store that has been known to use reputable breeders. They rescue homeless pets, and do adoptions, and have a very good reputation in the community. We bought our first dog from them back in 2009 and had an absolutely wonderful experience the first time around. Bella is our sweet little cavachon that is the picture of perfect health. The owner of the store breeds cavachons on their family farm and Bella came from one of the family friends litters. I guess over the years they have started buying puppies from "other out of state breeders" and we are convinced Shiloh is from a puppy mill. There's no way she came from a reputable breeder. We are frankly disgusted with the owners. I guess making truck loads of money became more important than doing the right thing. We are those people. We totally bought a dog from a pet store. Can't really change it now so all we can do is focus on helping our poor dog. I'm sure people will read this and think that we got what we deserved for buying a puppy from a pet store. And they'd be right.

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    Also, I forgot to clarify, the vet usually charges $20 to do the glands each time, and I guess what I was trying to say was that over the last 2 years we've spent hundreds on the glands They have showed us how to do it and we have tried several times but it just causes her pain and we can't seem to do it correctly. To be honest, even when the vet or groomer does them, she often times will be in more pain afterwards then before.

    I do actually have a question about something else. Is it normal for dogs with SM to lose control of their bladder? She was digging on the couch yesterday, and peed all over the couch. We no longer have a couch. It's currently sitting at the dumpster. She has had episodes before where after digging, she will pee, usually on the couch, which is always protected with blankets and towels bc she digs constantly. In the past I've been able to wash the blankets immediately but this time the couch was ruined...

    She also refuses to pee on the grass. She will only pee on the street.

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    Oh boy -- you have been through the mill. Good for you for standing up to the vet.

    With this (and any) breed, so much advance research by buyers, really needs to be done to determine exactly what the prospective buyer should ask the breeder. Sad to say very few breeders, especially not ones who are not actually showing their dogs (and therefore putting them under at least some scrutiny, though showing on its own or winning is NOT a sign on its own of a good breeder), do the health testing that is really needed in each breed. No one breeding cavaliers or cavalier crosses should ever be breeding at this point without cardiologist (not just vet) testing, and MRI scanning, all breeding stock before breeding and no cavalier should be bred without following the full breeding protocol (which means they are at least 2.5 yrs old before first litter and then ONLY if both grandparent dogs on BOTH sides were still murmur-free at age 5... with the right scan results... otherwise dogs should not be bred til age 5). Bichons have their own range of needed health tests. Simply crossing dogs gives no promise of healthier dogs unless the health history of all the families of dogs involved, and needed health tests on parents, have been performed. I will wager none of the parent cavaliers was ever MRId or cardiologist tested nor were grandparents tested nor protocols followed. People as you note, are more interested in making money and count on buyers not knowing about the extensive genetic issues in most purebreds (rare exceptions) that need careful breeding and testing to reduce incidence... cavaliers are truly a breed in crisis, as much as we all love them, and breeders have a heavy burden these days to properly test. But if they don't, they should not be breeding cavaliers or cavalier crosses. Ever.

    One thing that is alarming to me about your vet is how he has presented proper investigation and testing as impossibly expensive. As if this is an excuse to leave a dog in pain and do so little! Actually, I would think a basic clinical exam at a neurologist (you can ask for this) will be adequate given the symptoms you describe, no MRI needed. Even vets familiar with SM can pretty much diagnose without an MRI and the medications are very clearly defined now by Clare Rusbridge. MRIs are ideal but I cannot really see the point in them at times if symptoms are clear and the dog responds to SM meds.

    You can go get cimetidine over the counter at any pharmacy. Generally they come in 20mg tablets. Use a sharp knife or pillcutter to divide in fourths and give Shiloh a fourth of a pill in the morning and evening. This may also help. But please get a vet who will IMMEDIATELY get Shiloh on to some proper pain care. A vet can write a prescription for gabapentin. I'd tell your vet that those of us with very symptomatic dogs generally want to start on 100mg 3x. Try that with the cometidine (give cimetidine 2 hours before or after the gabapentin as it reacts with it). Drop the tramadol if it is making her sick; try another of the meds Clare recommends if that is also needed. I am guessing she will improve immediately on gabapentin which works as a neurological painkiller. She may need extra painkillers in addition. You need to work with someone who understands how to make adjustments or is willing to get advice from a good neurologist on how to treat and adjust dosages and meds.

    Please try to get these things done on Monday with the vet as an urgent priority. Where are you based? Someone may be able to recommend a good neurologist in your area to go see for a clinical exam which will not cost anywhere near an MRI.

    There's a list of neurologists and much more SM info on www.cavalierhealth.org/. I would steer your vet or whatever vet you decide to see, to that page and Clare's SM webpage. Clare is the leading vet neurologist and researcher on this condition. I would make sure your existing vet sees those pages and fully understands how widespread this problem is in cavaliers (but also a growing issue in many small breeds especially it seems yorkies, brussels griffons and chihuahuas amonst others) and therefore never spends two years missing a pain diagnosis).

    I cannot stress enough that I would not let Shiloh go another day without adequate medication. Her pain levels must be extraordinary for her to be behaving as she is. If meds cannot address this adequately, I think you will need to consider letting her go. But you have some way to go before such a decision. Please do try to get gabapentin and cimetidine by Monday. Cimetidine you can probably get today from any pharmacy.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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    I'm so sorry you're going through this with Shiloh. I can only echo what Karlin has said about the value of a neuro clinical exam even without the MRI. Within 30 seconds of observing Riley and hearing her symptoms, her neuro told me she had SM. It was later confirmed by MRI and she did have surgery 5+ years ago. He started her on meds that very day just based on her symptoms though. He didn't wait for the results of the MRI. My heart aches for you and Shiloh and what you've had to put up with. These little dogs are usually so stoic. She must be in such agony. I do know what you mean about going under the table. Riley hides under tables and chairs a lot. Please take Karlin's advice and get her on gabapentin tomorrow, or maybe start with prednisone even to jumpstart the pain control. I hope you will see a dramatic improvement. Our thoughts are with you.
    Bev
    Oliver (blenheim, born 3/2001), Riley (black & tan, born 8/2002,), Madison (ruby, born 9/2003), and Oz (tri-color, born 7/2007)

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    Thank you thank you thank you for your help! We are going to the pharmacy right now. I am calling the vet first thing in the morning and if they won't give us the meds we are calling every neuro in the area until we find someone to help us. There's no excuse! Someone will help us. I don't care what I have to do. Every time she fidgets or whimpers I just cry inside.
    I can not thank you guys enough for the support. It means so much. I feel like we are going down the right path now and that maybe there is hope. I just can't even fathom putting her down, but I also can't fathom how much pain she is in. She is so brave. I feel so guilty for letting her suffer as long as she has. She is so lethargic and doesn't want to do anything. She runs to jump in my lap when she's in pain but then she'll only stay still for a few minutes. Is there any chance she will be ok on the meds? I mean is there anything else we can do? I know some dogs have had brain surgery....is that the only other option?

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    We are in Atlanta, GA. If anyone has a recommendation for a neuro we would so appreciate it!!

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    I sent you a PM of some neuros in the Atlanta area.
    Sir Remington II (Remy) Oct. 17, 2012 -

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