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

Luckystar

Active member
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.
 
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. :flwr:

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. :flwr:
 
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.
 
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.
 
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.
 
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.
 
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.
 
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?
 
I wouldn't jump to thinking about surgery yet. Yes it is an option. My Riley had it and it was a great success for her. But it isn't for all dogs. We were lucky and had a great neuro. I would just first concentrate on trying to get her comfortable. Most dogs do fine on medication although it is a progressive disorder. I would also say to not beat yourself up about not getting her diagnosed or treated sooner. It took me years to figure out what was going on with Riley. You are going to the ends of the earth to take care of Shiloh. That what matters now. Please let us know what happens tomorrow. I've been there and it is heartbreaking.
 
I appreciate that so much. I'm dealing with a lot of guilt. But that's probably normal. I just want to be able to enjoy her and hopefully tomorrow she'll feel better if we can get the nerve meds. We gave her the OTC med a little earlier and she seems to be resting peacefully.

Is there anything else we can do to make her more comfortable? Or is there anything specific we should avoid? We went to my parents house tonight for dinner and she was running and playing for a few minutes with our other dog. That was really great to see. But then as the night went on she seemed to feel much worse. Just wondering if all the running in the yard made her worse? I'm going to do as much learning about this as I can and read all the info you have suggested on the websites. I am so grateful to all of you! You have no idea how comforting it is to have your support. Shiloh and I appreciate it very much!
 
Sorry to say that I've only just caught up with your thread Lucky Star (a first name would be really nice - mine is Flo and I live in Birmingham, UK, sharing my life with 4 Cavaliers).

My 10 years old boy Rebel has SM and showed some but not all of the symptoms you describe. It took some time for my vet to find the right treatment to relieve his pain, but for the last 3 months or so he has been behaving like a dog of half his age and, can you believe it, finding fault with everything I do, or even some things that he even thinks might be considering doing.

I have some sensible advice here. The first thing is that you have no reason to blame yourself for the pain that Shiloh is going through. My Rebel came from a very highly respected and health conscious breeder that I knew well. After a few month she told me it might be possible that he was carrying inherited problems and advised me that he should not be used at stud. I am so glad I took that advice, because I had him MRI scanned at 6 yrs old and was astounded to be told he has a very large syrinx. His symptoms only became accute a couple of years later and it helped my vet to have pictures of the syrinx to work with and of course Dr Rusbridge's treatment matrix. If I hadn't taken Rebel along to the scanning session because I was already taking my breeding bitch, I think the outcome might have been very different, as my vet was one of those who had never seen SM before. Now she has 3 other SM patients from other toy breeds.

The second suggestion I want to make is for you to CHANGE YOUR VET. Sorry, but this person seems to be totally uncaring, unsimpathetic and only interested in making as much money out of you as he possibly can. This is not how a vet should be and I am sure there are other vets within travel distance of your home with a much better attitude. Vets are supposed to be compassionate and caring as well as being skilled and efficient diagnosticians and this man is neither. Time to move on, for Shiloh's sake if not yours.

A better vet will be only too glad to refer you on to a diagnostic consultation with a good neurologist and should be more than happy to work with the specialist to effectively ease Shiloh's pain.

So sorry to be so abrupt over this. As I read through your thread I was initially blinded by tears which were soon replaced by anger at the so called treatment given by this vet.

There is light at the end of the tunnel in most cases I have heard about. My Rebel is living proof of this, so please don't give up yet and please come back to us here for all the sympathetic support you need. There is usually somebody around, day or night.
 
Im just reading your post now and my heart breaks for you and Shiloh. Good luck in getting your little one sorted and when you have change your vet........he needs a serious education in controlling pain and what are the causes!!! Mel XXX
 
Update on Shiloh:

We went to the vet today, but saw a different doctor! She was wonderful. She has seen Shiloh a couple times over the last year when the other vet wasn't available, and she knows her history. She took as much time today with Shiloh as I could have hoped for. She watched all of the videos I had and did a basic neurological exam along with a physical. She listened, answered questions, and explained SM to me. She started Shiloh on 100 mg of gabapentin and said we can give it to her up to 3 x a day if needed, as long as the side effects are not too bothersome. We are holding off on the tramadol for now so we can see how she responds to the gabapentin. We are going back in 2 weeks to follow up and will talk about where to go from there. She also gave some probiotics to start to help with digestion so that if Shiloh still needs the tramadol she will have something to help her tummy. For now, I'm really hoping there is some improvement with the gabapentin. She has only had one dose so far, but at 1:30 am I will give her the 2nd. She didn't get the first dose until 5:30 pm today, since we couldn't get to the vet until 4pm.

Im so relieved that she finally has medication, and relieved she now has a vet that I feel comfortable with. Even though her original vet works out of the same office, we will never be visiting him again. Dr. Pearce was absolutely great, and apparently she is the vet that handles the neurological issues at this office.

As relieved as I am, I am also scared of what the future holds for Shiloh. Dr. Pearce was hopeful, but also honest about the reality. She said that bc Shiloh is so young and her quality of life has been so bad, she can't promise that she will get better. Obviously without an MRi to confirm the diagnosis we can't be 100% certain, but based on the symptoms she feels pretty strongly SM is what's going on. She said it would be pretty hard for us to put Shiloh down without knowing for sure, but that even if we had all the money in the world and had an MRI confirm it, brain surgery is the only other option besides meds. Dr. Pearce said a confirmed dx may help us feel some closure if we have to put her down, but that ultimately if she doesn't improve, we have to think about Shiloh's quality of life. This is all very overwhelming to me. She's still a baby. She's not even 2 yet. But looking back at all these videos, I just cry because I can see how miserable she is. Dr. Pearce said that after the meds, there's nothing else they can do. I'm still trying to let all of this sink in. I'm just....heartbroken. There are no words really. This disease is horrible. I've always felt that no matter what I do for Shiloh, it's never good enough. It never gets better. And if it comes to the end, and she tells me it's time, that will be the only thing I've ever done to stop her pain. I'll have to make that decision for her, and it will be the most hideous moment of my life.
 
I'm so sorry that Shiloh and you are going through all this. It's terrible to watch a beloved pet suffer. I'm glad you found a doctor who listened and is caring, and I'm sending good thoughts that the medication will help your little one.
 
I'm so glad you have found a sympathetic vet who is working actively to control Shiloh's pain. Try not to get too depressed at this stage, thinking about the future. There are still quite a lot of medications for you to try - 100mg of gabapentin is the lowest starting point. The most usual side effect with gabapentin is sleepiness for a week or two, but then it can make a real difference in controlling pain. It can also be in itself confirmation of SM, since it only acts on neurological pain, not on ordinary muscular pain for example.

:hug:

Kate, Oliver and Aled
 
Take a breath and another and another. You've just started down the long path of managing Shiloh's symptoms medically. Medication can take a while to work and get the right cocktail for your dog. What works for one dog does not necessarily work for another. Riley is on prednisone. For her, that's the only med that had any effect on her symptoms. For others, they have had to switch to Lyrica from gabapentin. So in my opinion, you've got a way to go before you need to start thinking about saying goodbye to your little girl. That being said, I know that it was devastating for each and every one of us who has an SM dog to get the diagnosis. You feel like your dog has been given a death sentence and I know I started to treat Riley with kid gloves. I looked at every day as if it were her last and I think I stopped seeing her for the sweet dog that she was. Instead, she became the SM. Now here it is 5+ years later and my wonder dog is still alive and is doing so well. Please don't let SM conquer you yet. You're doing an amazing job being such an advocate for Shiloh. Give the meds time to work and if those don't work, try upping the dosage or try different meds. And remember, we are always here for support and a friendly ear.
 
I can't add much more advice other than echo what has already been given to you. Both you and Shiloh have been through the mill with this and thank goodness you are now on the right track with her. Thankfully it looks like starting proper pain relief has already made a difference to how she is feeling and she can start to enjoy her life again.
Let the future take care of itself and concentrate on how Shiloh is now :p

Bosco was diagnosed before 18 months, he is now aged 5. He has had various drugs including gabapentin and is now on Lyrica. Life isn't a bed of roses for him, but he is doing ok, some days are good, others aren't so good.

With regard to her anal glands - she was probably in pain due to the SM, but either way, you can help her very simply by adding fibre such as a spoonful of bran to her meals.

Best of luck with her treatment, and keep us posted. There are lots of us on this board with dogs that have various degrees of SM/CM and there are lots of treatment options as you will have seen from the alogrithim, so if one thing doesn't work, there are other drugs or combinations of drugs that you can try.
 
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