Have you read the thread started by GemmaMerlin? Merlin had facial paralysis, but this has improved as gabapentin began to get on top of the pain. Poor balance is a very common symptom of CM/SM. My Oliver has it but it doesn't seem to be painful, so I doubt that it is connected to his syrinx, and increased gabapentin doesn't make any difference. My personal (entirely lay and probably wrong!) theory is that balance is controlled by the cerebellum and for more than 6 years for Oliver this has been pushed by the Chiari Malformation and acting as a stopper in the top of the spinal cord, which cannot do it much good. So I wonder if the part that controls the balance has been damaged - but this idea is probably completely wrong! He has had one vestibular episode, but his terrible balance is never accompanied by the signature rapid eye movement, nausea etc. typical of vestibular problems And he has no problems with balance when he's trotting round the park!

I've not had your kind of ups and downs with either of my CM/SM dogs but I have had it with one of my Cavaliers who was in congestive heart failure for 9 months, so I have some idea how stressful it can be for you. But Cavaliers have a great enjoyment of life, even when that life is very limited by illness, and they have great powers of recovery, so I'm afraid the ups and downs with Sammy will probably continue and all you can do is learn to live with it.

Thinking of you both

Kate, Oliver and Aled