PSOM - Not sure what stage to take next.

Merlin has been diagnosed with CM, and he had a vestibular attack which was caused by PSOM (also known as middle ear disease or glue ear)

They took a sample of the mucus in the middle ear (whilst he was knocked out having the MRI) and sent it to the lab for testing, it came back all clear and no infection was present therefore they decided not to investigate further.

However he has now started to wobble a bit again and his head tilt is starting to come back (and since this happened he shakes him head all the time). He had right side facial paralysis as a result of the middle ear disease which has recified itself (even though the vet said it never would)

My concern now is that they said it wasnt infected, however some symptoms from the PSOM are showing again, so clearly this matter needs to be resolved once and for all.

The vet said the only way to sort it, would be surgery. To cut under Merlins jaw line, enter his middle ear from there, drain and flush the mucus away, and stitch him back up again.
But with Merlin being 7 and a heart condition, i'm worried about putting him through this surgery and the anesthetic.


Surely there are tablets/other options to try before surgery.
Makes me wonder how these symptoms are coming back again even though they claimed it wasnt infected (although in the lab they only had the sample growing for 4 days which I dont think is long enough for a 100% diagnosis)

Any comments would be appreciated.

Gemma and Merlin. :smile:

GemmaMerlin said:

... The vet said the only way to sort it, would be surgery. To cut under Merlins jaw line, enter his middle ear from there, drain and flush the mucus away, and stitch him back up again.
But with Merlin being 7 and a heart condition, i'm worried about putting him through this surgery and the anesthetic.


Surely there are tablets/other options to try before surgery.
Makes me wonder how these symptoms are coming back again even though they claimed it wasnt infected (although in the lab they only had the sample growing for 4 days which I dont think is long enough for a 100% diagnosis)

Any comments would be appreciated.

Click to expand...

My understanding is that PSOM is progressive and the glob of mucus will continue to get larger. So, it needs to be removed. I don't know of any pill that will keep that from happening. It is not due to an infection.

All that I know about PSOM is here: http://www.cavalierhealth.org/psom.htm

A friend had wonderful results after visiting Dermatologist. Perhaps should not mention names on Forum not sure. Her dogs ears were gross with ear drums ruptured and all ulcerated after the Vet tried to treat for over a year. Was very impressed.She feels surgery very last straw unlike some. Not a million miles from you.Can anybody advise if names can be mentioned?

You can always send a private message to Gemma - click on Notifications at the top of the page and address it to GemmaMerlin.

Kate, Oliver and Aled

I'd definitely see a neurologist who fully understands CM first. CM I believe could potentially cause such problems -- some dogs are very badly affected. PSOM only rarely causes severe problems, though it might be the issue.

I agree with you on wanting to be very careful before doing a surgery. In your shoes, I would take Merlin to see Dr Clare Rusbridge or perhaps one of the neuros at the Royal Vet College.

When Ruby was mri scanned two years ago, they confirmed psom, which i suspected, as well as cm/sm, she had gone completely deaf, within weeks, i asked what treatment was available for psom, there was no medication, just an operation, that would as you said Gemma drain the fluid away, but my neurologist advised that in most cases it would always return, Ruby has adjusted to her deafness, she is happy, but on saying that, she never really displayed any other symptoms, which i am thankful for, but every cavalier is different, you are obviously very worried as i would be, i would take Karlins advice, surgery is not always the answer,especially when most cavaliers have other issues as well. I really hope Merlin gets the help he needs, keep us updated with his progress. Karen,Ruby and Sadie

I know that I'm late to the party, but our girl just had a myringotomy and seems 10000% better. She was definitely in pain and it was pushing on a nerve in her face causing Horner's Syndrome.