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Thread: Diagnosis of Severe SM in 7 Months Old Puppy; surgery or medication?

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    Default Diagnosis of Severe SM in 7 Months Old Puppy; surgery or medication?

    Hey everybody,

    First of all, can I just comment on how great it is to have found a forum like this? My 7 months old Blenheim puppy, Beeru, was diagnosed yesterday with a very severe case of SM where the syrinx extends all the way down to his lower back

    Below is his MRI scan



    It's clear that his syrinx is large and severe, although he hasnt been showing a whole lot of the clinical signs of SM. What prompted my and my vet's suspicion is of a sudden onset of headtilt. His neck is now bent about 45 degrees to the left and the xray scans have shown clear scoliosis (neurologist says its due to the pressure of the syrinx and spongy tissues causing the spine to grow incorrectly).

    It is truly heartbreaking for me, as a first time Cavalier and dog owner, to be faced with a situation like this especially for a dog who is still so young... I am in the Seattle area and the doctor I went to is Dr. Sanders of Seattle Veterinary Specialist. He said that Beeru is the youngest patient he has seen with this condition and he is utterly shocked at how progressed his syrinx is.

    He is recommending immediate decompression surgery with the Titanium mesh due to the severity of his SM and also his young age, but there is no certainty of prognosis because there is way too much we dont know about how a puppy his age responds to surgery.

    Has anyone experienced a similar situation? Does anyone know of any case of a young puppy diagnosed with SM? Any help would truly be appreciated.

    I honestly thought I had my work cut out by going out of the way to find a reputable breeder, one who has been breeding Cavaliers for over 15 years and has seen no signs of SM in any of her dogs whatsoever.

    He is so young.....

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    I am sorry you are going through this.
    owned by BratBoy ^see avatar

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    Quote Originally Posted by yAnnie View Post
    ... I am in the Seattle area and the doctor I went to is Dr. Sanders of Seattle Veterinary Specialist. He said that Beeru is the youngest patient he has seen with this condition and he is utterly shocked at how progressed his syrinx is.

    He is recommending immediate decompression surgery with the Titanium mesh due to the severity of his SM and also his young age, but there is no certainty of prognosis because there is way too much we dont know about how a puppy his age responds to surgery.

    Has anyone experienced a similar situation? Does anyone know of any case of a young puppy diagnosed with SM? Any help would truly be appreciated.

    I honestly thought I had my work cut out by going out of the way to find a reputable breeder, one who has been breeding Cavaliers for over 15 years and has seen no signs of SM in any of her dogs whatsoever.

    He is so young.....
    He is very young for such a progressive stage of SM. He may be the youngest known with this stage. Dr. Sanders has a good reputation with CM/SM, but I would recommend a second opinion before opting for surgery. Your puppy's skull is still growing, and who knows what affect such a major procedure would have upon continued growth? I would like the input of a researcher like Dr. Clare Rusbridge first. Her email is neurovet@ virginmedia.com

    As for finding a "reputable breeder", my family has had CKCSs for over 40 years, and I know of very, very few reputable breeders, and if you add the requirement that they follow the CM/SM breeding protocol -- http://www.cavalierhealth.org/smprotocol.htm -- the number shrinks to about zero.
    Rod Russell

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    I am so sorry that you are facing this with your first cavalier and I do hope that your puppy can be treated and kept comfortable.

    These poor little dogs & the pet owning public are getting a very raw deal from cavalier breeders. This is not what should happen when someone buys a dog for their family.
    One of the excuses breeders make is that they don't set out to breed unhealthy puppies. The problem is that they won't do the tests that they know will give their puppies the best chance of being healthy.

    Here in the UK I have been contacted by owners of puppies that have needed to be PTS because they have SM and the pain could not be controlled and unfortunately I think we will hear of this even more often, until 'reputable' breeders realise that seeing no signs of SM in their dogs is no substitute for a MRI scan.
    Margaret C

    Cavaliers......Faith, The Ginger Tank and Woody.
    Japanese Chins.... Dandy, Benny, Bridgette and Hana.
    Remembered with love......... Tommy Tuppence and Fonzi

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    We have had some puppies with scans like this before here, and scoliosis is a common sign in younger dogs with SM --it does tend to go away over time but only because the dog probably adjusts to the pain. The scoliosis is actually a sign of fairly severe pain and would be a clinical sign. I am not sure if it is right that the spine grows incorrectly in response; I had thought the tilt was more the dog adjusting to a position to tolerate the pain, but many of these things are not very well understood so maybe these are more theories than knowns.

    Unfortunately as others note, it isn't uncommon to have breeders say they 'have never seen SM in a dog of their breeding over x years'. Most likely this is because they either haven't looked, or don't wish to, or simply are lying. Very definitely she won't have been scanning as all the breeders who are scanning have said they pretty much see syrinxes in about half the younger breeding dogs that they scan. That matches research figures for dogs without obvious clinical signs in a study of over 550 cavaliers. I have had 7 cavaliers and 5 have SM, a mix of show breeder dogs and rescues. All have MVD at this point. I find it hard to believe I somehow got dealt an unusual hand of cavaliers. There are a lot of health issues in the breed.

    I would agree that you might wish to get a second opinion. Dr Rusbridge will do these, given a copy of the scans, for a fee. She is more conservative about doing surgery, especially on young dogs under a year, and is the leading researcher into the condition. Your neurologist is correct that prognosis is unsure, but then that is true for all cavaliers with SM. It can help to get two different views and weigh up which makes most sense to you. There no easy or straightforward decisions with this condition, and I am sorry you are dealing with it in a young dog.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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    Thanks everybody for your input! I went to another neurologist for a second consultation. the doctor said that she is more conservative when it comes to surgery, but she definitely recommends it in Beeru's case considering his age and poor prognosis. We are going to schedule his surgery ASAP and hope for the best.

    Thank you for all of your help!

    Side story: It's funny. After I came to this decision I emailed my breeder to let her know of my thought. Since she had previously offered a replacement, I told her that I would love to consider another Cavalier so long as we can work out a way to have his parents scanned (I would pay for the MRI if necessary). She responds saying, "actually, this is a long and arduous road you're going down. It is not fair to Beeru or the new puppy if they did not have your undivided attention. Rather, I will refund the purchase price instead."

    Interesting how this all played out...

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    It seems that some breeders will risk producing sick puppies rather than check their breeding cavaliers and remove already affected animals from their breeding programme. One can only hope that your puppy's parents are not bred again, although in this country popular stud dogs with multiple SM affected offspring are still being used.

    It says a lot about stud dog owners that they will put a show dog under an anaesthetic for a cosmetic operation while maintaining they will not risk the same stud dog having a GA for a MRI scan.

    I have two puppies Beeru's age, I know what a joy they are to have around and how devastated I would be if I was facing this for one of my boys. Do let us know when you have a date for the operation. We will be sending positive vibes for your little fellow.
    Margaret C

    Cavaliers......Faith, The Ginger Tank and Woody.
    Japanese Chins.... Dandy, Benny, Bridgette and Hana.
    Remembered with love......... Tommy Tuppence and Fonzi

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    I'm glad you have a second opinion and feel better about how to move forward.

    On scanning: the funny thing is, there is a neurologist who several times trie to set up a low cost MRI scanning day for breeders in Washington State. I know he had problems getting enough breeders to make it worthwhile. A scan costs about the same price most breeders charge for a single puppy. This would seem a reasonable investment in responsible breeding for anyone who cares about the breed, their own dogs, and their puppy buyers, to prevent breedings likely to produce affected puppies. Certainly research has shown it is very significantly better than relying on never having seen it... (in unscanned dogs, where it certainly suits many breeders not to see anything).

    Please stay in touch and let us know how things go and feel free to ask questions. Several people here in the past, have had dogs go through surgery and there are past posts and threads from them that might help.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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    I am so sorry and I hope the surgery helps Beeru. I agree with Karlin and I'm glad you got a second opinion. Many people have strong opinions about surgery. I know of one cavalier on this forum that was diagnosed with severe SM a a long syrinx under one that is being well managed on medication several years later (she was recommended by a top neurologist surgery as well). Another that had surgery but I'm not sure if she was under a year or not and is also being managed with medication as well as the surgery. Surgery is not a cure but for some it is a hope to stop progression. All I can say is that you have to make that decision and you did. As for prognosis, I was told when Ella was diagnosed that the neurologist couldn't tell me 3 months or 3 years. All I heard was 3 months. Ella was diagnosed when she was almost 3 and she did have surgery. She is no longer with me but that was not because of her SM. She did not have the titanium mesh but at that time, Ella would have been her neurologists first. I think I spent so much time and worrying about if I did the right thing or if I did that would the outcome be different. She developed scar tissue which is why neurologists use different methods to try and prevent like titanium. However, all that time I spent questioning myself, I missed some good moments I could have had with her. So you got a second opinion which I feel everyone should do before surgery and made the hardest decision. That's the toughest part and looking back I feel I made the right decision at the time. The medication was not helping and I felt I did not have time to figure out the right medical management to help her. Beeru is young and as I said I have seen people choose different things but no one can tell you what to do. You make that decision based on the specialists and your own instincts. I am so sorry you are going through this at a young age.

    Ella was born in 2006 and very few breeders in the USA were scanning at that time. I know some were but even now it's hard to find breeders close by that do scan. I can honestly say that she wouldn't have breed if the parents were symptomatic. The parents had everything else like their hips and patella's along with heart, eyes etc. However, now I would do the same thing and want to have a puppy from a breeder who does MRI even if with that there are no guarantees. That was a long time ago. Ella's breeder offered me a puppy but it would have been from Ella's sister and she said she would rather it be from one not linked (even though she was not scanning). I did not want another not just because of that but it was very hard on me and Ella did have all my attention. I do not want to speculate on the breeder's reasons for saying that but it is a lot to have to take care of them after surgery. It is so hard and there are so many unknowns about the future but after losing Ella I can just say to treasure the good days.

    I do not blame Ella's breeder because she gave me the best thing that came into my life, Ella. I miss her everyday. It is so tough and you have to remain strong which seems impossible some days. So try to focus on the good and the support you can have. I have not posted in a long time but I do remember how great it was to have people there for me and Ella. I will check back and keep you in my thoughts.
    Anne Proud mother of Elton 5 and Angel Ella

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    So nice to hear from you Annie, and good that you can share your experience with another Annie. Hope you and Elton are OK.

    All the best

    Kate, Oliver and Aled (Oliver is nearly 13 now, a very wicked old man!)

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