My cavalier has had a couple of episodes that are indicative of SM but have been over a year apart. She already turned 6 on july 30, The first episode was october of 2013 so she was 5 yr and 3 mos. Are the medications just pain relief or do they have other benefits such as prolonging life? Unfortunately my mom is the owner so she wants to wait and see if she has another episode. She figures if she isn't currently experiencing pain there is no point in looking into SM if the treatment is only pain management. She definitely wouldn't pursue surgical options. Whats the benefit in reducing CSF?
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Whar's the point in treating dogs with SM?
- Thread starter Pokey5876
- Start date
Also, one more question now that the thread is up, would they likely even want to put her on medication because she (if this is syringomyelia) has only had 2 episodes and is asymptomatic in between so it would be very hard to tell if the medications are even helping in the first place. We also just found out she has a heart mumur 
. First time it was detected. Ive been debating if I should have her go to the university for a neuro consult or go to this specialist group (that specializes in multiple things, with neuro being one) that's closer.
Also, the second episode was very mild. She only yelped out in pain once and then lowered her head and started walking really slow while whining. Later that evening she did fly catch but only for a few seconds each time, there were about three times. Then a couple evenings later she did do some more flycatching and lip licking and paw licking. (That was actually yesterday) She's also been choosing to sleep on the carpet a lot lately instead of on the couch.
. First time it was detected. Ive been debating if I should have her go to the university for a neuro consult or go to this specialist group (that specializes in multiple things, with neuro being one) that's closer. Also, the second episode was very mild. She only yelped out in pain once and then lowered her head and started walking really slow while whining. Later that evening she did fly catch but only for a few seconds each time, there were about three times. Then a couple evenings later she did do some more flycatching and lip licking and paw licking. (That was actually yesterday) She's also been choosing to sleep on the carpet a lot lately instead of on the couch.
UrbanYogini
Active member
I have no experience or insight with SM but wanted to respond and offer a (((HUG))). I hope others on here can offer some insight that might help you?
Hi and welcome.
The first question I'd have is, has anyone checked this cavalier for SM? The first port of call would be your vet, to check whether something else is potentially causing these occasional outbursts that would indicate pain. If nothing obvious explains the outbursts (spinal issues or joints), and given the high rate of SM in the breed, it would be best to then request a referral for at least, a clinical exam by a neurologist (an exam in the office, without an MRI, which is more costly). Neurologists can do a variety of checks to se if there are symptoms of SM that may bot be obvious to either a vat or an owner. This includes assessment of pain, as many owners and vets will not understand the subtle signs that indicate the dog is living with a degree of chronic pain without showing a lot of obvious signs.
The short answer is, it is almost always important to treat SM if there are any outward signs of pain, no matter how sporadic. Many dogs will suffer day in and out from things that do not show as obvious pain (severe headaches are the most common symptom in humans with SM and dogs cannot really show a headache -- nor do most people 'see' headaches in other people, for that matter). There are a range of medications that can hugely increase the daily quality of life for a dog. Occasional breakthrough pain generally would suggest perhaps this cavalier lives with some chronic pain which occasionally becomes severe enough to cause an obvious outward show.
I cannot stress enough how important it is to talk to a professional if there is even a suspicion of SM. SM in humans is widely considered the single most painful affliction known in medicine. To leave any living creature to endure it is a cruelty that I know any caring owner would not knowingly inflict. The problem with neurological conditions is that the type of pain suffered often only shows in outward signs when it becomes really intolerable. So it may seem that there isn't really much pain at all, and people don;t have it checked -- many of us have found ourselves in this situation!
I'd see a vet that knowns about SM, or look for an experienced neurologist (www.cavalierhealth.org has a list of certified neurologists along with much info in SM). You could see if the people you are considering are listed.
Just to show how common SM is, 5 of my 7 cavaliers have it to some degree. If signs are seen that might indicate SM, it's best to explore the possibility further. Some of the meds, such as gabapentin. can transform the dog's life and is not that costly as generic forms are available.
Hope that helps and do let us know what happens next. It may be that your cavalier has some joint or spine issue causing the sporadic pain too, so that's why I'd recommend starting with a good vet.
The first question I'd have is, has anyone checked this cavalier for SM? The first port of call would be your vet, to check whether something else is potentially causing these occasional outbursts that would indicate pain. If nothing obvious explains the outbursts (spinal issues or joints), and given the high rate of SM in the breed, it would be best to then request a referral for at least, a clinical exam by a neurologist (an exam in the office, without an MRI, which is more costly). Neurologists can do a variety of checks to se if there are symptoms of SM that may bot be obvious to either a vat or an owner. This includes assessment of pain, as many owners and vets will not understand the subtle signs that indicate the dog is living with a degree of chronic pain without showing a lot of obvious signs.
The short answer is, it is almost always important to treat SM if there are any outward signs of pain, no matter how sporadic. Many dogs will suffer day in and out from things that do not show as obvious pain (severe headaches are the most common symptom in humans with SM and dogs cannot really show a headache -- nor do most people 'see' headaches in other people, for that matter). There are a range of medications that can hugely increase the daily quality of life for a dog. Occasional breakthrough pain generally would suggest perhaps this cavalier lives with some chronic pain which occasionally becomes severe enough to cause an obvious outward show.
I cannot stress enough how important it is to talk to a professional if there is even a suspicion of SM. SM in humans is widely considered the single most painful affliction known in medicine. To leave any living creature to endure it is a cruelty that I know any caring owner would not knowingly inflict. The problem with neurological conditions is that the type of pain suffered often only shows in outward signs when it becomes really intolerable. So it may seem that there isn't really much pain at all, and people don;t have it checked -- many of us have found ourselves in this situation!
I'd see a vet that knowns about SM, or look for an experienced neurologist (www.cavalierhealth.org has a list of certified neurologists along with much info in SM). You could see if the people you are considering are listed.
Just to show how common SM is, 5 of my 7 cavaliers have it to some degree. If signs are seen that might indicate SM, it's best to explore the possibility further. Some of the meds, such as gabapentin. can transform the dog's life and is not that costly as generic forms are available.
Hope that helps and do let us know what happens next.
It may be that your cavalier has some joint or spine issue causing the sporadic pain too, so that's why I'd recommend starting with a good vet.Where we are at so far is we took her to the vet recently because she bit her left hind leg to the point of being raw, they said it was contact dermatitis. We discovered the heart murmur then. (Really thankful she had the dermatitis because she just had her yearly check up in February so we wouldn't have known for a while.) When we brought her to a week check-up on the skin issue I brought him info on SM and during the first episode I had a table of when she exhibited pain responses and what she was doing at that time, so I brought that as well. He said I should go to a neurologist but didn't give a referral, he said we didn't need one for the place he recommended. And I made sure it wasn't a side effect of the steroids or antibiotics since her second episode occurred during the week between the skin check-ups. I'm glad you let me know that there can be pain that isn't obvious I thought it would be obvious, that will make my mom more willing to see a neurologist for her.
ByFloSin
Well-known member
Cavaliers are such stoic little dogs. They can tolerate a great deal of pain or discomfort without showing any outward signs. The fact that your Cavalier fails to show outward signs of pain on a daily basis, does not mean that she is not suffering from it.
My boy Rebel was diagnosed almost 6 years ago, without any symptoms, when I took him for a routine MRI scan. I was given prints of the scan, which I showed to my vet, who made a note of his evaluation. A couple of years later he did show signs of severe pain, so we went back to the vet so that he could be prescribed the appropriate medicines to relieve the symptoms. He has progressed up the scale since then, because this is a progressive disease for which there are treatments to relieve the symptoms, but not the disease, as you asked.
I would say yes there is a very definite point in treatment for the symptoms and not the disease. I have the pleasure of being with and sharing love and companionship with Rebel, despite the treatment he is receiving and the adjustments I need to make to his medications when pain becomes severe. These episodes are short lived and very few and far between I must say, so I do not feel guilty or selfish in continuing with treatment for what is after all an incurable and progressive disease.
Rebel is one of my four Cavaliers of both sexes and varying ages, so please do not think I am being selfish or clutching at straws by treating what you may see as a hopeless cause because you think I need a dog to love, no matter what the price. This is very far from the truth and I think you should start to think the same way. You have a dog as a pet to love and hopefully to be part of your family and lifestyle, which all my dogs over the past 40 years or so have been. If one of those dogs presents with a disease or injury which is terminal and causing undue suffering, then the decision has to be made to euthenase for the good of the dog. If the dog presents with something progressive but with controllable symptoms, then you utilise all the skills and expertise of the veterinarians to give that dog a comfortable and happy life until the time comes when he either dies or his condition becomes untreatable.
Please do not think that I am criticising you in any way or talking down to you. Far from it. I am just trying to rationalise all that needs to be considered when facing a disease such as SM.
By the way, I have had Cavaliers for 31 years now, usually in fours or fives at any one time. Several years ago I bred and kept a bitch who I think showed symptoms of SM at round about 13 years of age. Nobody had ever heard of SM at that time and some six months later she had poor quality of life so was euthanased. The only other dog I have had in all that time, including those of the 8 litters I bred, only Rebel has been diagnosed with SM. I prefer to remain optimistic about this disease and hope that the longer research continues the earlier either a retardent or a cure will be found, not to mention a genetic test for breeding stock to prevent sufferers ever being born.
My boy Rebel was diagnosed almost 6 years ago, without any symptoms, when I took him for a routine MRI scan. I was given prints of the scan, which I showed to my vet, who made a note of his evaluation. A couple of years later he did show signs of severe pain, so we went back to the vet so that he could be prescribed the appropriate medicines to relieve the symptoms. He has progressed up the scale since then, because this is a progressive disease for which there are treatments to relieve the symptoms, but not the disease, as you asked.
I would say yes there is a very definite point in treatment for the symptoms and not the disease. I have the pleasure of being with and sharing love and companionship with Rebel, despite the treatment he is receiving and the adjustments I need to make to his medications when pain becomes severe. These episodes are short lived and very few and far between I must say, so I do not feel guilty or selfish in continuing with treatment for what is after all an incurable and progressive disease.
Rebel is one of my four Cavaliers of both sexes and varying ages, so please do not think I am being selfish or clutching at straws by treating what you may see as a hopeless cause because you think I need a dog to love, no matter what the price. This is very far from the truth and I think you should start to think the same way. You have a dog as a pet to love and hopefully to be part of your family and lifestyle, which all my dogs over the past 40 years or so have been. If one of those dogs presents with a disease or injury which is terminal and causing undue suffering, then the decision has to be made to euthenase for the good of the dog. If the dog presents with something progressive but with controllable symptoms, then you utilise all the skills and expertise of the veterinarians to give that dog a comfortable and happy life until the time comes when he either dies or his condition becomes untreatable.
Please do not think that I am criticising you in any way or talking down to you. Far from it. I am just trying to rationalise all that needs to be considered when facing a disease such as SM.
By the way, I have had Cavaliers for 31 years now, usually in fours or fives at any one time. Several years ago I bred and kept a bitch who I think showed symptoms of SM at round about 13 years of age. Nobody had ever heard of SM at that time and some six months later she had poor quality of life so was euthanased. The only other dog I have had in all that time, including those of the 8 litters I bred, only Rebel has been diagnosed with SM. I prefer to remain optimistic about this disease and hope that the longer research continues the earlier either a retardent or a cure will be found, not to mention a genetic test for breeding stock to prevent sufferers ever being born.
I know you said you aren't talking down, but I still feel the need to defend myself. I, myself, believe there is a point in helping dogs with SM via medication. I've done a fair amount of research on the disease since her first 'noticeable' episode. Unfortunately, she is a family dog so my parents pay for all of her care and they just don't see the point in even taking her for a neuro consult. That's why I started the thread so I could see if there was a better way to explain it to them. We both thought they don't need medicine unless they are outwardly showing symptoms on a day-to-day basis. I know see that isn't the case, but she is still hard to convince. However, now that I see they may show signs we aren't aware of I find it even more crucial to get her in for a neuro consult and go from there. If it were up to me she would have been seen at the first episode, so we could at least establish a baseline.
I'm currently attending university and have a very sick horse that has had probably 15 appointments since the beginning of the year, none of which were routine and we still can't figure out what's wrong (meaning more appointments must be scheduled) . Therefore I really can't afford to step up and pay for her care when she's the family dog. I'll see what I can do though because it appears my parents are unwilling to even get a neuro consult, even after showing the response by Karlin on this thread. Luckily she's insured so I won't have to pay for all of it, hopefully if they dont find a reason to deny her.
ETA: I submitted this part earlier and it said it was pending approval but I will go ahead and post it anyways since for some reason this comment didn't need approval. Right now where we are at is we had an appointment a little over two weeks ago because she bit her left rear leg raw. They diagnosed it as contact dermatitis. That is when we found the heart murmur. Then we had her week check up and I brought info on syringmyelia and her "yelp log" (basically during the first episode I recorded when she exhibited pain and what she was doing at that time) and he said a neuro would be a good idea.
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Kate H
Well-known member
At the moment, sadly, all most of us can do is deal with the symptoms until the large amount of research being carried out comes up with a genetic test. But the symptoms can be very subtle - which is why breeders with a large number of dogs living in kennels cannot say definitively that none of their dogs show symptoms of CM/SM; many of the symptoms can only be picked up when you live together in close proximity 24/7. Oliver's first symptoms were squinting in bright light (both sun and fluorescent lighting) and being a restless sleeper; Aled - also with CM/SM - squints as well. Oliver has never scratched very much, his main problem has been headaches; now aged 13, he is beginning to show other signs of pain/discomfort. You (people generally, not you in particular!) can try ignoring CM/SM in your dog but it isn't going to go away, it will progress to a greater or lesser extent. Personally I'm not convinced that there is any such thing as a Cavalier with CM/SM who is asymptomatic - I think us dim humans just don't pick up all the subtle signs of pain. Anyway, if you can persuade your mother to talk to a neuro,you may find that your Cavalier doesn't have SM at all - it's possibly disk problems, arthritis or similar. So seeing a neuro is a win-win situation - if it's SM your dog starts getting treatment for the pain it causes, and if it isn't SM your mind is set at rest and you can explore other avenues.
Hope you can get it sorted,
Kate, Oliver and Aled
Hope you can get it sorted,
Kate, Oliver and Aled
I think your vet has made a good suggestion (the vet is right, you don't always need a referral; some places want one and others don't).
I think it is worth a clinical exam if you can manage it -- to me the most telling of the things you mention is your cavalier's wariness now of getting up on the sofa and therefore remaining on the floor. That's a sign of pain from the kinds of movement that would once not have offered any problems to a dog. This alongside the other things would raise suspicions. Hopefully a clinical visit to a neuro could answer your questions and your mom would be able to try some of the basic daily meds for SM.
One thing too is that it's easy not to notice changes in a dog with this condition as they often happen gradually as the condition progresses. Dogs can actually slowly come to bear a considerable amount of pain because of this, according to one US neurologist I spoke to a couple of times.
I'm sorry to hear you are also having such problems with your sick horse; illness especially when undiagnosed is so distressing in the animals we love.
I don't think any offence was intended by anyone on the thread; sometimes I know those of us who have managed dogs through this condition, especially for years, can come across strongly! But we do ll have the same end result at heart -- better knowledge of a confusing condition and the right help for any animal in pain/\.
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I think it is worth a clinical exam if you can manage it -- to me the most telling of the things you mention is your cavalier's wariness now of getting up on the sofa and therefore remaining on the floor. That's a sign of pain from the kinds of movement that would once not have offered any problems to a dog. This alongside the other things would raise suspicions. Hopefully a clinical visit to a neuro could answer your questions and your mom would be able to try some of the basic daily meds for SM.
One thing too is that it's easy not to notice changes in a dog with this condition as they often happen gradually as the condition progresses. Dogs can actually slowly come to bear a considerable amount of pain because of this, according to one US neurologist I spoke to a couple of times.
I'm sorry to hear you are also having such problems with your sick horse; illness especially when undiagnosed is so distressing in the animals we love.
I don't think any offence was intended by anyone on the thread; sometimes I know those of us who have managed dogs through this condition, especially for years, can come across strongly! But we do ll have the same end result at heart -- better knowledge of a confusing condition and the right help for any animal in pain/\.
The first couple of posts people make are automatically held pending approval to help manage spam on the board.
Thank you, I will definitely keep everyone updated. Any tips on how best to prepare for the neuro appointment?
I was able to get a video of her fly catching. After the 20 sec mark she started to do it again but I didn't get it on video. Sorry for the bad quality, it's from my phone, which isn't a smartphone. She'd been doing it off an on most of that morning.
Here's a link if that didn't work:
https://www.youtube.com/watch?v=yKAjxCBHW2k
I have more videos of her scratching and biting her back paws, and another showing the fly catching but I think one video is enough. I'm sure everyone's seen thousands of SM videos.
I was able to get a video of her fly catching. After the 20 sec mark she started to do it again but I didn't get it on video. Sorry for the bad quality, it's from my phone, which isn't a smartphone. She'd been doing it off an on most of that morning.
Here's a link if that didn't work:
https://www.youtube.com/watch?v=yKAjxCBHW2k
I have more videos of her scratching and biting her back paws, and another showing the fly catching but I think one video is enough. I'm sure everyone's seen thousands of SM videos.
Well...it's update time for the neuro appt!
I only got to see two residents and not the actual neurologist which was kind of annoying but it seemed like they were very thorough and knew what we were doing. The appt ended up being almost 5 hours! Though I left for the ultrasound part so only 3 hr appt for me.
So they did their neuro exams and the only things that were not normal was that for her right rear leg the femoral pulse was really weak, left one was normal. Also they did the paw positioning test (where they bend the paw and they should immediately want to put it back to normal). For that all legs were normal, except once again, her right rear leg. They did the test multiple times and she never wanted to make her leg correct except once and it took 20 seconds.
She also expressed pain in her mid back region and neck but it took quite a bit of pressure to get a painful response.
They ended up doing an ultrasound on her pelvic region to make sure her artery didn't have a clot or something. It checked out normal, but they did notice some foreign material in her stomach so that's something to keep an eye on esp since she did vomit a couple of times last week.
Also ran a lot of blood work and urinalysis which should be back tomorrow.
As far as the SM, she said 95% of cavaliers have it but I think she meant the CM not SM since the highest estimate for SM I've seen is 70%. I didn't correct her though because it meant she thought it was prevalent and wouldn't dismiss it like other vets. She said since she doesn't seem that bad that we could wait and she wants to see her again in 6 mos now that we have a baseline for the pain.
However, this thread has made me worried since the symptoms are so subtle. You guys also said that cavaliers can come to bear a lot of pain since it's progressive and that they are so stoic.
She said we could do an MRI or start on meds, but it would be better to postpone meds if we can. I just don't want her to be in pain since she displays so many of the SM symptoms and prolonging any suffering esp if she is being stoic about it. That was only after asking her if that would be a better course of action, so the resident vet seems to think waiting for 6 mos is best.
But I'm worried about delaying if she is in pain and the vet seemed to think she would definitely have an MRI that would show the occipital whatever-( CM?).
And yeah she's had only two major episodes but like you guys said on the thread it's likely we're just not noticing the subtle symptoms in between and that it's chronic but only intolerable during the episodes.
So my options are:
1)Wait 6 mos and go from there
2) start meds (she said prednisone and omeprezole which doesn't follow clare rusbridge's protocol, well the omepreozle does)
3) get MRI, see what we see and probably medicate
I have no idea what to choose! If our insurance for some reason refuses to cover the MRI I'd definitely wait or medicate. If they cover it though it would only be 500-600 at a max we'd have to cover which isn't that bad and it might be nice to see what's going on.
She's always been kind of itchy so I guess that's something she displays during the in-between period.
But she displays all of these:
-scratching (even till raw but was diagnosed as contact dermatitis she bit her left rear leg)
-pain for no reason and at light touches (anywhere on her body)
-weakness in limbs (not wanting to jump on couch and the right rear leg issues)
-feet licking
-tiredness and lethargy (this has been her whole life though she sleeps pretty much the whole day, we thought she was just taking cues from our 14 y/o hind end paralyzed westie who sleeps most the day away)
-fly-catching, head shaking and lip licking
-head rubbing
When she's affected it seems like its not long in duration but quick in frequency. i.e. 20 sec of scratching, stopping few seconds later 20 sec of scratching. longest duration of nonstop has been like 1 min.
I only got to see two residents and not the actual neurologist which was kind of annoying but it seemed like they were very thorough and knew what we were doing. The appt ended up being almost 5 hours! Though I left for the ultrasound part so only 3 hr appt for me.
So they did their neuro exams and the only things that were not normal was that for her right rear leg the femoral pulse was really weak, left one was normal. Also they did the paw positioning test (where they bend the paw and they should immediately want to put it back to normal). For that all legs were normal, except once again, her right rear leg. They did the test multiple times and she never wanted to make her leg correct except once and it took 20 seconds.
She also expressed pain in her mid back region and neck but it took quite a bit of pressure to get a painful response.
They ended up doing an ultrasound on her pelvic region to make sure her artery didn't have a clot or something. It checked out normal, but they did notice some foreign material in her stomach so that's something to keep an eye on esp since she did vomit a couple of times last week.
Also ran a lot of blood work and urinalysis which should be back tomorrow.
As far as the SM, she said 95% of cavaliers have it but I think she meant the CM not SM since the highest estimate for SM I've seen is 70%. I didn't correct her though because it meant she thought it was prevalent and wouldn't dismiss it like other vets. She said since she doesn't seem that bad that we could wait and she wants to see her again in 6 mos now that we have a baseline for the pain.
However, this thread has made me worried since the symptoms are so subtle. You guys also said that cavaliers can come to bear a lot of pain since it's progressive and that they are so stoic.
She said we could do an MRI or start on meds, but it would be better to postpone meds if we can. I just don't want her to be in pain since she displays so many of the SM symptoms and prolonging any suffering esp if she is being stoic about it. That was only after asking her if that would be a better course of action, so the resident vet seems to think waiting for 6 mos is best.
But I'm worried about delaying if she is in pain and the vet seemed to think she would definitely have an MRI that would show the occipital whatever-( CM?).
And yeah she's had only two major episodes but like you guys said on the thread it's likely we're just not noticing the subtle symptoms in between and that it's chronic but only intolerable during the episodes.
So my options are:
1)Wait 6 mos and go from there
2) start meds (she said prednisone and omeprezole which doesn't follow clare rusbridge's protocol, well the omepreozle does)
3) get MRI, see what we see and probably medicate
I have no idea what to choose! If our insurance for some reason refuses to cover the MRI I'd definitely wait or medicate. If they cover it though it would only be 500-600 at a max we'd have to cover which isn't that bad and it might be nice to see what's going on.
She's always been kind of itchy so I guess that's something she displays during the in-between period.
But she displays all of these:
-scratching (even till raw but was diagnosed as contact dermatitis she bit her left rear leg)
-pain for no reason and at light touches (anywhere on her body)
-weakness in limbs (not wanting to jump on couch and the right rear leg issues)
-feet licking
-tiredness and lethargy (this has been her whole life though she sleeps pretty much the whole day, we thought she was just taking cues from our 14 y/o hind end paralyzed westie who sleeps most the day away)
-fly-catching, head shaking and lip licking
-head rubbing
When she's affected it seems like its not long in duration but quick in frequency. i.e. 20 sec of scratching, stopping few seconds later 20 sec of scratching. longest duration of nonstop has been like 1 min.
ByFloSin
Well-known member
Just because I have one dog with diagnosed CM/SM it doesn't make me an expert on symptoms, diagnosis or treatment of either complaint, but something makes me feel uneasy here about your very lucid account of tests and symptoms by the neuro. residents. What I can tell you without a shadow of a doubt is that the one sure day of diagnosing SM is to perform a MRI scan. This is what I would do, if I had the means to pay for it if the insurers did not.
Kate H
Well-known member
Rather an unsatisfactory visit, which is frustrating for you! ' it would be better to postpone meds' rather raised my eyebrows. CM/SM is not like MVD, where you don't medicate until the dog goes into heart failure or shows serious symptoms. Starting gabapentin will often clarify whether neurological pain is present by dealing with it. It has no side effects except possibly a couple of weeks of drowsiness at the start, and is considerably cheaper than prednisone (which is a refined version of gabapentin). 100mg twice or three times a day may well deal with a lot of your girl's symptoms and be a good indicator of the presence of CM/SM. Though, as Flo says, the only 100% way of finding out is an MRI. One of Oliver's early symptoms was stumbling going up kerbs because he lost nerve sensation in one front leg (I do exactly the same thing myself now, and yes, I'm on gabapentin too!); he's now, many years later, lost it in both hind legs, though his front legs, fortunately, are now fine.
Hope you can get it sorted,
Kate, Oliver and Aled
Hope you can get it sorted,
Kate, Oliver and Aled
RodRussell
Well-known member
Pokey5876, this is a really interesting report you have given us, from the resident neuros. It is a dilemma which I have imagined -- get an MRI scan or just assume that SM medications would indicate some sort of relief? My first concern would be whether the dog is in pain. MRIs are the gold standard to determine if the dog has SM, but MRIs do not confirm pain or its extent. (Yes, I know that the more extensive the syrinx, the likelihood of the worse the pain.) And, lack of confirmation of SM does not assure no pain if the dog has just CM. And, since such a high percentage of cavaliers have CM, what would an MRI prove (unless it showed no CM)?
If a CKCS has clear signs of pain, I have wondered about experimenting with an anticonvulsant, like gabapentin, or an NSAID, to see if the pain signs diminish.
I think with the symptoms you describe, and their obsessiveness, I would opt for experimenting with the medication now, and carefully document the apparent results.
If a CKCS has clear signs of pain, I have wondered about experimenting with an anticonvulsant, like gabapentin, or an NSAID, to see if the pain signs diminish.
I think with the symptoms you describe, and their obsessiveness, I would opt for experimenting with the medication now, and carefully document the apparent results.
Love my Cavaliers
Well-known member
For some reason I haven't weighed in on this discussion before, but Oz, my youngest, just recently started on gabapentin 100 mg 3 times a day based solely on his symptoms and a thorough neurological exam. He was 7 years old July 1. His symptoms were scratching more than all 3 of my other dogs put together, yelping when being touched, but not often, being very sensitive around his ears, and obsessive licking. The obsessive licking could be related to his inflammatory bowel disease. I trust his neuro completely because I have another dog with severe SM who he has treated for the last 6+ years.
I would start your dog on a trial of gabapentin now - not prednisone. Prednisone makes everything seem better so it wouldn't really be a fair trial. Oz is so much better since he started on gabapentin. He still scratches (less), but he doesn't yelp as much and is not as sensitive to touch. The licking unfortunately has not decreased, but I really think that's more associated with his IBD. He's only been on it a short while now - he hasn't even had his first follow-up appt. That will happen in November. I saw no need for an MRI as he so clearly displayed SM symptoms on the neuro exam. Riley, my other SM dog, has severe weakness in several of her legs and was not able to jump either before or after her SM surgery. Sometimes, she can barely stand or sit. So, with your dog's symptoms, I would say go for the meds now. As everyone has said, these dogs don't show their pain until it is so severe. There's no harm in starting her on a trial of gabapentin. I wish I had started Oz earlier, but I was dealing with his IBD for so long, I neglected his signs of SM.
Let us know what you decide. Good luck.
I would start your dog on a trial of gabapentin now - not prednisone. Prednisone makes everything seem better so it wouldn't really be a fair trial. Oz is so much better since he started on gabapentin. He still scratches (less), but he doesn't yelp as much and is not as sensitive to touch. The licking unfortunately has not decreased, but I really think that's more associated with his IBD. He's only been on it a short while now - he hasn't even had his first follow-up appt. That will happen in November. I saw no need for an MRI as he so clearly displayed SM symptoms on the neuro exam. Riley, my other SM dog, has severe weakness in several of her legs and was not able to jump either before or after her SM surgery. Sometimes, she can barely stand or sit. So, with your dog's symptoms, I would say go for the meds now. As everyone has said, these dogs don't show their pain until it is so severe. There's no harm in starting her on a trial of gabapentin. I wish I had started Oz earlier, but I was dealing with his IBD for so long, I neglected his signs of SM.
Let us know what you decide. Good luck.
RodRussell
Well-known member
I agree about the prednisone. I cannot understand the obsession of so many vets with pred (steroids in general, actually). It does so much damage in so many ways. It unquestionably is the drug of choice if the dog has an immune-mediated disease, like masticatory muscle myositis. But short of the dog having a whacked-out immune system, pred makes no sense to me.