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**KEY ISSUES: MVD, syringomyelia, patellas/eyes/hips

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Karlin

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Cavaliers, like almost all purebred dogs, have some breed-specific health issues to watch out for. These are particularly prevalent in the breed:

1) Mitral Valve Disease (MVD) -- a potentially serious heart valve condition which will eventually affect nearly all cavaliers (50% will have a murmur by age 5), though in most cases it is a mild form, and appears when the dog is older, and may not ever require medication. Several medications are available and are generally easy to give.

2) Luxating patellas, hip dysplasia and eye problems

3) Syringomyelia -- another potentially very serious condition caused by a skull malformation where the skull is too small for the brain. This forces the brain to protrude through the base of the skull into the opening for the spinal cord. The fluid that normally circulates around the brain and down the cord gets blocked, causing rising fluid pressure which in turn can create pockets of fluid (syrinxes) in the spine. This often has neurological effects and can produce great pain.

All cavalier owners need to know about MVD as it will eventually affect nearly every cavalier. Also, evidence is that most cavaliers have the skull malformation that can cause pain on its own and potentially cause SM; breed health surveys are showing a worryingly high level of incidence of SM (around 70% eventually will have it). However, a lower percentage of cavaliers seem to be symptomatic for SM, and thus many seem to live with the condition without it outwardly affecting them. Also it is good that these are all known issues to watch out for, and in two cases (MVD/mitral valve disease, and patellas/eyes/hips), the symptoms and treatment choices are well understood and documented.

The negative side is that two of the three can be very serious, and syringomyelia is poorly understood, has no cure and limited treatment options. Research is underway to try and find a genetic marker for the condition so that in future, breeders can breed away from SM. You can get more informatiion on SM in cavaliers at http://www.smcavaliers.com and www.cavalierhealth.org.

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Here is more detailed information on each condition:


MVD - mitral valve disease
Acquired degenerative valvular disease is the most common cardiac disease in the dog, with the mitral valve most often affected. MVD can result in progressive cardiac enlargement and congestive heart failure. Symptoms can include shortness of breath, coughing, fainting and exercise intolerance. Heart medications, diet and weight management can give years of good quality life for Cavaliers living with MVD. Although MVD is very common in elderly small breed dogs, in the case of Cavalier King Charles Spaniels, the disease has an earlier onset and a faster progression. Studies indicate that 50% of Cavaliers aged 5 and older have MVD, with nearly 100% affected by the age of 10. These statistics are the same for lines from American, English, Irish and European kennels. Cavaliers with MVD exhibit heart murmurs, which are graded I to VI depending on the intensity. Some regular veterinarians have difficulty hearing low grade murmurs, which is why breeders and owners use board certified veterinary cardiologists to listen for murmurs.

It is currently the most serious and prevalent disease in the breed. In advanced stages it can lead to heart failure and death. If a breeder does not seem to know much about it, is unwilling to share information with you, claims the tests unreliable, or tries to tell you their dogs don't get it, find another breeder. Responsible breeders try to delay the onset and severity of MVD by screening ALL of their breeding stock for this condition, using a veterinary cardiologist or the OFA*. Ask to see certificates. Look closely at the date of the examination, as the clearance is only good for one year. The certificate should state that the dog is clear. If they cannot or will not show you the certificates, find another breeder. NB: A VET CLEARANCE IS NOT ADEQUATE. No reputable breeder will try to convince you that it is. Vets generally are poor at detecting early murmurs and only a cardiologist clearance is considered acceptable.

Places to find more information on MVD:

MVD & cavaliers:
http://www.premiercavalierinfosite.com/mitralvalvedisease.htm
http://www.backcsc.com/heart.html

Living with MVD:
http://www.ckcsc.org/ckcsc/ckcsc_inc.nsf/Founded-1954/mvd.html

Health and care:
http://www.ckcsc.org/ckcsc/ckcsc_inc.nsf/Founded-1954/mvdhc.html

Detailed info on tests, care and prevention: http://www.cavaliertalk.com/phpBB2/viewtopic.php?t=561

Canine heart disease:
http://www.nhahonline.com/k9cardiology.htm

Cavalier MVD support group: http://uk.groups.yahoo.com/group/mvdincavaliers/

*The OFA doesn't do any heart screening but is just a database where results can be posted.

Many may not realise that the CKCS club breeding protocol on MVD, now widely recommended across all the worldwide CKCS breed clubs (and in some cases, like Sweden, an actual requirement for breeding) was only brought in in 1998. This was at the CKCS USA club's symposium on MVD, which considered the results of studies by researchers on thousands of cavaliers. Out of that came the recommendation many will be familiar with: to only breed dogs when they reach age 2.5 minimum, and have been certified heart clear AND if their parents were heart clear at age 5. Otherwise, it is advised not to breed any cavalier of unknown heart history until age 5, and only if it is murmur-free (certified by a cardiologist, not a vet, as vets are known to be poor at picking up murmurs until they are fairly serious. See: http://board.cavaliertalk.com/showthread.php?t=8737 ).

There is an abridged transcript of the proceedings here: http://www.ckcsc.org/ckcsc/formsdocs.nsf/filelookup/98heartsymp.PDF/$file/98heartsymp.PDF

It's an important piece of cavalier history and also might help people better understand the issue of MVD (mitral valve disease) in the breed.

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Eyes, hips, patellae (kneecaps)

Some of the common eye problems in Cavaliers are retinal dysplasia, corneal dystrophy and cataracts. Breeders screen their breeding stock through CERF. Ask to see the certificates. Again, they are only good for one year.

Hips- Many breeders also test for hip dysplasia. Breeders can test through either the OFA or PennHip. Hips should be rated fair, good or excellent.

Patellae (kneecaps) - Patellar luxation is also sometimes seen in Cavaliers. It is a condition where the kneecap (patella) pops out of place causing discomfort. Breeders clear their stock either by a regular veterinarian (this is the ONLY test that can be done by a regular vet) or by the OFA.

For more information:
http://www.offa.org/ Orthopedic Foundation For Animals

http://www.premiercavalierinfosite.com/hipdysplasia.htm

http://www.premiercavalierinfosite.com/patellarluxation.htm

http://www.italiangreyhound.org/patella.html

http://www.premiercavalierinfosite.com/eyeproblemsofconcern.htm

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Syringomyelia

A condition in which the back of the skull is too small, forcing the brain into the opening for the spinal cord, which in turn impedes the flow of the cerebro-spinal fluid (CSF) that flows around the brain and spinal cord. Pressure caused by this blockage creates fluid pockets known as a syrinxes. Research on syringomyelia is still in the early stages. The most common symptom is scratching at the neck/shoulder (often not touching the skin), especially when the dog is excited or on a lead, although no skin or ear problems are present. Many dogs are also sensitive in the neck, shoulders and/or limbs, and some cry or yelp for no apparent reason. Other symptoms include scoliosis (curvature of the neck/spine), sudden collapse or paralysis and a wobbling gait. The condition is believed to be polygenetic (carried on several genes, which must combine in a particular way to produce the condition.

There currently is no prevention or genetic screening breeders can perform though there is a detailed breeding protocol designed to assist breeders:

http://sm.cavaliertalk.com/breeding/breeding/breeding.html

The only way to definitively diagnose the condition is by MRI. Treatments include steroids and other medications to manage pain, and medications like Lasix (frusemide/furosemide) to lower CSF pressure, and for more severe cases, surgery may be recommended. Dr Clare Rusbridge, a leading SM researcher in the UK, believes SM genes to be widespread in all cavalier lines (ie all lines have large numbers of carrier dogs though these may not themselves be affected) and unfortunately describes the condition as "increasingly common". All cavalier owners should be aware of the symptoms, which typically present between 6 months-3 years but can develop at any age. Some 35-70% plus of asymptomatic cavaliers in research samples have some degree of SM so it is likely to be widespread in the breed -- research studies are showing this ratio to be fairly consistent.

From ACKCS article: "Veterinary neurologist, Clare Rusbridge, and her team are conducting research into this condition and have found that 13 out of the 24 top stud dogs since 1998 have sired affected progeny. It is found in all colours, in all lines, and affects both sexes."

For more information:

CKCS Syringomyelia InfoSite: http://www.smcavalier.com

Podcast: introduction to SM by Dr Clare Rusbridge: http://sm.cavaliertalk.com/rusbridge.mp3

SM researcher Clare Rusbridge's key explanatory paper:
http://www.cavaliersonline.com/health/syringoinfo.htm

UK CKCS Club articles and links:
http://www.thecavalierclub.co.uk/syringo/syringo.html

ACKCS article:
http://ackcsc.org/syringoarticle.html

Discussion group:
http://groups.yahoo.com/group/CKCS-SM/

Support group:
http://groups.yahoo.com/group/CKCS-SM-support

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Important note on cavaliers that seem to exhibit LOW BLOOD PLATELET or WHITE CELL COUNTS!!

There is a common Cavalier condition (in 30-50% of Cavaliers) called idiopathic (because they don't know the cause) symptomless thrombocytopenia. The key word here is "symptomless." These Cavaliers do not need any treatment! Here are some articles to print out to give your vet. If a blood test for a cavalier comes back indicating low platelet or white cell counts, tell your vet they MUST do a hand count of the cells because of this condition in some cavaliers.

http://ackcsc.org/health/cavalierplateletissues.pdf

This is from the above article, and explains what this is:

Notes from the Educational Program 8/7/01 Presented to CKCS Club of Greater Atlanta “Asymptomatic thrombocytopenia and Macrothrombocytosis in the Cavalier King Charles Spaniel� By Club Member Dr. Kim Hamer, DVM

Terminology: 1. Platelets are also called thrombocytes. These are the blood cells that are responsible for normal blood clotting. 2. Thrombocytopenia is an abnormally low blood platelet count. 3. Macrothrombocytes are abnormally large blood platelets.

Normal blood platelet counts should be between 150-200,000. Dogs will have bleeding abnormalities if their counts are below 40,000. However, Cavaliers may have counts well below 40,000 with no problems. Approximately 30% of Cavaliers have macrothrombocytosis and/or thrombocytopenia.

This appears to be a congenital abnormality. The Cavalier does not experience any health problems despite these changes. It is thought that the large platelets of the Cavalier are able to provide the same function in lower numbers than that of other breeds. Because Cavalier platelets are so large, automated cell counters may mistakenly count them as white blood cells, artificially lowering the platelet count. Additionally, these cells may not be recognized when examined under the microscope on a blood smear because they may not look like the platelets of other breeds.

This condition should not be confused with immune-mediated thrombocytopenia, where the body attacks its platelets. Dogs with this disorder will be having SYMPTOMS: i.e. petechiae, bruising and bleeding. Remember, the Cavalier does not experience any health problems due to this condition, which has only been reported in our breed and no others!

Kim Hamer D.V.M. DeKalb Animal Hospital, (770) 938-3900

More info:

http://cavalierhealth.org/platelets.htm

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NB: If you are reading a printed version of this cavalier health issues article, and want to find it on the web so you can easily click through on the links, it is here:

http://board.cavaliertalk.com/showthread.php?t=8701
 
Cavalier Health on Twitter

The www.cavalierhealth.org site is now on Twitter: @cavalierhealth

The site keeps regular updates on cavalier health research and locations an times of various health clinics where cavalier owners can get heavily discounted heart auscultations etc, and I am sure this type of information will feature on @cavalierhealth Twitter updates. (y)

You can go to www.twitter.com/cavalierhealth to read posted updates or you can create your own Twitter account and 'follow' cavalierhealth.

I recommend using Tweetdeck (www.tweetdeck.com) to manage Twitter accounts if you have your own account or follow several people.
 
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