When we got the estimate for Rory's surgery, they took off the cost of the MRI (since we'd already had it through the NCSU study) but told me it normally is $1300 which is still a ton of money, but much less than here at UC DAvis. Although I'm not entirely sure that $1300 includes anesthesia... that would make a difference I think.
Yes - it seems more and more neurologists are able to diagnose SM by symptoms alone. Unfortunately, this is probably due to the increase number of cases in Cavaliers that they are seeing.
Some on the AC list have said that you MUST have the MRI to know how advanced or serious the disease is, but I don't know how correct this is. Many of the dogs have very large syrinxes or herniation of the cerebellum, but no symptoms! And then there are the dogs w/ terrible pain, but no syrinxes!! So I'm not sure what use the MRI has in these instances. There often is no correlationo between the symptoms and the size of the syrinxes. In my mind, how the dog feels is much more important than what it looks like on an MRI.
Basically -- all to say that I don't think an inability to get an MRI should prevent anyone from seeking treatment for their dog. If you are confident your dog has the classic SM symptoms or even if you just strongly suspect it, there is no reason you can't try any of the various medical or holistic approaches towards relieving pain. an MRI is needed if you want to pursue surgery -- they have to know whether or not it's operable and would the surgery relieve symptoms? (for example - i know of a dog with terrible syrinxes and pain, but not the bone deformity, so removing the occipital bone probably wouldn't provide any relief for this dog.)
Penny - I think if you are concerned that Chaucer's pain could be SM, it might be worth it to try the lasix (Furosemide) or maybe acupuncture or something like that to see if it relieves his pain. Non-steroidal anti-inflammatories would probably help, too, but this won't give you any clue if it's SM. If he responds to the lasix, there's a very high likelihood that it's SM. I'm not sure of any back problems that would resolve by administering a diuretic, but many dogs with SM get relief from this treatment. That way you will know what you're dealing with (hopefully) and have a better idea of how to treat it and provide relief for Chaucer.
Keep in mind, however, that if he does not respond to the Lasix, this doesn't rule out SM as not all SM dogs respond positively to the lasix therapy.
Very sorry to hear Chaucer and you have had such a rough year!
Dogs are not our whole life, but they make our lives whole.