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PSOM--second surgery?


Well-known member
Barkleigh has PSOM and had a very successful surgery (from sudden stone deafness) at the U. of Florida vet school--an amazing place! He was 6 then and just turned 10. His hearing declined steadily over the next 4 years, even though he gets medication (allergy meds) daily. He also has a B2 murmur, which has not changed in 2 years. Now he is hardly hearing at all, not even our clapping. He's pretty good with hand signals but is acting quite differently, moping, has to be coaxed to go outside, avoiding walks, and might be in pain. Of course the vet will be evaluating him thoroughly next month. We DO have good vet insurance and I am considering another PSOM surgery if it would improve his quality of life. I know that more than one is often needed. (He could also use some dental work, although until now his teeth have been excellent, but he has some problems. I am a big teeth brusher!)

Just wondering if anyone has done 2 surgeries or has a comment on doing it with the MVD. I hate to see this usually chipper, adorable little guy lose his zest for life.
I've never dealt with PSOM, but deafness in older Cavaliers is common, even without PSOM. My Oliver went more or less completely deaf, getting gradually worse from about the age of 8; he could still go off-lead on walks and I handled him as much as possible to make up for not being able to talk to him, but he did get rather withdrawn, living in a silent world of his own - it is such a huge disability for a dog, though easier to live with for a younger dog. In his younger days Oliver would go into the garden every morning and sit listening to what was happening in the neighbourhood - what I called his morning news bulletin, so hearing was very important to him.

Kate and Ruby
Lucky only had one surgery but his PSOM was coming back before he died.

I'm not sure what a B2 murmur is and how it compares to Lucky's grade 4 (out of 6). I would probably not have had surgery on Lucky with is grade 4, but his first surgery was when he was a 2/3 murmur (Cardiologist okayed procedure and provided protocols) . For the quality of life and the pain Lucky was in, I'd absolutely have done a second surgery if the Cardiologist cleared it.
I'm not sure what a B2 murmur is and how it compares to Lucky's grade 4 (out of 6).

B2 is a stage of chronic degenerative valvular disease, and this references comes from the ACVIM Consensus Statement: Guidelines for the Diagnosis and Treatment of Canine Chronic Valvular Heart Disease. Using the classifications/stages from this paper gives a MUCH more definitive description of the stage of disease than giving the grade (I-VI) of a murmur, and this is very helpful when discussing a dog's situation with a vet or when making decisions about surgery or when to start medications. Here is a (cut and paste) quote from the paper defining stage B and B1 versus B2:

Stage B identifies patients with structural heart disease
(eg, the typical murmur of mitral valve regurgitation is
present), but that have never developed clinical signs
caused by heart failure. Because of important clinical
implications for prognosis and treatment, the panel
further subdivided Stage B into Stage B1 and B2.

Stage B1 refers to asymptomatic patients that have
no radiographic or echocardiographic evidence of
cardiac remodeling in response to CVHD.

Stage B2 refers to asymptomatic patients that have
hemodynamically significant valve regurgitation,
as evidenced by radiographic or echocardiographic
findings of left-sided heart enlargement.

Pat B.
Atlanta, GA