Sunday, January 9, 2011

Cavaliers Chiari Malformation and Syringomyelia - What Makes Sense and What Doesn't

When you type "Cavalier King Charles Spaniel and health" into Google or any search engine it doesn't take long to come across the terms Syringomyelia and Chiari Malformation. From there it takes no time at all to realize that this is *the* hot topic of discussion across many publications, forums, blogs, and email lists. There is *so* much information, research, debate, and yes controversy that many are often left more confused than when they started researching. There has also been a large divide that has been created between some breeders, researchers, and pet owners..always over the same things. What is being done, what isn't, who is in support, and who isn't.

I have been involved in working with Chiari Malformation and Syringomyelia for several years now. I have seen research studies start, and be completed. We have come a long way in understanding both conditions, yet we also still have a lot to learn. Research is continually evolving and changing. We are very lucky to have Professionals that do care enough to research and study our breed.

My involvement with our scanning program here has given me the unique opportunity to be in contact with many Cavalier owners and breeders all over the world. I have engaged in both debate, and discussion regarding many opinion and thought. I have viewed a ton of MRI images. I have listened to many heartbreaking stories. As I continue to view more MRI's, talk to both breeders and pet owners regarding results, discuss symptoms, and scan my own dogs, the more questions I have.

I will *always* be a huge supporter of research, MRI scanning, and following protocols, however I also believe in good old common sense.

The supporter of research, MRI scans of dogs, and following protocols part of me absolutely loves that there is being awareness and education brought to both CM and SM. I'm the first to step up and say donate to research. Scan your dogs. Talk about those dogs who have been impacted. Be transparent regarding MRI results. Without discussion and research there will never be any answers.

What we have found so far that does make sense.

* MRI scanning provides much needed support of research, and a greater understanding of breeding dogs. It enables breeders to make responsible breeding choices, and follow set out breeding guidelines in the attempt of reducing Syringomyelia in our beloved breed. The preliminary stats do seem to be favourable in improvement.

* MRIing is the only way to properly diagnose dogs showing symptoms. Neurological symptoms can be very similar between conditions and to know what really is going on with a dog having problems you have to MRI it.

* Much education and awareness has been brought to CM and SM. Pet owners are encouraged to do their research and support responsible breeding practices. Don't go out and buy that cute cavalier puppy in the pet store, or become involved in getting a rescue if you aren't ready to deal with a Cavalier who is likely going to have severe health problems.

The common sense and balance part of me knows that only the popular aspects of CM and SM are continually discussed, and that several of the questionable areas are always quietly swept under the rug.

I'd like to share some of what is hardly ever discussed, yet is happening all the time. Some of what just plain doesn't make sense.

* Clear of Syringomyelia dogs, or Cavaliers with a Grade of A on breed screening reports can be EXTREMELY symptomatic from Chiari Malformation pain.

Some of the most symptomatic Cavaliers I have met, are ones that have had beautiful clear MRI's. Yes even their CM is fairly mild. This is a subject near and dear to my heart as Mylee is one of them. When I first went through this with Mylee I thought she was a rare case. I now know that she is not, and that as we MRI more we are finding more Cavaliers just like her. She is a challenge to keep comfortable and pain free on the best of days. Yet both of her MRI's were beautiful with her second being *better* then the first. Would you like to buy a puppy from my A grade clear Cavalier who is on a combination of Lyrica and Prednisone and screams in severe pain some days?

* Cavalier's who scan WITH Chiari Malformation AND Syringomyelia, can and DO remain symptom free their entire lives. Just because they scan with SM doesn't mean they will develop symptoms from it. Some do yes, however there are many who don't. If a breeding dog has SM, yet never shows symptoms from it, and produces dogs that have SM yet never show symptoms from it, what can be said for that?

* D to D breedings of Cavaliers CAN produce CLEAR Cavaliers. I know several examples of this.

* A to A breedings of Cavaliers CAN produce severe Syringomyelia. Sadly I also know several examples of this.

* Clear Cavaliers and ones with severely symptomatic Syringomyelia can come out of the same litter. Yes a Boy who is an A clear and a popular breeding dog, can have a sister who scanned with severely symptomatic SM.

* Reports and gradings on MRI's can differ greatly depending on who has read them. A dog can be interpreted as a Clear by one expert, and be graded a D with Syringomyelia by another.

* It is not just pet owners who have dealt with the heartache, helplessness and distress, of seeing a beloved pet suffer with severe neurological pain. Breeders are *just as* heartbroken and devastated when their own dogs, or dogs they have bred are impacted with severe CM or SM symptoms. I have yet to meet a Cavalier breeder who is involved with their breed Clubs who do not care about the dogs they produce. They are all extremely passionate, and devoted to their dogs. They may not think the same way, or be supportive of all research or breeding protocols but they do love and care about their dogs.

* Many other dog breeds have been identified as having Chiari Malformations and Syringomyelia. Friends of Lola illustrates some of the breeds impacted. From those breeds you will only find CKCS breeders, and Brussels Griffon breeders MRI'ing their breeding stock.

* Only a very small percentage of Cavaliers are bred by registered Breeders. Almost all are produced by puppy mills, and backyard breeding. No matter what protocols are followed by those of us breeding responsibly, those who aren't are producing WAY more puppies.

I think I will end this list here as it could go on and on.

As you can see this is a topic that I care deeply about. I would love to see the day that CM or SM is not a problem in the breed but I also know that outlook is unrealistic. No matter what breeders do, or don't do, these will be two major areas of concern that they will continually deal with.

Breeders who MRI every dog they own, and breed will produce Cavaliers with CM and SM.

Cavaliers with SM need wonderful unique homes, so some owners and breeders will experience the heartache of owning a symptomatic Cavalier. We will cuddle them when they are ill, pay for their ongoing prescriptions and specialist appointments, love them unconditionally and do the best we can for them.

I also hope that the vast majority can and will experience owning a Cavalier who is healthy. One that we can take anywhere without worry, does not require daily prescriptions, and lets you truly experience how wonderful this breed is. In my house I have experienced both.

What I do hope that some of you will come away with after reading is maybe an understanding of what goes on "behind the scenes". Why questions are asked, and why debate and controversy takes place. Some "food for thought" if you will.

For me I will continue to advocate MRI scanning, research, and breeding to protocol. You have to start somewhere, and work towards a common goal. I also will continue to ask questions, and be both critical and objective in my thinking. Nothing in regards to CM or SM is black and white. Shades of grey is a much better fit.

On to the fun stuff..

I have an awful habit of leaving my camera connected to my computer with it on. Hence draining the battery completely and pissing me off the next time I go to use my camera and the battery is dead due to the same reason again. Iphone 4 to the rescue.

Some pretty girls in my kitchen tonight.

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19 comments:

  1. Very informative post. While my high school level genetics allows me to understand how two clear parents could produce symptomatic offspring I find it very distressing that clear dogs can have symptoms themselves. I had not realized that was possible until a few months ago. It helps me understand why some breeders choose not to scan although I also agree with you that we have to do the best that we can with the information currently available. I was lucky enough to have my Mindy for twelve years without either MVD or symptomatic SM or any other debilitating health problems until she developed cancer. When I spend much time thinking about it it seems that the law of averages is not in favour of Max and Rylie as far as either disease and that makes me sad.

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  2. You write well as this is packed with information but is an easy read that I wish all Cavalier owners and potential breeders would pay attention to. The girls look happy and Mylee always steals the show posing like the perfect little model dog.

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  3. So nicely written and I appreciate your taking the time; not an easy task, but an important message to get out there.

    I agree, we need to support research with funding, but keep an OPEN mind. There are many untold stories or told but ignored which illustrate all that grey (still).

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  4. This is where I feel strongly as a breeder, before they standardize anything overseas, they should ensure ALL neurologists and radiologists are on the same page when it comes to reporting. Because the more I scan, the more my fellow breeders scan, the more litters born by protcol there is an awful lot NOT making sense when scanning these offspring, *confused* is putting it extremely mild. I know what it like to have 2 reports from different specialist for the same cavalier, and the reports being totally the opposite - who is right and who is incorrect with the reporting??? I too have seen with my own eyes cavaliers whom you would bet your last dollar on are affected with full blown SM - to find after MRI scanning the said dog has a beautiful - solid dark spinal cord, very mild CM. Thanks Embee for opening the door, my hope is more will speak out. I just fear for the future - the what If's, the unknown and what will be in store for our breed we love with every inch of our being. If the wrong path is taken. I will close now, by saying there is a great need for people to gain some "common sense" and lastly - I am proactive about health, supporting research - yet does research support owners the way it should? Just to clarify I am not meaning $$$ wise. Again thanks for this much needed post. Huronkin

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  5. Excellent post. This was so well thought out and posted in layman's terms. Do wish this wasn't so baffling but so good to know there are people out there trying to find an answer. We all have to work together to solve this as we all suffer.

    Mom to 3 CKCS

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  6. WOW, I had no idea. That was well written and even I could understand it! Loved the pictures too!

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  7. Norma Inglis (CRAIGOWL CAVALIERS) UK
    This blog should be widely circulated as it states clearly what so many breeders worldwide feel about the health issue CM/SM. Well done Mary Beth. I was beginning to think common sense was dead and buried. But your words have inspired me. Everyone who reads this with an open mind will see that there are still more questions than answers re SM. Please do what you can to ensure that when the experts are trying to improve something, that the good parts don't get thrown out with the bad. Norma Inglis Craigowl Cavaliers UK

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  8. Norma I can't agree with you more with what you've written in your comment to Mary Beth. We can only hope more "common sense" is gained by others who read this well written post. Karen Murray - Mysticmoon Cavalier, ON Canada

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  9. Well written Mary Beth! I follow your blog regularly and I know why - you really have a way of putting a blurry subject in focus. I too MRI and do not understand the unanswered questions, but know we must be careful as breeders not to make haste judgements when it comes to health. I just wish others would understand the predicament we face.

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  10. I do the same thing with my camera all the time! It's very frustrating indeed!

    Lauren

    PS: love the cute picture of Zoey in your header!

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  11. I have an 8 month old Cavalier who when MRI scanned at 7 mo. showed mild CM. He has some pretty strange painful symptoms. His neurologist tells me those symptoms can't come from his mild CM, because he doesn't have SM.

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  12. I have to thank you for this article. When the link was first sent, I was thinking, oh no, another person who has never bred a litter and yet is an expert in SM. I was pleasantly surprised when you explained your relationship to the study of the disease and ownership of an affected dog. I think your thoughts are spot on, as a breeder I try so hard, MRI my dogs, knowing I have really no more knowledge or ability to predict the future than anyone else. Everything you described in the "Doesn't make sense" category is true, we see it all the time. I will make sure all my puppy buyers get to see a copy of this. Again, thank you.

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  13. Diane thank you so much for your comment. I have never bred a litter but consider myself a breeder in every other regard by being involved and learning as much as I can. Hopefully my girl will be able to full fill the last part of that breeding equation by actually having puppies for me!

    It was very important to me to have the other side out there and i'm so glad it is being read and appreciated in its true meaning.

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  14. Anonymous,

    I encourage you to print off some more research and findings and take them back to your neurologist. Your 7 month old could very well be symptomatic from just CM. Mylee started showing severe symptoms at 5-6 months old. They progressed very rapidly to the time of diagnosis at 1 year.

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  15. Jill Scandroli Catesby CavaliersFebruary 1, 2011 at 9:37 AM

    Study that Differentiates Hydromyelia from SM - they found some cases of Hydroymyelia can cause pain, but the good news is they tend to not get worse & over time can actually improve. The full articles is on pages 12 thru 13 on this link. I felt it gave some explanations that we have had need for as we have Hydromyelias or small Central Canal Dilations that are NOT syrinxes that have feel into a grey area - with little known about them. Study Differentiates Hydromyelia From Syringomyelia
    This is the link - www.conquerchiari.org/Printable/Print%207(4).pdf Dated 2009

    The MRI's that show the pic's on page 12, are EXTREMELY Good to refer too. I found this in a search as I like many are frustrated in needing more answers for the grey areas we have found that little is being talked about with small CC Dilations or Hydromyelia - when I 1st MRIed all I knew was blk or white - clear or with SM - I was what is this Hydromyelia stuff :) on a 8 yr old dogs scan in limited area & small I held him back due to lack of answers & for fear the shoe was just going to drop & he was going to get worse in time. 3 yr's later he is still doing great & I should have bred the heck out of him as he had a clear heart til just after 10 yr's of age. Experts were like well they didn't know & it could change & they can make worse than themselves - well so can a A dog none of it made sense. He showed me that this article I just found holds water in being crediable. My hope is to help give some answers by sharing this. Best - Jill Scandroli Catesby Cavaliers Memphis Tn & a Southern Neighbor to my Friends up in Cananda

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  16. Hi Jill,

    Thanks for posting the interesting article and leaving a comment. The more discussion and exchange of information the better. Hydromyelia for me isn't something i've spent much time reading on. Mylee had no hydromyelia present on her MRI but I have seen it on other MRI's. Heart clear and symptom free at 10 is wonderful. :)

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  17. Jill Scandroli Catesby CavaliersFebruary 1, 2011 at 12:16 PM

    I know Mylee has only CM & yet needs med's. There are some MRI's with small CC dilation /hydromeylia that experts have not been able to give much information about. At best the Neuros suggested they be treated with caution like a yellow light ( grey area) even with considerable age to them which d/n make alot of sense to me what you see at 8 yr's old is pretty much it. CR later advised older dogs they do tend to hold with what you find then. There is not alot of information about Hydromeylia. This was a break thru in doctor's learning more about it. My boy is now 11 yr's old & is on no med's. My wish is for EVERY Cavalier/dog to have this fortune. The hope is for us to realize Hydromeylias are fairly common findings, thus the reason I shared the article as it is not just my experience, but a study. Best to Mylee & your girls, Jill Scandroli Catesby Cavaliers

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  18. Jill Scandroli Catesby CavaliersFebruary 1, 2011 at 3:06 PM

    Some links that show how wide spread CM can be as found in Various Species.
    Arnold-Chiari malformation and associated anomalies in Calves written in 77.-
    http://www.springerlink.com/content/q351v34u88726316/

    http://www.vetsci.org/2008/pdf/215.pdf

    www.jwildlifedis.org/cgi/reprint/34/3/661.pdf Lion with COMS -
    COMS has been found commonly in Cattle, a Baboon, a sheep & a pig. another litter of Lions have been reported. (this is in 1998) Arnold-Chiari Malformation in a Captive African Lion Cub
    animals. (Jubb et al.,. 1996). Arnold-Chiari malformation
    People due to the wide press the Cavalier has gotten & how the depth of work done by breeders in MRI's forget that this is a Mammalian defect/disease. Just many animals are not confirmed by MRI. Not all animals with CM have issues either the Airedale & the domestic cat along with wild cats CM is commonly found, butthe majority do not all SM and many do manage the CM well & others do not - finding out why is the key.

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  19. I have a symptomatic scanned "A" with only a mild malformation who has an "A" grade litter brother who is just fine, it's just hard to believe. I have 5 Cavaliers and all scanned. 2 affected on medication and doing well, 1 symptomatic and 2 clear with no symptoms, so a mix of all here.
    There are some good and dedicated breeders out there doing their very best for this breed, scanning and caring and never giving up. One day I just hope they will have the answers and the key to SM.
    Your article is excellent, clear and well written. Lovely pictures!
    Alison U.K.

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