Syringomyelia in CKCS

Re: Syringomyelia in CKCS

Vikki Halliday LLB — Thu, 03 Jun 2010 13:22:58 GMT

If it is not being controlled with pred/NSAID or fruse/Gabapentin, I would most certainly be reaching for the Euthatal I'm afraid.

This is a horrendously painful and debilitating condition, and animals must not be allowed to suffer. Even if the dog is not screaming in pain, I would be concerned about pain scoring on a daily basis for more subtle signs.

Re: Syringomyelia in CKCS

Bob Russell — Thu, 03 Jun 2010 11:24:28 GMT

Unfortunately our experience here with syringomyelia is disastrous. NSAI's useless, preds little value. Even the one we referred for MRI came to a very sticky end. Unfortunately I am coming to the conclusion that unless it is very mild euthanasia is the most humane action. Very depressing. Fortunately most of our cavaliers become ACe inhibitor candidates rather than 'blue juice' candidates. I hope this balance remains but I fear it may be shifting!!!

Re: Syringomyelia in CKCS

shanley barber — Tue, 25 May 2010 20:38:21 GMT

Hi there, I've had a CKCS with syringomyelia with very similar clinical signs that has responded very well to pred, initially 2 mgs/kg, which we have tapered. He is now stablised on a much lower dose EOD. He still occasionally scratches his left neck area but this is significantly reduced than when first presented.

Hope this helps!

Re: Syringomyelia in CKCS

Kate Richardson — Tue, 25 May 2010 18:00:40 GMT

Amitryptilline is worth a try as well. I have a middle aged CKCS patient with syringomyelia (confirmed on MRI) who initially was moderately-poorly controlled with Rimadyl, ++ side effects with gabapentin so discontinued this, added cimetidine and further improvement, then relapsed a few months later so trialled frusemide which helped settle things again but recently relapsed again so trialled amitryptilline which has made the most difference of all medications so far. Dog is currently on frusemide, rimadyl (for arthritis as well) and amitryptilline.

We discussed surgery but the info I received when I researched it suggested that 50% deteriorate by 2.5 years after surgery, it rarely resolves signs but may improve them, and most dogs continue to require medical therapy post op to some degree, so the owner chose not to go down that route.

Re: Syringomyelia in CKCS

Rob Loxley — Mon, 10 May 2010 23:14:28 GMT

http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

Re: Syringomyelia in CKCS

Rob Reid — Mon, 10 May 2010 22:13:42 GMT

The first thing I tend to use in these cases is drugs that lower CSF pressure - frusemide (1-2mg/kg TID) is usually my first option, but I have heard of people who have tried cimetdine and omeprazole as well so they may be worth a go.

I generally find that NSAIDs are completely useless in these cases. I will tend to use Gabapentin and have had some cases respond to prednisolone. You need to use a fairly high dose of pred - I tend to start at 2mg/kg BID. I have tried tramadol in a couple of cases as well and I felt it probably helped one of them.

I assume that surgery is not an option on a cost basis and the dog hasn't had an MRI scan, so therefore we don't know the full extent of the problem. TBH that's fairly understandable and most of the CKCS I see with this don't get as far as the MRI!!

Signalment-wise I saw a similar one a few years ago that started fitting and which ended up PTS. Bottom line is that if you have a case that is this severe in a young dog, if surgery is not an option you should strongly be considering euthanasia. Difficult cases these and at the moment there is not a lot of data on them medical treatment-wise- I don't think there have been any published clinical trials as yet on medical management of the condition (anyone seen anything to the contrary?)

Hope this helps.

Re: Syringomyelia in CKCS

jenny overton — Mon, 10 May 2010 20:44:09 GMT

Sorry forgot to mention NSAIDs really didn't help this dog.