Health Alert - Syringomyelia found in Chi's

This is becoming a real problem in our breed. We all need to learn what this is and learn the signs/symptoms so we can be alert to it. It is often called the "neck scratching" disease as this can be one of the first symptoms.

An overview: (From Syringomyelia in dogs)
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Syringomyelia in dogs

Syringomyelia is a condition where a sac filled with fluid develops in the spinal cord of the dog. This can be due to several different reasons, where the most common one in dogs is a malformation of the Chiari I. In dogs suffering from this type of malformation, the occipital bone is underdeveloped and interferes with the circulation of spinal fluid. This causes fluid to accumulate in the cervical spinal cord of the dog. This is a congenital disease and small dogs are much more at risk than medium sized and big dog breeds. The Cavalier King Charles Spaniel is especially plagued by inherited Syringomyelia. If your dog develops Syringomyelia, it can become weak and start moving its limbs and torso in a clumsy fashion. It can also show signs of pain in the neck.

Symptoms of Syringomyelia in dogs

The main symptom of Syringomyelia in dogs is pain in the neck region and the dog can be sensitive to touch on one side of the neck, shoulder, ear and/or sternum. In many dogs, the pain will be worse during the night, in the morning when the dog gets up, and during really hot or really cold conditions. Some dogs will prefer to sleep with the head elevated.

Another common symptom of Syringomyelia in dogs is scratching on the ear, shoulder, neck or sternum – typically only on one side of the body. Sometimes the dog will scratch without ever making skin contact, and the dog can start scratching while moving.

In severe cases of Syringomyelia in dogs, the symptoms can include neurological signs such as weakness in the limbs (both fore and hindlimbs) and wobbliness when the dog walks. Seizures can occur, the dog can become deaf, and facial nerve paralysis is possible.

Young dogs with Syringomyelia sometimes suffer from scoliosis, i.e. a twisted spine.

Syringomyelia treatment for dogs

Several types of treatment are available for dogs diagnosed with Syringomyelia. The four basic options are surgery, medical pain control, drugs that reduce the production of cerebrospinal fluid formation, and Corticosteroids.

Surgical Syringomyelia treatment for dogs

The most common surgical procedure for dogs with Chiari malformations is suboccipital decompression. This procedure will remove the hypoplastic occipital bone, and sometimes also the cranial dorsal laminae, which causes decompression of the foramen magnum. This procedure can be made with or without a durotomy. Surgical treatment is normally only carried out on dogs with serious pain or worsening neurological signs, but it should on the other hand be performed as early as possible before any permanent damage has occurred.

The results vary. It is possible for the problems to recur after several months or even years. In some dogs, repeated surgery will be required.

After surgery, the dog will normally be hospitalized until a combination of NSAIDs is enough to control the post-surgery pain. Many vets will for instance combine Rimadyl and Neurontin (active ingredient in Neurontin is Gabapentin).

Medical pain control

In mild cases of Syringomyelia in dogs, the pain can be controlled by administering non steroidal anti-inflammatory drugs (NSAIDs) such as Rimadyl and Metacam. In more serious cases anticonvulsants may be necessary, such as gabapentin (not licensed for dogs in the United States). Opioids are also very effective pain killers. Methadone and Pethidine are two examples of opioids that can be administered orally.

CSF reducing drugs for dogs with Syringomyelia

Proton pump inhibitors such as Omeprazole will reduce the formation of cerebrospinal fluid, thereby decreasing the problems with Syringomyelia. Omeprazole are sold under several brand names, including Losec and Prilosec. Carbonic anhydrase inhibitors such as Acetazolamide are another alternative. Acetazolamide is sold under the name Diamox. A third option is Furosemide.
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More information and links at the link below that specifically pertain to our breed:

Syringomyelia and Chiari Malformation