Syringomyelia in Cavalier Spaniels

Cavalier King Charles spaniels like any other breed of dog can suffer from various diseases and illnesses; however one of the most distressing for the animal and for the owner to deal with is Syringomyelia.

What is Syringomyelia?

This is a condition that affects the spinal-cord where fluid filled cavities develop within it. It is a very painful condition for the dog and is often called ‘neck scratchers disease’ because scratching in the air by the animal, near the neck is a common sign.

What causes Syringomyelia?

Syringomyelia is caused when there is an obstruction of cerebrospinal fluid (known as CSF). In the normal dog the CSF around the brain is shunted back and forth by the arterial pulses, if there is an obstruction, then the pressure is transmitted down the spinal-cord and it becomes distended below the blockage. This distension results in the formation of a cavity. The most common cause is when the brain pokes out the back of the skull! (Anatomically this means that the cerebellum is herniated through the foramen magnum). This is normally because there's not enough space in the back of the skull. Although this condition can occur in many small breeds, it is common in the Cavalier King Charles spaniel, in fact estimates think there is at least 50% (and some even think 70%) of the breed is affected, although only a small proportion severe enough to display clinical signs.

What are the signs of Syringomyelia?

Owners of dogs affected with Syringomyelia may see one or several of the following signs:

• Pain – this is the most important sign of the disease and is commonly in the neck region. Dogs can be affected worse at night, when first getting up, when excited or during hot or cold temperatures.
• Excessive scratching – especially at the ears, head, face, neck and shoulders.
• ‘Air scratching’– this is when the hind leg makes no body contact and often happens during walks.
• Scoliosis – this is where the dog's neck and spine becomes twisted, leading to a C type shape. This is much more common in younger dogs.
• Weakness – particularly in the hind legs.
• Ataxia – wobbliness when standing.
• Flipping around to bite the hindquarters – although this could be anal gland problems!
• Facial nerve paralysis, deafness and seizures may also be part of the condition.

The clinical signs of Syringomyelia are normally recognised between six months and three years of age, however dogs of any age may be diagnosed. Animals with severe symptoms are normally presented before two years of age.

Diagnosing Syringomyelia

The only way to confirm the diagnosis of Syringomyelia is by referral to a specialist centre that uses MRI scanning (Magnetic Resonance Imaging). This specialist imaging gives the veterinary staff a picture of the water content of the body as well as soft tissue and bone, it can be viewed as sections and its unparalleled clarity can aid the diagnosis of numerous conditions. Nervous tissue which contains a lot of water cannot be viewed by normal x-rays but can be viewed in great detail using MRI. Because of this Syringomyelia can easily be visualised as a pocket of fluid within the spinal-cord. Because of this specialist technique, the spinal-cord itself can also be measured and in severe cases of the disease where the cavity is large, the spinal-cord may only be shown as a very thin rim.

Treatment of Syringomyelia

There are both medical and surgical treatments for Syringomyelia, and both have their merits as well as limits.

Medical management

The drugs that are used to treat Syringomyelia fall into three categories:

• Analgesics – these are used to control pain in mild cases and are usually non-steroidal anti-inflammatory drugs (NSAIDs). Drugs in this class are medication such as Rimadyl and Metacam. For more severe pain oral opioids could be used such as pethidine, methadone or buprenorphine.
• Drugs which reduce cerebrospinal fluid production – there are drugs available that can inhibit CSF production such as omeprazole and acetazolamide. The downside to using these drugs is the side-effects including abdominal pain, lethargy and weakness. Long-term use (over eight weeks) of omeprazole is not recommended due to the increased risk of stomach cancer. Some vets may use furosemide as this can decrease intracranial pressure.
• Corticosteroids – these are very effective at reducing pain and its neurological effects. Because of the long-term effects of steroids on the body, such as immunosuppression, weight gain and skin changes, many vets will only use at a very low dose (and alternate days) to control signs, if no alternative is possible.

Surgical management

This option is available for dogs with significant pain or with worsening neurological signs. It is an option the majority of owners can neither afford (it is massively expensive and is only carried out by specialist teams in a few locations in the UK) or will put their animal through. If surgery is carried out then there is no guarantee that surgery will be completely successful. There are very big risks with the surgery as there are major blood vessels in the area and if damaged then the dog could quickly bleed to death. Because of the proximity to the spinal-cord and/or brain there is also a risk of permanent neurological damage. These risks should be fully discussed with the veterinary surgeon.Many dogs may experience Syringomyelia re-occurring after several months and years. This is why many owners must weigh up the risks and benefits of surgery compared to medical management with medication or no intervention whatsoever.Some owners, even with their dogs that have been diagnosed with Syringomyelia, may choose to let nature take its course, however because it is a progressive disease, taking no action could mean further deterioration.

Summary

Owners of dogs such as Cavalier King Charles spaniels should not be alarmed because of this disease, but be aware of it. If there are any signs that they find worrying, then they should discuss these with their veterinary surgeon. Because the only way to diagnose the disease is by MRI, financial implications should also be discussed.

If your looking to get a Cavalier King Charles spaniel puppy, you can view all the Cavalier King Charles spaniel puppies for sale on the Pets4Homes website.