Our Bertie... Progression of SM

[julieb7]

Our little Bertie, who was 8 in May had been diagnosed with SM/CM (by MRI scan) at the age of 2 and a half but had shown no symptoms.... well until now...

I approached our vet with these symptoms and to my horror the vet we saw said that he had very little knowledge of the illness. I left photocopies of Bertie's scans from 2009 and 2010 with him and he did internet/Vet journal research and got back to me the day after.

I'm pleased to say that after a trail with gabapentine Bertie's symptoms have been supressed and he's a much happier dog... and he will continue with this treatment until symptoms dictate that it is altered...

I'm horrified that there are still vets out there that do not comprehend this illness. We have been with this practice for 9 years now, however the vet that saw us through this illness first time around with our Jake from 2009 - 11 is no longer with the practice and subsequent vets to the practice do not have the same insight in to SM/CM as this vet did.

It appears that this vet has taken all on board..... Has anyone had this experience when the vet gives you a blank look when you are asking questions/putting forward symptoms. Fortunately I had the MRI images to back up my questions and the vet did the right thing and found out about the illness... What would have happened if neither of us knew anything...????

[ByFloSin]

I had similar experiences with my vet's practice both with Rebel's SM and Holly's CC/DE. They just give you blank looks and say they're sure there are other things it could be, although you already have expert diagnosis!

I almost came to blows with Holly P's vet when we returned from the referral ophthalmologist with a lengthy list of pain killing and other medicines, all of which were designed for humans and not licensed for dogs. He still wanted to remove the eye, at which point I lost my temper completely and was on the point of giving him a black eye when our very good friend Reg pinned my arms to my sides and frog marched me out of there. Thanks to this common sense our next call was to the pharmacy to get the prescribed medicines. Eventually the vet realised there had been a massive improvement and decided to help me to follow the treatment plan.

It was another vet in the same practice who I saw with the then symptomatic Rebel. Fortunately, like you, I had already given them prints of the MRI and I had spoken on the 'phone to the neurologist and had a starter suggestion for medication. Eventually the vet readily admitted she had no knowledge of SM at all so I provided her with prints of the relevant information sheets and the treatment matrix from Stone Lion. She agreed that it would be good for us to work together about medication, which went on for about 4 years, when it was suddenly time to let Rebel go.

Everything was done for both my dogs that needed to be done, but it was such an uphill task at the start. As I've said Julie, like you, I had to be armed with the relevant information so that the vets could research and study details of what they should be doing. I'm not sure that either of us should have had to do this, but on the other hand, there are so many breeds and 'designer' breeds of dogs around nowadays that I wonder how possible it can be for every vet to have knowledge and understanding of all the diseases and conditions which can affect each of them. Thank goodness for breed education and all the information we can download off the internet to point the vet in what we believe to be the right direction. Forums like this one can play an enormous part in the education we owners need before we can discuss the condition with the vet and the sharing of experience with other members can be absolutely invaluable.

You ask "What would have happened if neither of us knew anything..", my answer in Holly's case is that she would have lost each of her eyes in turn with her life being prematurely ended by the lack of appropriate treatment for her skin and hair conditions In fact I doubt that she would have reached her second birthday.

In Rebel's case, maybe he would have gone on, in severe pain and discomfort for another 2 or 3 years, but his quality of life would have been poor and I doubt that I could have let him continue more than a few months.

With the treatment plans they needed Rebel lived a mostly comfortable life until he was almost 12 years old (diagnosed at 6 yrs by MRI) and in Holly P's case, as you know, she has a happy and comfortable life with her 8th birthday due at the end of October.

[Dorothy]

Sorry to hear about Bertie. I do hope the treatment will work.

Before being too harsh on vets, I think we must remember that there are just so very many different conditions according to the different breeds and of course they have other animal species they must also know about - I know that over here a potential vet must correctly answer the questions on six different species or he will not pass the exam. It is important that we breeders and owners are conversant with what affects our own breed; even we continue to learn through discussing with each other.

As a point in case, I recently had a dog (not a Cavalier) diagnosed with Diabetes insipidus. This condition is so uncommon that my vet had never seen it. Due to the dog being 13 years old she was reluctant to do the diagnostic test which meant with holding water from the dog for an extended period of time - she felt that at that age Harriet could go into renal failure. So she contacted a specialist who travelled across to see Harriet and confirmed the condition with a brand new test. Even the specialist had only seen one other dog with the condition. Harriet is now on a human medication and is much improved.

So if you're not happy about the vet not knowing, do ask them to refer you to a specialist.

Hugs to Bertie

Dorothy

[Janelise]

Oh Julie, how sad - but I'm really glad that Bertie is responding to treatment.

Maybe the fact that the vet didn't know much about it is an indication that the disease isn't quite as rife as we've been led to believe? Not to diminish it: it isn't good, but the veterinary magazines do tend to publish articles about things seen more commonly, with just the odd article about rarer problems.

I think I'm rather lucky as the vets here do seem happy to refer you to a specialist if they're not sure, and do listen to what you say. Dr L, for example, is always interested to know the latest heart news after the local delegation of the club has had the annual "report" by Dr. le B. He freely admits it is impossible to keep up with everything in every breed, let alone all the farm animals and exotic pets

With Bijou, the vets referred me to Dr Goulle, a specialist in ophthalmology in dogs and cats.

My friends had a dog; a Berger Picard, with an odd condition and none of the vets in the practice had any idea what it was. They were going to refer them to a neurologist but of the vets did a bit of research and came up with maxillary myosotis, which absolutely fit Verlaine's symptoms, but still said they'd do the referral if Aline and Alain wanted. Treated with steroids the condition improved.

Dr L also sent me to a veterinary oncologist with Tchi: he said he had no knowledge of current treatment.

Thinking of human medicine, I have been (eventually!) referred to specialists when my GP hasn't know what I had or been confident to treat it. One was a wonderful misdiagnosis: doctor (with whom I didn't have a great deal of confidence anyway) thought I had a suspicious lump on my intestines, but it turned out to be a fibroid tumour in the uterus........ He based it on the fact that when I lay on the examination couch the lump could be seen on the right side of my abdomen - I was quite thin then. The "stye" another doctor diagnosed on my eyelid didn't go away after treatment and he reluctantly agreed that it didn't really look like a stye and sent me to the local eye hospital. Even then it took over a year before the diagnosis of cancer was made - and then it wasn't the correct type - after which I was sent to Moorfields in London and operated on within a fortnight. What I had was rare: the previous case at Moorfields had been 5 years earlier.

My sister has a recurrence of the Guillain–Barré syndrome she suffered ten years ago, and the hospital where she is now ignored her when she told them what it was because she doesn't have the classic symptoms - she rather forcefully insisted they do a lumbar puncture for the diagnosis (which proved that it was GBS!) and get her records from her last hospital. Although the actual records still haven't arrived (!) she has at last seen a doctor who's willing to listen, but never seen another case. She prescribed appropriate treatment and Sally is slowly improving.

Maybe we expect too much of professionals: there are so many illnesses and diseases they can't realistically know them all!

Jane

[bridgette]

My vets have no experience of this condition and freely admit that, they have read all the books etc I've taken down there for them but all say they have never come across it. Which considering some are no spring chickens is reassuring

[julieb7]

Well just back from the vets with our Bertie.. Once again his SM is progressing. He's had a pain killing injection to go with his Gabapentin/frusimide and the vet will study the options on introducing either a steroid (pred) or some other pain relief (tramadol) in to his mix of medication.. for tomorrow... (Sigh)

[Janelise]

Poor Bertie! Forgive me for asking, but how old is he? I can't remember.

Jane

[ByFloSin]

Well just back from the vets with our Bertie.. Once again his SM is progressing. He's had a pain killing injection to go with his Gabapentin/frusimide and the vet will study the options on introducing either a steroid (pred) or some other pain relief (tramadol) in to his mix of medication.. for tomorrow... (Sigh)

So very sorry to read this Julie.

I don't know if it might help Bertie or not; you and your vet know him and his symptoms much better than I can from this space; but when Rebel's pain became worse after similar medicines the vet added Tramadol to his regime, which made him much more comfortable. Rebel had a large syrinx between C1 & C5, so the vet was surprised at how well he did. As Jane seems to think that age may have a bearing on Bertie's condition, Rebel was 6 days short of his 12th birthday when he lost the use of his back legs and it became obvious that euthanasia was the kindest route to take.

[julieb7]

Bertie is 8 and a half today! and it is 6 years today when he had his mri scan and was graded D.. a small syrinx between C2 and C3 (max 3mm).. So I think that he's done quite well not to have had any symptoms until his 8th birthday last May...

I'm just waiting for the vet to ring me.. Fingers are crossed that Tramadol will be prescribed... I know how ravenous dogs are on Pred and we have just got Bertie under 8kg for his heart condition!!!

Poor Bertie... It doesn't rain, it pours!

[julieb7]

Update on Bertie.

As he was comfortable with the pain killing injection(metacam) last night the vet has decided to try the oral version over the next few days and monitor him before rushing in and giving him something which maybe too strong for him at the moment. He has also suggested acupuncture... Has anyone heard of this for SM???