the chiari causes the syringomyelia see this link

Syringomyelia (SM) and the Cavalier King Charles Spaniel

No fever either and her spinal tap came in normal.

My girl did live a good long time with this condition and remained the same till about a month before she passed. So there is deff hope for Bella but I think the rite meds is what made Sassy live as long as she did. And the cost of foods is out of line here too. I paid $80.00 for 30 lbs of HD that didn't do the trick. that was 2 yrs ago and it's gone up since then. Not sure what they do at UC Davis but the only thing they did to Sassy was sedate her for the neuro and take the picks, not too hard to do on a sedated dog and he was rite there the whole time making sure they were taking pic from the rite angles. He had them look at the MRI to see if they would catch it but they didn't. I first heard about Chiari in humans about 9 yrs ago on a TV special and it was said that very few neuros know what to look for . And even fewer know how to surgically correct it. That is why I chose the teaching school because I think they are most up to date on things and it all worked out. However I am neurotic and did tell them I wanted the neuro to do the spinal tap. They will do what you want because you are paying the bill. Even when the Dr does everything the students still learn by watching.

Heres what Sassy did. 1st early on the vomiting for no apparent reason and all blood work showed nothing, stool showed nothing. As quick as it came on it was gone. Total of 3 days in hospital can't remember for sure but I think 3 times. Then when she turned 5 I noticed when she would roll over she could not rite herself, like a turtle. Shortly after she started scratching at her ear. The vet could find nothing wrong. Then shortly after that she started cocking her head very slight hardly noticeable if you don't know what your looking for and stumbling that's when vet said she needs an MRI. And her spinal showed nothing too but the MRI showed the cyst and the base of her skull was more flat then round and that's the part that they don't often catch and is slightly diff then in humans.

The vet at WSU said it is a deformaty so can vary from dog to dog as well as symptoms they don't always have all the same ones and some have certain ones and not others but they usually all show more then one of the symptoms. So if nothing else I would at least see if the neuro at UC Davis can take a look at her MRI . Another reason to always have copies. Doesn't have to mean the original reader of the MRI doesn't know what they are doing , just maybe missed something. They are only human .

Oh , something else I had forgotten about. Sometime after diagnosis she did act like her neck was out and very painful. Vet said sometimes it happens but not always he gave pain meds and in about 4 or 5 days she was fine and that's the only time that happened. I have to tell you , I take my dogs to the Chiro but don't EVER take a dog with this condition to the Chiro. Sometimes it will have a domino effect and they will develope back problems and that can be treated by a Chiro but NEVER the neck when they have this condition.

thanks for this tip..
 

Never knew you could do dogs at Chirapractor. Glad you gave us the tip on not taking dog with this problem.... Good to know just in case... Never know what the future holds ...
Jessie an Poohbear:)

Hopes Bella feels better soon
 

Hi mly,

I'm new to the forum and haven't read all of the posts on Bella. I do hope she will be fine soon.

From what I read from your posts, it seems your regular vet is not really open to other possible diagnosis. And you mentioned that you hope the vet would give you the referral to neurologist when the vet suspected liver shunt. If you have any doubt as to what the vet would do (which should be whatever is best for Bella), I think it's time for a new vet.

I also have issues with the neurologist place that would not give you appointment until receipt of referral from your vet. That was outrageous. With you describing Bella's conditions and that she was progressing to having difficulty walking, it was possible that she could have intervertebral disc disease resulting in pinched spinal cord possibly causing paralysis if not treated in a timely manner. The neurologist office should know that in such cases, time is of the essence and should have given you appointment asap.

I do hope that you give up updates on Bella's condition soon and waiting anxiously for good news that the meds improved her condition. Thoughts and prayers with you and Bella.

Mia

ALWAYS question vets, I too am new and VERY MUCH AGREE with Mia...A VERY nice vet once KILLED my Toughie. He trusted me and she forgot to know geriatic dogs cannot take always take same meds as young ones can. Vets like Drs. to often forget they are only human and need to look things up instead of fly from the seat of their pants on ego.!! I aLWAYS QUESTION NOW and look up things myself. My Prayers are with you and Bella. Jessie

Yeah the spinal tap was my concern not the mri and they told me NO the student will do it and i said no way not for that price and posted here as spinal tap i would want done by a bc neurologist

this is true and would not be bad to pay for a consult but depends on how much as i think this neuro is good she went to but i personally did not like the attitude of the person answering the phone there at ucdavis she was a little rude and it always bothers me when front staff is rude to new customers and tend to go elsewhere. When i asked the price she told me 2500.00 then i asked if bc neurologist could do the procedure and she said no way the student does it with bc over seeing them and said thanks and posted. Now maybe she had a bad day as we all have them but when people are calling in about sick dogs you should have someone compassionate on the phone or at front desk. She was adimant there was no way bc neurologist would do this procedure it is a student and she was sarcastic saying this is a teaching hospital. I think each vet, teaching hospital etc are different and this one i have my question mark up about as my own vets friend's dog had internal liver shunt surgery on a boxer and it died and she felt horrible she referred the dog there and i have had a few other incidents that i have heard about there as well so I am not 100% confident with it to be honest :(

Now that being said i love our dentist and he came from there and he recommended below the person i posted but due to price being same as private practice no question in my mind private practice.

I go to a facility here where there are alot of interns and they are sharp and are very nice and helpful to me at night but a spinal tap not sure i would have them do that :( I will say they did know more than a 20 year vet to not give nsaids and steroids lollll

yeah i would never take a dog either to a chiro with this as aai is a bad condition too and my friend always says no chiro and that is in the neck region as well where they brace the neck - i have always myself been a little skeptical of chiros for humans as have seen where they have done damage so i prefer massage over chiro but dh swears by his

yeah some areas are unlike ours and will not do things without referrals thank goodness that is not the case where i live as i go without them all the time as the owner should have the right to go to whoever they want if they are paying - it also leads me to believe there may be kick backs in this profession as why be so adimant about referrals but that is a whole other topic lollll

here is the reason i say kick backs for referrals because i did two dental consults with demi as first person i was not 100% confident with as she was talking bone packing and all kinds of crazy stuff quoting me 3k and i went to my personal dentist and she was like wth bone packing i hope you have another 10k in your pocket for this as bone packing does not work well in humans let alone dogs and this dentist wanted to put demi under every 6 mos and use stitches and all kinds of stuff - she freaked me out and glad i went to the one i go to now BUT what happened also with her is a called and receptionist said is this a direct consult or referral from vet and i said what is the cost of each and she said 50.00 direct 150.00 through vet and i said DIRECT as i found her and she was not referred by a vet. SO why the extra $100 - possibly a kick back for a referral to get her business going as she was new to area ???? Hate to think this way but after 25-30k in vet bills i am starting to ask ALOT OF QUESTIONS and EDUCATE myself because of all this stuff and pass on what i am learning

I think that could be correct. Dr's offices would probably get compensation for the referrals they make elsewhere. I remember my vet recommending me to take Bella to the place in Santa Rosa before to get her trachea checked out and that was the same place she recommended me for the neuro. I don't know if it was because it really is the closest place to where I live or if they do really get something from recommending people. Another thing was, she was insisting I take her to internal med (not neuro) because she thought her head tilt could be a result of her liver since she had elevated bile acids and sometimes liver shunts can result in neuro problems.

I actually told my vet I found a neuro and I would to be refer there but she said that she had called the place I wanted to go to and they weren't internal med, just neuro so we wrote me a referral to the place she had recommended. I took the referral form and called the neuro I wanted to go to and just told him I was refer somewhere else and have a referral form with me but it wasn't for them. He said ok and schedule me anyways. I think they just need to know if it was really necessary to see a neuro or not because they never requested my referral form once I got there.

The other places I called wouldn't schedule me in until the referral form was faxed or something. With that alone, I rather not go there.

WSU Report
 

Iris atrophy of the left eye, lenticular sclerosis OU
Mentation: Depressed
Head Posture: intermittent left head tilt
Gait: Mildly ataxic with inward rotation of the left thoracic limb
Diffuse hydrocephalus, Caudal occipital malformation syndrome, CSF cyst off the 3rd ventrical with compression of the cerebellum, Syringohydromyelia diffuse cervical spinal cord, Hyperintensity in the dorsal spinal cord at C1 with a focal cystic area ( suspected subarachniod cyst)
Displacement of the cerebellum with possible mild herniation of the cerebellum through the foramen magnum
DIAGNOSIS 1. Hydrocephalus
2.Caudal occipital malformation syndrome
3. Syringohydromyelia
4. Subarachnoid cyst C1
Meds Compuonded Theophylline 25 mg) 0.1 ml 2 x a day
Omeprizole 1/4 tab 1 x a day
Prednisone 1st wk 1mg/1 tab every 12 hrs
2nd wk 0.5 mg/ 1/2 tab every 12 hrs This she took for the rest of her life. She weighed between 4 3/4 and 5 lbs back and forth.

Also my dog had some wheezing and am pretty sure that's what the Theophylline was for. And I know what Deb means by Rude. That's how they are at WSU when you call but when you get there it's a whole diff story. And I think I figured out why you have a say so in who treats your pet at WSU also. Because they are only place here to get an MRI and lots of other things. Maybe that's the reason for getting to choose.

I would love to compare Bella's notes with yours once I get it in the mail. Also, I wish I was able to give her omeprizole in tabs but unfortunately, it's compounded for a lot more money.

I just remembered something else they told me. The Neuro said the spinal fliud was biulding up just a tiny bit at the top of the spine in the neck before going into the brain also caused by the deformity. Hmmm wonder that's not on the report. He said it was very slight but it was there.

Yea I don't get that because Bella weighs about the same as Sassy did. And for most of the time after she started the Pred she stayed at 5 lbs. I would ask about that too. Maybe Bella has more of a blockage then Sassy did. Or maybe it's not this prob at all. But it sure looks and sounds the same. I just hope she responds to the meds and they get it figured out soon. And keep an eye on her shaking because that's a sign of pain , probably a headache from the fluid build up. That's what started happening to Sassy a few days before she passed and they could no longer control it with meds. I used to buy the omeprazole at Wal-mart in tab form.
How is Bella doing today ?

Huh, I just found the total. I was wrong it was $1571.66 They had to get that 66 cents you know. That must have been for the free coffee and doughnuts, lol. I'll tell you that was the cleanest place I've ever seen though and HUGE it's like a whole city.

i thought you found a compounding pharmacy to do for much cheaper?

lol yeah that reminds me when dex was in the hospital i took them krispy kremes daily loll with a pic of him saying thanks for taking care of me and said SAVE DEXTER DONUTS lollllll They loved it and dex was the hit so i knew they would take good care of him as sometimes when you do a little extra to appreciate them they go above and beyond i feel so when i call now they are very attentive and help us. Not to mention the plasma we paid for lolllll He also wore his

M.D. Mad Dogtor shirt when he went in for follow up and the doctors all took pics with him lollll

Hey Now ! you are too good. Kissing up can never be a bad thing either;) Love the shirt.

lol yep whatever to get my kids the best care - pucker up lollll

Yeah I found a place that would do it for $27 instead of $45 except if i was doing tablets, I can buy a box for about $30/42 (20mg) tab. The liquid I get at the compounding pharmacy is only equivalent to about 1.5 (20mg) tab.

Hope that makes sense.

Gezz..that's pretty darn good. I wish I could have paid that amount instead of about $2500.

lillymae, I think you may be right and Bella has the same thing as yours. i received bella's medical records today and i'm going through it. there's a lot of terms and stuff that i'm not well educated on. from what i can tell, it is what your little one has but hopefully you and anyone else out there can clarify it in simpler form for me.

There's a lot of information so hopefully just this part can help.

MRI IMPRESSIONS:
"there is increased signal intensity on the t2 weighted images starting in the left caudate nucleus and continuing through the thalamus and mid-brain. there is also a cystic change within the thalamus associated with the previous described changes. the ventricles are moderate to severely enlarged symmetrically with involvement of the lateral, third and fourth ventricles. the cerebellum is displaced caudally by a fluid fill cyst (intracranial intra-arachnoid cyst) and the cerebellum is flattened caudally with a small cerebuellar herniation through tthe foramen magnum. there is increased signal intensity on the t2 weighted images involving the right pariental lobe. no abnormalities are noted of the structures that are seen outside the cranium. after the injection of contrast there is a heterogenous contrast enhancement pattern associated with the previous described thalamic changes. no unusual meningeal enhancement is noted. these changes are consistent with multifocal disorder involving the thalamus and right parietal lobe. a cystic change that results in caudal displacement of the cerebellum with cerebellar herniation results in secondary hydrocephalus involving the entire ventricular system. the differentials include infectious inflammatory previous injury with secondary necrotic changes."

MRI IMPRESSIONS:
"increased signal change is noted within the spinal cored of the vertebral bodies of c3 through c4. these changes are consistent with byrosyringomyelia associated with altered cerebrospinal fluid flow.



Doesn't this sound the same as your little one? If so, please give me more info on your little one such as age of diagnoses etc. Anything will help.

Thanks!

how is she feeling the last few days any improvement?

Another thing that might be helpful:

NEUROLOGICAL EXAMINATION:

gait: ambulatory tetraparesis, hypermetric movements all limbs, right more involved than the left, righ sided hemiparesis

mentation: normal
cranial nerves: right head tilt, absent menace OD, no other deficits noted
placing reaction: thoracic limbs-normal Lt, very slow Rt
Pelvic limbs- normal Lt, very slow Rt
segmental reflexes: thoracic limbs-normal
pelvic limbs-normal
pain sensation: thoracic limbs (deep and superficial)-normal
pelvic limbs (deep and superficial)-normal
cutaneous trunci: normal
perineal response: normal
palpation of the head/neck/spine: non-painful

PROBLEM LIST:
-ambulatory tetraparesis with moderate ataxia
-right head tilt
-absent menace OD
-right sided hemiparesis
-hypermetric limb movements Rt worse than the Lt
-bilateral medical patella luxation


:(