We picked him up on a Saturday. The next day we took him to a health clinic where Dr. Buchanan diagnosed him with a grade 3 murmur. From the get-go it was evident that he had several major problems. He spent every waking minute licking/chewing his paws and scratching constantly. The fur of his paws and around his mouth was maroon from the constant wetness. He didn't have any sign of fleas, but I immediately put a dose of Frontline Topspot on him, started him on benadryl, and switched his food to Wellness Fish and Sweet Potato. His licking eased up dramatically within days. But we noticed that he couldn't be touched/petted/groomed around his left ear without causing him to frantically scratch with his left back leg. We also noticed that he yelped/screamed whenever we picked him up.
Our Vet at the time diagnosed him with bilateral grade 3-4 patellar luxation, and thought that might account for his pain. He was neutered a week after we got him and his wound got infected. A new Vet we started seeing then thought his pain might be due to a spinal problem. An x-ray of his back showed spondylolisthesis, which is slippage of vertebra out of alignment. He put Chessie on an antibiotic and some Rimadyl to help with the pain. Prior to starting the Rimadyl, he always looked downcast and had no vim or vigour. I couldn't get over the difference in Chester's demeanour on the Rimadyl. He went from acting sluggish and like an old man, to a dog with the energy of a puppy, and he lost that awful "hang dog" look. I realized he must have been in constant chronic pain before that. Unfortunately, he started vomiting so I stopped the Rimadyl (not sure if the vomiting was due to the Rimadyl or the antibiotic- cephalexin). A few days later I started him on a baby aspirin (81 mg) twice a day and that seemed to do just as good a job as the Rimadyl had.
We noticed from the beginning that Chester walked funny. He waddles when he goes down stairs. He stumbles a lot. His front feet are extremely numb. I Dremel his nails and he shows no sign of feeling it at all in his front feet. I have to be careful not to grind them too short, as I can grind them until they bleed and he doesn't react. His front feet (especially the left one) turn over when he takes a step, and the top of his feet brush the ground, wearing away the tops of his nails. Once he wore a nail all the way down to the quick on a walk and bled all the way home but showed no sign of pain.
He often stands with one leg thrown awkwardly out to the side, as if he isn't aware of where his limbs are in space. This is evidence that he has a proprioceptive defect.
He can't stay standing for very long, but collapses into a sit or lies down. We call him the "amazing collapsible dog". He screams when we pick him up, unless we do it very carefully and in just a particular way. He often does a three-legged bunny hop, scratching with his left back leg, while walking on lead. This is due to the pressure of his collar on his neck.
When lying down, he has to either prop his head up on something (the bolster of his bed, or my leg when sitting in my chair with me).
Our Vet examined him during one of these episodes and thought it might be seizure activity. She gave me some Phenobarbital, but advised me not to start it right away, but instead wait to see what developed. I then took Chester to a Vet cardiologist who diagnosed him with sick sinus syndrome, causing his abnormally low heart rate. I still wasn't sure if his collapsing episodes were seizures or cardiac origin.
By then, Dr. Clare Rusbridge had given her seminar which I had unfortunately not been able to attend. I got some information on syringomyelia from Pat Winters and then Randi Rosvoll sent me a copy of Dr. Rusbridge's article on the subject. Being a Family Physician, I was able to understand the medical jargon and interpret the MRI findings in the article. Once I read that article, I was convinced that Chester had SM. I emailed Dr. Rusbridge and outlined Chester's signs/symptoms. She agreed that he most likely does have SM. She advised me that dogs with SM often do have co-existing seizures. After a few months of continued occasional collapsing episodes, Chessie had 2 grand mal seizures in front of me within an hour and I immediately started him on the phenobarb. He hasn't had any collapsing episodes or seizures since.
We've made the decision to not put Chessie through an MRI because we feel he isn't a good candidate for surgical correction. Given his advanced age, his MVD, and his sick sinus murmur, we don't know if he'd survive the surgery. I also don't know how much improvement he would get from the surgery, and we're not willing to take that risk. He seems to have adapted/accommodated to his SM, since he probably has suffered with it for many years. His pain is under good control with aspirin. I occasionally have to give him a third one per day, but two a day seems to hold him. We try not to touch him around the left side of his head/ear, unless I have to brush him there. We try not to pick him up unless we have to. We have steps up to our bed so he doesn't have to jump up or down. He loves to go for walks, but we don't over-do, and try not to over-tire him. We think he has a darn good quality of life and plan to keep him as comfortable as possible for as long as he lives.
To summarize Chessie's typical SM symptoms:
- Chronic look of being in pain before starting pain meds
- Sensitivity/pain/scratching when touched around the left side of his neck/armpit
- Scratching when walking on lead
- Yelping/screeching when picked up
- Numbness front feet
- Foot drop (motor weakness) front feet
- Inability to stay standing or sitting for long-weakness of back end?
- Proprioceptive defect
- Head tilt which worsens when he barks or gets excited
- Frantic head/neck rubbing on the ground when excited
- Need to support his head
- Twisting of head with leg thrown out to side when lying down
- Associated seizures