Long‐term outcome of Cavalier King Charles spaniel dogs with clinical signs associated with Chiari‐like malformation and syringomyelia

Abstract

The disease complex Chiari-like malformation (CM) and syringomyelia (SM) has been associated with the development of neuropathic pain (NeP), and commonly affects Cavalier King Charles spaniels (CKCS). This prospective cohort study followed 48 CKCSs with CM and/or SM and clinical signs suggestive of NeP for a period of 39 (±14.3) months from diagnosis. At the end of the study, 36 dogs were still alive; five dogs died of an unrelated or unknown cause, and seven were euthanased due to severe clinical signs suggestive of NeP. During the follow-up period, the clinical signs of scratching, facial rubbing behaviour, vocalisation and exercise ability were evaluated. Nine out of 48 dogs stopped scratching (P<0.001), but there was no statistically significant change in the number of dogs exhibiting exercise intolerance, vocalisation or facial rubbing behaviour. The overall severity of clinical signs based on a visual analogue scale (VAS) (0 mm: no clinical signs 100 mm: severe clinical signs) increased (from median 75 mm (interquartile ranges (IQR) 68-84) to 84 mm (IQR 71.5-91), P<0.001). A quarter of the dogs were static or improved. In general, the majority of the owners felt that the quality of life of their dogs was acceptable. Medical treatments received were gabapentin or pregabalin and/or intermittently, carprofen. The owner's perception of their animal's progress, and progress based on VAS, had strong positive correlation (Spearman's rank correlation (s(r)) 0.74, P<0.001). Overall, this study suggests that clinical signs suggestive of NeP progress in three-quarters of CKCSs with CM and/or SM.

2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats

“…62 Along with published clinical case reports in animals, the data suggest a strong rationale for using gabapentin in dogs and cats with similar conditions. 63,64 one canine study suggested a diseasemodifying effect in experimental DJD, but clinical studies are lacking. 65 in cats, one unpublished study demonstrated a benefit of gabapentin in naturally occurring DJD (E Troncy 2013), and one case series of chronic musculoskeletal pain has also been published.…”

Association between the findings on magnetic resonance imaging screening for syringomyelia in asymptomatic Cavalier King Charles spaniels and observation of clinical signs consistent with syringomyelia in later life

“…SM is a progressive disease in CKCS Plessas et al, 2012). The severities of clinical signs and clinical progression are correlated with the size of the syrinx (Rusbridge et al, 2007).…”

Evaluation of the effect of oral omeprazole on canine cerebrospinal fluid production: A pilot study

“…However, the mechanism by which omeprazole affects CSF production was not elucidated in these studies. Moreover, despite the fact that both studies only focused on the immediate effect of IV or VC administration of omeprazole on CSF production, oral administration (0.5-1.5 mg/kg/day) is currently recommended for the long-term management of dogs with hydrocephalus or syringomyelia (Rusbridge et al, 2006;Thomas, 2010;Plessas et al, 2012).…”