Background: Recent studies including an innovative machine learning technique indicated Chiari-like malformation (CM) is influenced by brachycephalic features. Objectives: Morphometric analysis of facial anatomy and dysmorphia in CMassociated pain (CM-P) and syringomyelia (SM) in the Cavalier King Charles Spaniel (CKCS). Animals: Sixty-six client-owned CKCS. Methods: Retrospective study of anonymized T2W sagittal magnetic resonance imaging of 3 clinical groups: (1) 11 without central canal dilation (ccd) or SM (CM-N), (2) 15 with CM-P with no SM or <2 mm ccd (CM-P), and (3) 40 with syrinx width ≥4 mm (SM-S). Morphometric analysis assessed rostral skull flattening and position of the hard and soft palate relative to the cranial base in each clinical group and compared CKCS with and without SM-S.Results: Sixteen of 28 measured variables were associated to SM-S compared to CM-N and CM-P. Of these 6 were common to both groups. Predictive variables determined by discriminant analysis were (1) the ratio of cranial height with cranial length (P < .001 between SM-S and CM-N) and (2) the distance between the cerebrum and the frontal bone (P < .001 between SM-S and CM-P). CM-P had the lowest mean height of the maxillary area.
Conclusions and ClinicalImportance: CKCS with CM-P and SM-S have cranial brachycephaly with osseous insufficiency in the skull with rostral flattening and increased proximity of the hard and soft palate to the cranial base. Changes are greatest with CM-P. These findings have relevance for understanding disease pathogenesis and for selection of head conformation for breeding purposes. dogs without central canal dilation or syringomyelia with no clinical or behavioural signs of pain; CM-P, dogs with clinical and behavioral signs of pain with no syringomyelia or with a central canal dilation less than 2 mm wide; CSF, cerebrospinal fluid; DA, discriminant function analysis; DICOM, Digital Imaging and Communications in Medicine; FS, feature selection; ICC, intraclass correlation coefficient; ML, machine learning; MRI, magnetic resonance imaging; SM, syringomyelia; SM-S, dogs with syrinx width ≥4 mm and with SM specific signs of phantom scratching, scoliosis, paresis or proprioceptive deficits.