Friday, February 13, 2009

Syringomyelia


Hydromyelia (HM) is a condition where there is a widening of the central canal (channel) of the spinal cord. Fluid can accumulate in this region, causing increased pressure on the spinal cord (known as syringohydromyelia).

Syringomyelia (SM) is a condition that involves fluid collecting in the area of the spinal cord that is outside the central canal. The result of hydromyelia and syringomyelia is essentially the same: an abnormal cyst or cavity (collection of fluid) in the spinal cord that is associated with a wide range of neurological disorders and destruction of the cord. To simplify, the term syringomyelia is used to refer to a fluid-filled cyst in the spinal cord that is inside or outside of the central canal.

The disease affects both Cavalier King Charles Spaniels (CKCS), in the cervical (top part) spinal cord and the brainstem, as well as, Weimeraners, in the lumbar spinal cord (back part towards the tail). Causes include genetic (as in the case of the above breeds), trauma, infection and tumours. In the case of the CKCS, sometimes the skull is too small to accommodate the brain and so the end portion of the brain squeezes out of the hole at the back of the skull (the foramen magnum) blocking the flow of spinal (CSF) fluid down the canal. This abnormal flow of fluid lead to the formation of a cyst.

Common symptoms as the dogs grow and the condition develops include pain (can be very severe) and scratching of the shoulder and neck. As it gets worse and the spinal cord deteriorates, it can cause weakness of the limbs and paralysis. In Weimeraners, it tends to affect only the back legs and cause hopping (like a rabbit).

Diagnosis is normally confirmed by an MRI. If not genetic (e.g. a tumour), the underlying cause should be treated. Otherwise, drugs used include steroids and anticonvulsants (to stop seizures if very serious). One anticonvulsant sometimes used is gabapentin, which controls fits, helps with nerve pain and acts as a pain killer.

Sometimes other drugs used include: diuretics (e.g. frusemide), carbonic anhydrase inhibitors (e.g. acetazolamide) or proton pump inhibitors (e.g. omeprazole), to decrease the fluid build up in the brain (if showing brain signs e.g. fitting) and painkillers (like tramadol).

Surgery to promote drainage may be performed although complicated and expensive. The aim of surgery is to allow the spinal fluid to flow. This will reduce pain and deterioration. Recovery rates are better when the surgery is performed before the condition has developed to an advanced stage.

One alternative treatment option is periodic acupuncture. There are some reports that this can help to make the animals more comfortable.

If surgery is not an option and all else fails, sometimes euthanasia may be the kindest option to minimise the suffering.

2 comments:

  1. The quality of your blogs and articles and worth appreciating. can-C Free shipping

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  2. Interesting this condition occurs in humans and dogs. I wonder if occurs in other mammals. Maybe it also occurs in livestock and other domesticates. Genetics are fun, I once worked in a DNA sequencing center and some animal gain and lose traits over time. I wonder why this mainly just happens to weimeraners ans cavilers, so strange. http://www.chiariinstitute.com/syringomyelia.html

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