Cavaliers & SM/CM (Syringomyelia-SM/Chiari Malformation-CM)
Olive was recently diagnosed with SM/CM. Unfortunately, it's very common for the Cavalier King Charles Spaniels breed to be prone to this neurological condition. In this post, I will discuss the conditions, symptoms, and what you can do to help your Cavalier if they are affected.
What Is SM/CM?
Syringomyelia (SM) is a condition in which fluid-filled cavities, called syrinxes, develop within the spinal cord. These syrinxes can cause damage to the nerves in the spinal cord and lead to a variety of symptoms, including pain, weakness, and loss of coordination.
With Cavalier King Charles Spaniels, Syringomyelia is often associated with Chiari Malformation (CM), which is a structural abnormality of the skull that can cause the brain to be compressed and pushed down into the spinal canal.
(These scans are directly from Olive's MRI)
Symptoms of SM/CM
Early Warning Signs & Recognizing When Something Was Not Right
Looking back at when Olive's symptoms began to the moment of diagnosis, was about a 3 year process. Her early symptoms were minor, but they also got mixed up with her food allergies she was experiencing (chicken). Symptoms of Syringomyelia and Chiari Malformation in Cavaliers can be quite variable, and often misdiagnosed with allergies to food, environmental, and/or seasons. Early Warning Signs of SM/CM Olive had (not a symptom of allergies)
Scratching her neck & head (not too often but enough to be noticeable)
Rubbing on furniture (especially after finishing a meal)
Hesitation to jump up onto the sofa (like 6-12 inches, not very high).
Recognizing When Something Wasn't Right
Olive experienced the symptoms above for a few years without any sign of pain or changes in behavior, until November of 2022 when she began yelping out randomly.
She would be sitting on the ground, and then yelp out as if someone stepped on her foot. Olive would run to me and become very scared at what was going on. At first I thought her foot might be hurting, so I took her into the vet and had it X-Ray'd.
Long story short, her vet was saying Olive had some arthritis, and Cold Laser Therapy would be beneficial. I knew something was still off, until it clicked in my head her vocalization (yelping) was a KEY SYMPTOM of SM/CM.
The Difference Between SM/CM & Allergies (this is from Olive's experience)
SM/CM | | Allergies |
Scratching the head, neck, and ears | | Scratching all over, but more paw biting and ear scratching. |
Sensitivity to touch (especially around the neck area) | | Ear infections |
Pawing at their head (looks like their trying to cover their eyes) | | Skin sores & infections |
Rubbing up on furniture (especially after a meal and/or exercising) | | Diarrhea and/or Vomiting |
Gabapentin seems to reduce the symptoms/pain. | | Cytopoint injections reduce the itching for 3-6 weeks (not a solution, nor a long term solution. Only masks the allergy problem). |
Vocalization (barking, yelping, whining, moaning)almost like they got hurt all of a sudden but nothing was happening). | | |
Neck & back pain. Also, their neck feels stiff/tight. | | |
Difficulty walking or standing, & reluctance to climb stairs or jump | | |
Behavioral changes (aggressive, anxious, scared, etc...) | | |
Worsens with a rise in humidity, or drop in barometric pressure. | | |
When Do Symptoms Worsen?
Olive's symptoms became worse when we experienced a drastic change in weather. We had heavy rainfall and high humidity, along with barometric pressure changes. This was when Olive began randomly yelping out.
Anytime I know the weather is going to have humidity over 80% I will up her medication to prevent further discomfort.
Diagnosing SM/CM
It's a confusing and long process, especially if your dog may have allergies. If you suspect that your Cavalier may be suffering from syringomyelia and/or Chiari Malformation, it's important to seek veterinary care as soon as possible.
Your veterinarian will likely perform a neurological exam to assess your dog's symptoms and may recommend imaging tests, such as an MRI, to confirm a diagnosis. The only way to 100% confirm SM/CM is through an MRI. They are very expensive, but well worth it to get an accurate diagnosis.
One of the main reasons I decided to pursue the MRI was because PSOM-"glue ear" (often associated with SM/CM) can't always be seen through a vets ear scope, and if not detected early can lead to deafness. I didn't want to take any risks with Olive, and wanted to make sure she had the most accurate plan of action.
Many cavaliers suffer from painful symptoms due to improper treatment.
MRI Diagnosis
Imaging done to perform an MRI for your dog involves anesthesia, because the dog needs to hold still. Imaging can take anywhere from 1 to 4 hours, depending on what the doctor deems necessary. It is important you have blood work done, a full heart evaluation, and physical to ensure your dog is clear for anesthesia.
The results from MRI for Olive were received within 24 hours after the MRI.
Treatment For SM/CM
I've found a variety of treatments that help Olive manage her SM/CM. Treatment options will be suggested from your vets neurologist depending on the severity of the condition.
Mild cases may be managed with medications including (ex: Gabapentin, Omeprazole, etc...) to control pain and inflammation, while more severe cases may require surgery to relieve pressure on the brain and spinal cord.
Olive's SM/CM was considered mild, yet the vet recommended surgery... I definitely considered that a red flag and am not jumping straight to the scalpel. I am seeking multiple vets opinions for course of treatment, as Olive is thriving on just Gabapentin at this time. Surgery felt a little extreme for her mild case.
I am huge believer in integrative medicine, with the western medicine. I have found that alternative therapies are very helpful, such as cold laser therapy, acupuncture, food/herbal therapies, supplementation, and massages.
Preventing SM/CM
Preventing SM/CM in Cavaliers can be challenging, as these conditions are believed to be inherited. However, responsible breeding practices and genetic testing can help to reduce the incidence of these conditions. Please ensure your cavalier is from a reliable breeder who is actively testing for SM/CM.
On my Instagram, you will find a highlight titled "SM/CM" with a full story of Olive's experience along with a post where I share videos of what Olive's symptoms looked like in the early phases of SM/CM.
Always Speak With Your Vet.
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