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Syringohydromyelia in Dogs:
Implications for the Cavalier King Charles Spaniel
What is Syringohydromyelia?
Syringohydromyelia (syringomyelia, hydromyelia, syrinx,
SM) is a congenital or acquired intraspinal disease. It is a disorder where a
cyst or herniation, known as a syrinx, forms within the spinal cord and cause
the flow of cerebrospinal fluid (CSF) to become obstructed and accumulate,
causing symptoms such as scratching, pain and limb dysfunction. In some cases it
is seen in combination with hydrocephalus.
This condition is thought to be similar to the Arnold
Chiari Syndrome in humans which may also be accompanied by secondary
syringomyelia or hydromyelia. It is considered multi species and has been
reported in humans, dogs, cats, horses among others. Nor is it limited to one
breed having been reported in breeds such as the Labrador Retriever, Weimaraner,
Fox Terrier, Lhasa Apso, Pomeranian, Cavalier King Charles Spaniel.
What are the symptoms?
The most common symptoms of Syringohydromyelia are a
hypersensitivity in the neck area resulting in an uncontrolled urge to scratch
at the neck and shoulders, quite often to the point that the dog will fall over.
There is quite often discomfort and pain in the neck and ear areas. There may
also be progressive weakness in the limbs and loss of bladder and bowel control.
In the congenital form symptoms are usually first seen
from 6 to 18 months of age but depending upon the degree affected could manifest
at any age. In the acquired form symptoms can be seen any time after the
original injury or trauma to the spine.
How does a dog get Syringohydromyelia?
Syringohydromyelia can be either acquired or congenital.
If acquired, this would occur due to trauma, complications of surgery or disease
such as a tumour and the syrinx would develop in the damaged segment of the
spine and may expand causing difficulties. If congenital, the condition would
develop in the womb or during birth as a malformation and in this case the
syrinx is usually in the cervical region of the spine. In the congenital
condition, there is some suspicion that it may be a genetic and there are
currently studies going on to establish a familial link and hopefully understand
the mode of inheritance if genetic. (Please see the section "Implications
in Cavalier King Charles Spaniels" for more information)
How is it diagnosed?
Though the condition was recognized symptomatically
earlier it has only been due to the advances in advanced imaging techniques
through the use of Magnetic Resonance Imaging (MRI) that this disease has been
understood and diagnosis been able to be confirmed.
The MRI is the leading diagnostic tool used in
determining Syringohydromyelia. It has only been since 1993 that a functional
MRI was developed and around 1996 when it was advanced enough and readily
available to diagnose spinal conditions in dogs.
MRI images are formed by the combination of a strong
magnetic field and radio wave interacting with the hydrogen protons in the body
and then using a computer the information is collected and made into three
dimensional pictures of the body. The MRI can then characterize and discriminate
among the tissues using their physical and biochemical properties (water, fat,
iron, blood and its breakdown products) allowing blood flow, cerebrospinal fluid
(CSF) flow and contraction and relaxation of organs to be evaluated.
Using the MRI then allows the neurologist to study the
spine for the presence of a syrinx or any other abnormality, such as a tumour
which might obstruct the flow of the spinal fluid.
What is the treatment for Syringohydromyelia?
There are several different treatments for
Syringohydromyelia, some more successful that others. In some less severe cases
the use of cortisteroids or non steroidal anti-inflammatory drugs may relieve the
clinical symptoms. Decompression surgery to allow the CSF to flow normally may
be necessary and in some cases a shunt is installed.
Implications in Cavalier King Charles Spaniels
"I have a Cavalier, should I be concerned"?
This particular condition is known to affect less than
0.002% of Cavalier King Charles Spaniels so odds are very much in your favour
that your dog would not have this condition. If your dog is scratching or
displaying some of the other symptoms more than likely it is due to another
cause such as allergies which is a common condition in dogs. If concerned see a
veterinarian for evaluation.
Is Syringohydromyelia genetic?
There is a suspicion that Syringohydromyelia is of a genetic nature. Due to the
development of the MRI and genetic mapping, diagnosis and study of diseases such
as this is now being made possible. The Cavalier King Charles Club (UK) has
approached Mr. Simon Platt, Head of Neurology at The Animal Health Trust to
undertake research into the possible genetic nature of this condition.
So as it stands right now the jury is still out and I will keep you posted as
you all know my heart belongs to my dogs.
