Syringomyelia

Syringomyelia occurs when there is abnormal movement of cerebro-spinal fluid (CSF) in the spine, which causes fluid-filled cavities within the spinal cord. As the fluid cavities grow they cause damage to the spine, resulting in pain and neurological symptoms.

Syringomyelia usually occurs secondary to Chiari-like malformation (abnormal skull bone development), but can also be due to trauma, inflammation or cancer. Symptoms can vary considerably as well as progress over time and in severe cases have a great impact on quality of life.

It is most common in small and toy breed dogs, particularly Cavalier King Charles spaniels where the condition is hereditary. Symptoms can begin at any age in both males and females.

Some dogs with syringomyelia may not have any symptoms; however, when present the most common symptom is neurological pain, particularly in the neck. Dogs may cry out for no obvious reason as well as when touched. Changes in skin sensation can cause dogs to rub their face or chew their feet. Affected dogs are frequently presented to the vet for excessive scratching but when watched closely the dog’s foot does not make contact with the skin. This “Phantom Scratching” often occurs during times of stress or excitement.

In extreme cases there can be problems walking and paralysis of the legs as well as scoliosis (sideways curving of the spine) but this is uncommon.

The best way to diagnose syringomyelia is with advanced imaging, usually an MRI scan. Most general practices do not have an MRI machine and so your vet may refer you to a specialist centre. These scans allow your vet to see the fluid cavities within the spine as well as look for any underlying cause. However, the extent of the changes seen does not necessarily correlate with the severity of the symptoms shown by the dog. Often a CSF sample is taken to help rule out other underlying diseases.

Dogs with very mild or no symptoms may not require treatment. Dogs that require treatment initially are given medication to help control their symptoms. This includes pain relief with drugs such as gabapentin or an anti-inflammatory, as well as medication to decrease the amount of CSF being produced (furosemide, prednisolone and/or omeprazole).

Around 70% of patients will show improvement with medical treatment; however, symptoms do not usually go away completely and the disease can still progress over time. Surgical options to reduce the compression of the spine and brain are available in dogs where medical management is inadequate. However, recurrence of symptoms and further/repeat surgery is commonly needed due to scar tissue formation.

There is currently no reported way to prevent your dog from getting syringomyelia. In breeds where the condition is known to be genetic (e.g. Cavalier King Charles spaniels) it is worth informing your dog’s breeder to prevent further pups being affected, as well as not breeding from your own dog.