Click here for Bonnie’s pedigree chart
Bonnie, a beautiful blenheim Cavalier, my first dog, came into my life when she was ten weeks old.
I looked forward to my new lifestyle as a dog owner, doing some training with her, some agility maybe, and lots of walking in the countryside where we lived.
Bonnie was a very happy and confident little dog. Everybody fell in love with her, and I wanted to take her everywhere with me.
Right from the beginning, I noticed that Bonnie scratched rather a lot, but was told, ‘all dogs scratch’. I groomed her regularly, changed to a hypoallergenic shampoo, treated her for fleas, and got used to the fact that she was a scratchy dog.
One or two people commented that Bonnie had a ‘funny walk’. It was a sort of rolling gait, which looked slightly comical from behind, and I wasn’t worried by it.
I began to see that Bonnie was often quite restless in the evenings. She would frequently move to another part of the room, or go to lie down on the stone tiles in the kitchen. She also had this very strange habit of licking the air as if trying to catch imaginary flies.
When Bonnie was twenty months old, she suddenly screamed with pain for no apparent reason, and for the next few days did so intermittently. The vet couldn’t be sure what had caused the pain, but prescribed pain relief and rest for six weeks.
Cutting a long story short, I will just say that over the next two years Bonnie had more bouts of pain, and was given every possible diagnostic test to try to reach a diagnosis. Her restlessness increased, the scratching increased, she obsessively licked her front paws, and she no longer looked forward to walks. I would take her to our favourite open space and she would just sit down and not want to follow me. Bonnie found it increasingly difficult to jump up or down from furniture or steps and her movements seemed increasingly uncoordinated.
Another very strange symptom occurred, which is what finally indicated to my vet that Bonnie should be referred to a neurologist. While walking on the lead, Bonnie’s left hind leg would make a scratching movement which did not make contact with the skin. It got worse, more frequent, and stronger. It was not just when on the lead, but with any kind of excitement. The crying/screaming episodes were almost unbearable to witness. She would often tremble with the pain, and try to hide in a dark corner or under a chair.
The neurological examination and MRI scan revealed all. Bonnie had severe Syringomyelia. Part of her cerebellum herniated through the back of her skull, and there were three large syrinxes (fluid filled pockets), in her spinal cord. In fact most of Bonnie’s spinal cord had been destroyed – the white colour of the fluid present instead of the black solid colour of a healthy spinal cord. As the neurologist put it, ‘a rod had become a tube’. The vets were astonished that Bonnie had managed as well as she did.
I was devastated to discover how much damage my beloved Bonnie had sustained, and how much pain she must have been in. I turned to the internet and found a website which another pet owner had set up, whose Cavalier had also suffered from Syringomyelia. There I learned about the work of Geoff Skerritt, a neurologist in Cheshire, who had been performing a surgical procedure known as sub-arachnoid shunting. I also learned of the work of Clare Rusbridge who was researching the mode of inheritance of Syringomyelia.
I decided that Bonnie’s best chance was to have the surgery performed by Mr Skerritt, and so I took time off work and drove the two hundred miles to Cheshire. Leaving her there, so far from home, was awful, but I believed that I would be bringing home a beloved companion who would no longer be in pain, or unable to walk without ‘scratching’.
This was not to be. Although Bonnie seemed better in herself for a while, her leg ‘scratched’ just as before and I could see that she was becoming more and more disabled. Six months or so post surgery, the episodes of severe pain started again and we returned to Cheshire. Bonnie was re-scanned and the shunt was judged to be in place and working. There was no more that could be done.
My own vet did warn me that I should be prepared for the time when Bonnie’s quality of life would be such that euthanasia would be the only course of action to take. For some time, however, in spite of everything, Bonnie was still a happy, lively and sociable little dog. She could enjoy the garden, even go for short walks, and greeted every family member and visitor with a waggy tail.
But Bonnie tired easily, and whimpered when driven to distraction by the irritation (burning sensation?) around her neck and ears. This was always worse when she became excited, and I tried to avoid any situation which might trigger her symptoms, such as visiting other people, or doing too much, or getting too warm.
One Sunday in March 2003, I took Bonnie for a walk, to a local beauty spot. She seemed fine. We strolled; she sniffed things; the sun shone. Back home, I lifted her out of the car and noticed that her back legs could hardly stand to take her weight. I carried her in to her bed, and in the evening we sat together on the sofa. She couldn’t get comfortable; she didn’t cry out, but I knew she was in severe pain. The following morning my beautiful, brave Bonnie couldn’t move. I phoned my vet and sat with her until he came. It was time for Bonnie to be released from her suffering. I couldn’t hold her in case I hurt her, so I put my hand under her head, while the vet gently injected the anaesthesia.
There was a feeling of relief for a short time, and then an overwhelming grief for the bravest and most gorgeous little soul, who I had been privileged to share my life with. She could not have been more loved, and truly was the bravest of the brave.
I can’t think of Bonnie without the pain of knowing how badly she was let down by everyone, including myself. How bravely and stoically she coped with her pain and disability. However, there is some comfort in knowing that her story is helping to raise awareness of this terrible hereditary condition, which so many other Cavaliers are now suffering with.
Click here for Rosie’s pedigree chart
Four months after losing Bonnie in 2003, I started to look for another Cavalier puppy.
I contacted many breeders all over the country and told them about my experience with Syringomyelia. I wanted to be as sure as I possibly could that my next Cavalier would be healthy. and at that stage I hadn’t understood how widespread Syringomyelia was in the breed.
In the end I took a chance with Rosie, a beautiful ruby girl who became available at the age of ten months.
It was not long before I began to worry. Why was she scratching her ears and rubbing her face back and forth along the carpet? I heaved a sigh of relief when my vet found an ear infection which was easily treated. But the face rubbing continued and my anxiety kicked in again. I was aware that I had an irrational fear of Syringomyelia but I had to know if Rosie, too, had inherited this disease.
My vet agreed to an MRI scan and this was done when Rosie was fourteen months old. The results showed that Rosie did have the chiari-like malformation at the back of her skull. Her hindbrain (cerebellum) was compressed and her brainstem slightly kinked. There was a small herniation of her brain into the spinal area, but no syringomyelia. This was both good and bad ws: no syrinx, but there was the skull malformation which could cause it to develop in the future and this is indeed what happened.
A second MRI scan a year later, carried out by Dr Clare Rusbridge at the Stone Lion Veterinary Centre, Wimbledon, London, UK, showed that a small syrinx had formed in the upper (cervical) spinal cord. We re-scanned a year later and could see that the diameter of the syrinx had widened.
As you can imagine, during all this period I was consumed with worry. By this time I had learned a great deal more about Syringomyelia and I knew what lay ahead. I didn’t know how I would cope emotionally with another SM dog. What kept me going was the thought that Rosie was the innocent victim who had inherited this awful disease. I loved her as I had loved Bonnie and it was my responsibility to take care of her and give her the best quality of life I could.
I discussed the treatment options with Dr Rusbridge: to treat medically for pain relief or surgically by foramen magnum decompression. It was an agonising choice, but in the end I opted for the surgery in the hope that the progression of the disease could be halted or slowed down.
Decompression is major, invasive, pioneering and expensive surgery. Recovery can take many weeks or even months. It involves cutting a piece of bone from the back of the skull and top of the spinal column. The outer covering of the brain is also incised in order to remove adhesions which have formed on the surface of the brain. A patch is then placed over the incision site.
The outcome of this surgery is that the hindbrain and brainstem should have more room and the fluid around the brain and spinal cord should be able to flow back and forth freely.
Rosie recovered remarkably quickly from this major surgery and after a few months her medication (Gabapentin) was reduced to 100mg each evening. There are as yet inconclusive findings about the long term results of decompression surgery so we will work with Dr Rusbridge to monitor Rosie’s post surgical progress. I think she has headaches and some level of discomfort, particulary in the evenings, but she can’t tell me so I don’t really know.
Post-surgery MRI and cancer
I arranged to have a post surgical MRI scan at the Stone Lion Veterinary Centre in October 2007. Just before that I noticed a small lump near one of Rosie’s mammary glands. Lab tests were inconclusive but it was recommended that the lump be removed. So while Rosie was under the anaesthetic for the MRI the tumour was removed. Further laboratory tests found that the lump was a carcinoma. Cancer at five years old and something else to worry about!
The good news, however, was that the post surgical MRI showed that the decompression surgery had been a success. Rosie’s hindbrain was no longer compressed and the cerebrospinal fluid (CSF) pathways were clear. The small cervical syrinx remained but had not progressed.
Is this the end of Rosie’s Syringmyelia story? I wish it was. In so many ways Rosie is a very normal little dog and has a good quality of life. She exercises a lot, chases leaves and butterflies, has chased, killed and eaten a rabbit or two(!!), assisted by our cat, Freddy. She loves life and of course is spoilt rotten. However, there are some signs which will not go away.
Rosie rubs her face and head probably a few times a day. Sometimes I think she ‘hides’ behind a chair or under the table and every evening and sometimes during the day as well, she goes to a chair and ‘digs’ frantically at it. I don’t know why she does this but it is puzzling and at the back of my mind is the thought that these behaviours are a response to some pain or unpleasant sensations.
Three years post surgery in March 2009 we trekked to Wimbledon again for what I hoped would be Rosie’s last MRI. For once I was optimistic, but sadly this time the news was not good – there had been some progression of Syringomyelia. The syrinx had not lengthened but it had expanded from 1.5mm in width to 3.5mm. What can I say? The future is not quite so ‘rosy’ now, but we have some new medicine to try (Cimetidine) which should reduce the production of cerebrospinal fluid (CSF), relieve the pressure and hopefully slow down any further progression of SM.
Rosie doesn’t seem to be in any pain, but I’m reminded of the fact that dogs are very stoical animals. They will put up with chronic pain and still be positive and cheerful. I do so wish she could tell me.
Heart disease (MVD)
I have followed the advice of cardiologists and the Cavalier Club and had Rosie’s heart tested by simple auscultation every year. In 2007 and 2008 she was found to have a grade 2 heart murmur. In 2009 she was found to have no murmur, but in 2010 a grade 3 murmur. I’ve been told that this does not impact on her quality of life and that heart medication is not yet necessary. It is a cause of worry, though.
MRI scan 15 March 2011
Rosie had her final MRI scan on 15 March 2011 at Stone Lion. There has been minimal, if any, progression of Syringomyelia since her last scan in 2009. Dr Rusbridge thought that at eight and a half years Rosie’s SM had stabilised and would be unlikely to progress further.
This is the best news I could have had and hopefully we can look forward to a few more years of good quality of life.
Heart Disease update December 2013
Rosie’s heart murmur is now at grade 5 and she has started coughing. Cardiologist, Mark Patteson, performed an ultrasound scan which show that Rosie’s heart was enlarged and pressing on her trachea. We have started heart meds: cardalis, vetmedin and frusemide. For a further six months Rosie still had a reasonably good quality of life
Death 18 May 2014 aged 11 years, 8 months
Rosie had become slower and slower and on Saturday 17 May her respiratory rate had increased to 50+. She was given intensive treatment intravenously overnight at the vets but did not respond. I made the decision on Sunday morning to have Rosie euthanised as I did not want her to suffer more. She greeted me with a waggy tail and a kiss. We had ten minutes together in the garden at Vale Vets and then I held her as she was gently given her wings. For Rosie it was the best possible end I could give her. For me it was devastating. I took her myself to the small pet crematorium nearby and I now have her ashes at home with me. Jemima Harrison has done a beautiful tribute to Rosie here:
Poppy came into my life on 16 January 2015. She is a retired Cocker Spaniel breeding girl aged four and a half years. She is the sweetest, gentlest dog and full of life. She comes from a breeder who carries out all the health testing and health screening available for Cocker Spaniels and who also breeds only from dogs with a superb temperament.
Here we are on Stinchcombe Hill, Dursley, Gloucestershire 11 February 2015.