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Recognising the signs of Chiari-like malformation-associated pain

Abstract

Clarissa Wu reports on a recent study examining the signs of Chiari-like malformation and syringomyelia

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Both Chiari-like malformation and syringomyelia can cause significant pain

Canine Chiari-like malformation can cause significant pain and impact on activity, temperament and sleep. It also has some distinct clinical signs to syringomyelia, new research has found.

The condition, which is a developmental malformation of the head, causes overcrowding of the brain and spinal cord at the craniospinal junction. This can alter the flow of cerebrospinal fluid and lead to syringomyelia – a condition characterised by fluid-filled cavities (syringes) within the central spinal cord.

Chiari-like malformation and syringomyelia are commonly reported in Cavalier King Charles spaniels, and diagnosis is often challenging as the clinical signs can be non-specific.

A recent study, carried out by researchers from the University of Surrey School of Veterinary Medicine, reviewed clinical symptoms in 130 Cavalier King Charles spaniels diagnosed with Chiari-like malformation-associated clinical signs over a five-year period.

The research team aimed to characterise the common signs of both Chiari-like malformation-associated pain and syringomyelia and relate these to the syrinx diameter.

The common signs present in all the dogs were vocalisation, spinal pain, reduced activity, reduced ability to jump or use stairs, touch aversion, altered emotional state and sleep disturbance.

Charlie, one of the dogs in the study, was confirmed to have Chiari-like malformation but no syringomyelia. His condition is mostly controlled by medication, but has the occasional breakdown. Here he can be seen on a good day (left) and a bad day (right)

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Head scratching/rubbing was also common and was found to be more likely in dogs with small or no syringes, suggesting this may be a sign of head discomfort associated with Chiari-like malformation.

The only signs that were found to be specific to syringomyelia were phantom scratching, scoliosis and weakness. However, these signs were only present when the syrinx was large (at least 4 mm wide), suggesting they could be related to spinal cord damage caused by the syrinx.

Both Chiari-like malformation and syringomyelia can cause significant pain and, the researchers say, may have serious impacts on the health, welfare and behaviour of dogs.

However, the researchers warned that the findings of this study were based on reports from owners and, as such, conclusions should be made with caution.

Nevertheless, this study is important because it suggests that Chiari-like malformation alone is a cause of pain in dogs.

The researchers hope to use the information gained in their study to develop a tool to aid the diagnosis and treatment of both conditions.

The study is published in the Journal of Veterinary Internal Medicine and can be found here: http://bit.ly/2ZdqUI3

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