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Behavioral and clinical signs of Chiari‐like malformation‐associated pain and syringomyelia in Cavalier King Charles spaniels

Rusbridge, Clare, McFadyen, Angus K. and Knower, Susan P. (2019) Behavioral and clinical signs of Chiari‐like malformation‐associated pain and syringomyelia in Cavalier King Charles spaniels Journal of Veterinary Internal Medicine, 33 (5). pp. 2138-2150.

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Background: Diagnosis of Chiari-like malformation-associated pain (CM-P) or clinicallyrelevant syringomyelia (SM) is challenging. We sought to determine common signs.Animals:One hundred thirty client-owned Cavalier King Charles spaniels with neuroaxismagnetic resonance imaging (MRI) and diagnosis of CM-P/SM. Dogs with comorbiditiescausing similar signs were excluded with exception of otitis media with effusion (OME). Methods: Retrospective study of medical records relating signalment, signs, and MRIfindings. Dogs were grouped by SM maximum transverse diameter (1 = no SM;2 = 0.5-1.99 mm; 3 = 2-3.9 mm: 4 =≥4 mm). Differences between all groups—groups1 versus 2-4 and groups 1-3 versus 4—were investigated. Continuous variables wereanalyzed using 2-samplet-tests and analysis of variance. Associations between categori-cal variables were analyzed using Fisher's exact or chi-square tests. Results:Common signs were vocalization (65.4%), spinal pain (54.6%), reduced activ-ity (37.7%), reduced stairs/jumping ability (35.4%), touch aversion (30.0%), alteredemotional state (28.5%), and sleep disturbance (22%). Head scratching/rubbing(28.5%) was inversely associated with syrinx size (P= .005), less common in group4(P= .003), and not associated with OME (P= .977). Phantom scratching, scoliosis,weakness, and postural deficits were only seen in group 4 (SM≥4 mm;P= .004). Conclusions and Clinical Importance: Signs of pain are common in CM/SM but arenot SM-dependent, suggesting (not proving) CM-P causality. Wide (≥4 mm) SM isassociated with signs of myelopathy and, if the dorsal horn is involved, phantomscratching (ipsilateral) and torticollis (shoulder deviated ipsilateral; head tiltcontralateral).

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Veterinary Medicine
Authors :
McFadyen, Angus K.
Knower, Susan P.
Date : 9 July 2019
DOI : 10.1111/jvim.15552
Copyright Disclaimer : This is an open access article under the terms of the Creative Commons Attribution-Non Commercial License, which permits use, distribution and reproduction in anymedium, provided the original work is properly cited and is not used for commercial purposes. © 2019 The Authors.Journal of Veterinary Internal Medicinepublished by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Depositing User : James Marshall
Date Deposited : 26 Jun 2020 09:41
Last Modified : 30 Jul 2020 10:04

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