Does medical therapy influence the size of the syrinx in dogs with Chiari‐like malformation/syringohydromyelia complex?

Abstract

I wish to report on the effect of medical management on progression of syringohydromyelia (SHM) in cavalier King Charles spaniels with Chiari-like malformation (CM). Seven cavalier King Charles spaniels (age: 1 to 5 years; mean, 2·3 years) with history, clinical signs and MRI findings suggestive of Chiari malformation/syringohydromyelia received long-term (0·5 to 4·5 years; mean, 2·8 years) furosemide therapy (dose: 0·8 to 2 mg/kg twice daily; mean, 1·1 mg/kg twice daily) and had repeat MRI scans between 0·5 and 4·5 years (mean, 2·8 years) after diagnosis. Additional oral medications (gabapentin, corticosteroids and omeprazole) were prescribed when furosemide failed to control the clinical signs associated with CM/SHM complex. In all seven dogs, syrinx width and length increased at the follow-up MRI and in four cases a new syrinx had developed (Table 1). Furosemide did not prevent further syrinx expansion nor reduce the size of the syrinx but it remains unknown whether the medical treatment may have delayed the inevitable expansion of the syrinx. Studies of a larger population and prospective, randomised, blinded comparisons between different treatments (medical, surgical, medical vs surgical) are needed to ascertain which will produce the best clinical results. L. Motta Chester Gates Veterinary Specialists (CVS UK LTD), Chester, Cheshire, CH1 6LT