Plessas IN, Rusbridge C, Driver CJ et al.
Royal Veterinary College, Hatfield, UK.
Vet Rec 2012;171:501.
Mark Lowrie’s review: Chiari-like malformation (CM) and syringomyelia (SM) are prevalent in Cavalier King Charles Spaniels (CKCSs) and cause signs of neuropathic pain, occasionally accompanied by ataxia and scoliosis. Neuropathic pain can manifest as phantom scratching of the neck and facial rubbing, potentially with intermittent yelping. Medical management includes the use of non-steroidal anti-inflammatory drugs, drugs that reduce cerebrospinal fluid production (e.g. omeprazole and cimetidine), corticosteroids, and antiepileptic drugs that have analgesic properties (e.g. gabapentin and pregabalin). Surgery is frequently performed in humans with CM, and it has been demonstrated that 80% of dogs improve symptomatically after surgery, although with no change in SM and some continuing signs of neuropathic pain (Vet Surg 2007;36:396–405). One-quarter to half of these dogs have recurrence or deterioration of signs within 3 years of the surgery.