Cavalier King Charles with neuropathic pain (NeP) induced by a condition characterized by a brain-skull size mismatch do not show significant improvement after nonsurgical treatment for the condition, indicate UK study results.
Just a quarter of dogs with Chiari-like malformation (CM) and/or syringomyelia (SM) showed an improvement in their condition after treatment with gabapentin, pregabalin, and/or carprofen, the research team reports.
Despite the majority of dogs deteriorating during the study period, three-quarters of the cohort were still alive after the 39-month follow up, and their owners reported no significant compromise in quality of life.
Holger Volk (Royal Veterinary College, Hatfield, UK) and co-investigators explain that CM, which is associated with herniation of the cerebellum through the foramen magnum, and SM, accumulation of fluid within the parenchyma of the spinal cord, are common in this dog population.
Clinical signs of either or both conditions include cervical scoliosis, thoracic and pelvic limb ataxia, thoracic limb paresis, and signs of NeP.
A total of 48 animals with CM/SM were included in the analysis - conducted after a 2-week trial of NeP medication in 39 of the dogs - and their owners assisted with evaluation of clinical signs by reporting presence of phantom scratching or rubbing, vocalization, and/or evidence of spinal pain.
While nine dogs had reportedly stopped scratching by the study follow up, there were no significant differences in the number of dogs exhibiting compromised exercise ability, vocalization, or facial rubbing behavior indicating NeP, report Volk et al.
Furthermore, the owner-reported visual analog scores for clinical signs increased significantly from an initial median of 75 mm to 84 mm at the study follow-up point. Indeed, severity of clinical signs based on VAS deteriorated in 75% of cases, remark the researchers, while 14.5% of dogs' clinical signs remained static at follow up, and just 10.5% showed an improvement.
Owners of the dogs that were alive at the end of the study reported that their animals' quality of life was not severely compromised, and that had it deteriorated, they would have opted for euthanasia. Therefore, "non-surgical management of this condition can be an acceptable option," say Volk and colleagues.
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