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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 32846
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Hi - We have a Cavalier King Charles puppy, aged 16 weeks,

Customer Question

Hi - We have a Cavalier King Charles puppy, aged 16 weeks, and collected him from the breeder at 10 weeks. He is generally very happy and contented, eating well, good toilet habits, firm stools etc. However, once or twice a day he will suddenly give a pained yelp and usually turns his head to his rear end. This can happen when he is just casually strolling through our lounge.
We've already taken him to the vets twice. First time she cleared his anal glands, second time she checked his hips (100%) his ease of walking and running (100%) and gave him a thorough exam generally. She said it was rare for her to be baffled, but she couldn't give a logical answer. He has recently gone a couple of days without doing it, but again today he has yelped in obvious pain several times.
We were having him neutered at 6 mths and the vet wanted us to keep an eye on him and then she might x-ray him then.
Today an ex vet-nurse said it could be a cruciate ligament condition, though after Googling it, he doesn't show any signs of limping, or hanging a leg.
It's a mystery and rather distressing to see him have such obvious discomfort. Any ideas?
Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin
While I don't have the luxury of carefully palpating Dougal's neck, I have to be concerned about a Chiari type malformation in any CKC exhibiting occasional yelping. This describes a congenital malformation of the skull that results in intracranial overcrowding and compression of the cervicomeduallary junction at the level of the foramen magnum; in other words, his brain would be abnormally compressed in the area of his brain stem. This disorder is being diagnosed earlier and earlier in this breed and so his vet may not be familiar with this fact. Historically the age of onset of signs was between 3-6 years. The most common symptom seen in the CKC was incessant scratching at the shoulder and head/neck region - a suspected paresthesia. Neck and/or head pain is often detected on palpation.

Please share our conversation with Dougal's vet. The diagnosis is dependent upon MRI. I'll be at a veterinary convention this morning but promise to reply to you as soon as I return if need be.
Customer: replied 3 years ago.

Thank you for the reply. He doesn't seem to have any pain in the neck area when we stroke or touch him there, though obviously we don't know which specific area you would palpate.

Also, he will play and run around with puppyish enthusiasm and the yelping invariably happens if he gets up following a sleep or relaxation.

If the condition is what you suspect (1) can it be helped or contained, (2) would it usually require medication or surgery?

Thanks again.


Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for the additional information, Richard. I might have to be quite "rough" with my patient when palpating in order to elicit a response. I wouldn't expect owners to be so rough with their pets. It isn't clear to me why he's more painful after a rest other than the adrenalin of running around might obscure discomfort.

If this condtion exists and I certainly hope that it doesn't, most dogs respond favorably to medical therapy - antiinflammatories and narcotic pain relievers; however, the disease tends to progress over time. In one small study, 5 of 10 dogs diagnosed and treated medically were euthanized within 2 years because of disease progression. Surgical therapy is associated with an 81% success rate.

Please continue our conversation if you wish.