Understanding and Treating Chiari-like Malformation and Syringomyelia in Dogs

Chiari-like malformation (CM) and syringomyelia (SM) are common and debilitating conditions in toy and small breed dogs. CM, considered ubiquitous in the cavalier King Charles spaniel (CKCS) population, results in abnormal cerebrospinal fluid dynamics which can lead to the development of SM. The clinical signs associated with CM/SM are frequently confused with other otologic and dermatologic conditions, which may delay appropriate treatment. A definitive diagnosis of CM/SM requires advanced imaging; however, due to expense associated with this, many cases are managed presumptively and symptomatically for the condition. The primary goal of treatment is to manage neuropathic pain and neurologic deficits through pharmaceutical or surgical approaches. Current literature suggests that most CM/SM-affected dogs have progression of their clinical signs in spite of medical or surgical management; however, most maintain a good quality of life based on owner assessments. Lack of correlation between structural markers of disease and clinician and owner-derived measures of neuropathic pain highlight the need for more robust, quantitative measures of pain in this common veterinary disease.