Fergie was a 6 year old female spayed King Charles Spaniel who was presented to our Springfield location for difficulty with stairs and high curbs and neck pain. This had been slowly progressive and was getting worse, even with pain management.
-Difficulty with stairs
Cervical spinal cord +/- caudal fossa – primary differentials included COMS, IVDD, immune-mediated encephalomyelitis
CBC and chemistry profile were normal.
MRI showed flattening of the occipital bone (large arrow) causing compression of the cerebellum with complete ablation of cistena magna. Syrinx at C3 along midline took up about 30% of the spinal cord (small arrow). Cerebral spinal fluid was normal.
Caudal occipital malformation (COMS) and syringohydromyelia
Foramen magnum decompression
By the two week mark at her suture removal Fergie was comfortable and by six weeks post-op she was well enough to walk up the stairs. One year later she is comfortable going for walks, visiting friends and sharing her love of life with her family.
Take Home Points:
- Medical management with gabapentin +/- prednisone and omeprazole can be helpful for milder cases of caudal occipital malformation (COMS) and syringohydromyelia.
- Foramen magnum decompression can be incredibly helpful to relieve pain and some incoordination seen with COMS, but does not reverse the syrinx that has formed in the spinal cord.
- Diagnosing and treating COMS early can lead to a better long term prognosis.
One year later, Fergie is still doing well. CHeck out this video Fergie’s mom sent about her progress.