One of our readers was given the opprotunity to submit Interview questions for Dr. Marino a leading researcher here in the US for CLM /SM. The interview is rather long and so it has been broken up into three parts in order to be easier to read.
There is a lot of focus on Syringomyelia but can you discuss some things about CLM?
Clinical signs relating to cerebellar or brainstem compression are not as common as those related to syringomyelia. If a dog has a cerebellar compression without the formation of syringomyelia and subsequent clinical signs, we do not consider the “abnormality” or the “variation of normal anatomy” to be pathologic and therefore do not recommend surgery. We do not make decisions on surgery based on just cerebellar compression unless it is regarded as pathologic. Thus, if there is a compression significant enough to altar CSF flow and result in syrinx formation, we absolutely recommend surgical intervention to restore the normal physiologic flow pattern of the CSF. That being said, certain types of compressions are suggestive of AOO and should be investigated further.
Do you know why some dogs can experience pain with CM alone while others don’t?
I believe it is based on whether a syrinx has formed and how “effectively” we are assessing the presence of clinical signs; after all, what does a migraine look like in dog?
Is there hope for dogs diagnosed with CM / SM to live relatively pain free lives with the proper treatment protocol?
YES. Our experience is very positive when this condition is dealt with in a comprehensive manner both diagnostically and surgically. We have shown that dogs treated late in the course of the condition don’t do as well as those operated earlier in the course of the disease. Therefore there is no logic in medically managing this condition until medication does not work and then considering surgical options. The damage to the cord will eventually become irreversible. Obtaining an accurate diagnosis is key to early intervention.
On the Canine Chiari Institute that you along with Dr. Curtis Dewey first began research on “Chiari-like Malformation” I am sure there have been some advances along with promising information that have been discovered since you first began research. I saw on the Canine Chiari website that you can donate money to this. Can you tell me more about what this is used for?
To help defray the costs of a comprehensive screening program, which at The Canine Chiari Institute includes: Neurologic examination, Radiography, 3 Tesla whole body MRI, Multislice CT imaging, BAER test, Medical Infrared Imaging (Thermography).
For breeders wanting to screen groups of normal dogs, the costs are around $550 and for dogs exhibiting clinical signs it is around $1,500.
Additionally, every dog operated at The Canine Chiari Institute, gets a free follow up MRI 6 months post op to assess progress.
By helping to defray costs, we have developed the largest data base of dogs in the United States and have long term follow up on many cases. We typically diagnose 3 dogs per week and operate 1-2 dogs each week. 60% of our patients fly in from out of state to have surgery here.
Is there an organization that we can donate to here in the US that is trying to find answers? How does the institute help in finding answers and hope for the future.
The New York Veterinary Foundation, www.NYVF.org, supports the work of the The Canine Chiari Institute, www.CanineChiariInstitute.org. The work of these organizations is detailed on their respective websites as are directions on how to donate to support their efforts.
I saw that LIVS does not only focus on Cavalier King Charles Spaniels. Can you tell me a little more on the other breeds being scanned? Does you feel that the other breeds who can develop this disease, should also have MRI scanning done.
YES. We have clearly shown that this is not a CKCS disease although most of data was collected because of unprecedented breeder support and cooperation in researching this condition. To them we owe a tremendous debt of gratitude, we never would have been able to move so quickly in the scientific community without breeder support. 40% of our patients are not CKCS, thus this is a condition of small breed dogs (under 30lbs)
What should a potential puppy buyer look for here in the US before purchasing a puppy?
Use a reputable breeder and learn about the breed by attending the many shows available which almost always include CE and certainly consult your veterinarian.
Has research for Canines helped humans that have CM or SM?
I believe so. I have been lecturing at both human and veterinary conferences on this condition for ten years and always leave better off for attending. The “Bridging the Divide” message of The New York Veterinary Foundation is meant to address just that. The exchange of information between human and veterinary medicine for the benefit of both communities. Because of my work on this condition, The CSF foundation, a human Chiari research foundation, is recognizing me this year at their charity ball (see attachment)
What is the hope of research being done to help breeds in diagnosing, managing, and hopefully decreasing the number of canines having CM or SM?
I am very optimistic we will improve the quality of life of dogs with this condition based on the dramatic advances we have made in the past 10 years. Remember, it was not that long ago, we in the veterinary community did not know this condition even existed. Today, without only donation dollars and without government support, we have approached the level of understanding found in human medicine. The next decade holds tremendous promise. - Dr. Marino