Vet Guide 2025: Syringomyelia in Dogs – Causes, Diagnosis & Care 🧠🐶

Welcome! I’m Dr Duncan Houston, your veterinary neurologist sharing a comprehensive 2025 update on syringomyelia—a spinal cord condition notably affecting Cavalier King Charles Spaniels but seen in other breeds too.

What is Syringomyelia?

Syringomyelia describes fluid-filled cavities (“syrinxes”) within the spinal cord, caused by abnormal flow of cerebrospinal fluid (CSF). In dogs, this often stems from a mismatch in skull and brain size, particularly in the caudal fossa.

Chiari-like Malformation

In many affected dogs—especially Cavaliers—the Chiari-like malformation compresses brain tissues, obstructs CSF flow, and sets the stage for syrinx formation in the upper spinal cord.

How Syringomyelia Develops

• **Disrupted CSF flow** creates pressure waves.
• Excess CSF is forced into spinal cord tissue, forming cavities.
• The spinal cord is compressed by surrounding bone and tissue, triggering pain and neurological dysfunction.

Who’s at Risk?

Most common in Cavalier King Charles Spaniels, but can occur in other small breeds. Symptoms usually emerge between 6 months to 3 years of age.

Clinical Signs

• Neck pain (ragged neck posture, whimpering)
• Phantom scratching at neck, shoulder or chest
• Facial nerve paralysis (drooping lips or eyelid)
• Limb weakness or ataxia
• Seizures (common in Cavaliers—association still under investigation)

Diagnosis: MRI is Essential

Only MRI accurately visualizes syrinxes and identifies underlying conditions. Differential diagnoses include:

• **Primary Secretory Otitis Media (PSOM):** Mucous-filled middle ear can feed similar behaviors.
• Disk disease, inflammation, tumors, taste or ear issues.

When eardrum exam is inconclusive, MRI clarifies the cause—and rules out PSOM.

Treatment Strategies

1. Surgery

Foramen magnum decompression to restore CSF flow shows an 81% initial success rate in relieving pain. However, scar tissue may recur, and long-term benefits drop to ~45% at two years post-op.

2. Medical Management

Medications focus on:

• **Reducing CSF production:** Furosemide or omeprazole
• **Pain relief:** Neuropathic agents like gabapentin, NSAIDs, or corticosteroids

Note: Omeprazole is best limited to ~8 weeks to avoid side effects. Most dogs will continue to deteriorate without surgery over time—about 75% require long-term multimodal management.

3. Supportive Care

• Use **harnesses** instead of collars to reduce neck pressure
• Apply **elevated water & food bowls** to ease stress on cervical spine
• Create **low-stress, padded environments** with minimal slipping or jumping
• Offer **calm, routine schedules**—sudden excitement or temperature shifts can worsen symptoms

When to Consider Screening

Asymptomatic dogs may be MRI-screened for:

• **Breeding candidates:** to reduce heritable risk
• **Early detection or monitoring:** assess progression or need for intervention

Since MRI requires anesthesia, screening is best reserved for cases where benefits outweigh risks. Any dog diagnosed with Chiari-like changes—symptomatic or not—should not be bred.

Prognosis & Ongoing Life Quality

• **Post-surgical dogs:** pain relief for many, but syringomyelia may recur over time
• **Medically managed dogs:** can thrive with stable pain control but need ongoing monitoring
• **Pain-free asymptomatic dogs:** may live full lives without therapy, but regular check-ins recommended

2025 Key Takeaways

• Common in Cavaliers, but other breeds affected
• MRI is necessary for definitive diagnosis
• Treatment options include surgery, medications, and lifestyle support
• Early recognition and veterinary care improve outcomes
• Breeding affected dogs is discouraged due to heritability

What You Can Do Next

• If your dog shows neck pain, scratching without contact, or facial paralysis, **consult a neurologist**
• Book an **MRI** to differentiate syringomyelia from ear or spinal conditions
• Discuss multi-modal pain management or surgical referral
• Adopt neck-sparing practices like harnesses and slow movement pacing
• Never breed a dog diagnosed with Chiari changes or syringomyelia

About the Author

**Dr Duncan Houston, BVSc** is a board-certified veterinarian specializing in neurology, dedicated to advancing understanding and care for complex neurological diseases like syringomyelia.