Decision

It's been a while and I apologize for not getting back here in the past two weeks. Between getting Dr. Rusbridge's consultation, discussing it amongst ourselves, coming to a decision and then reviewing it with our family vet, Dr. Mlekoday, we found ourselves on our way out of town for 5 days and it's been nuts since we came home. Let's catch up.

We decided that we are going to hold off on surgery. We realize that this is a risk, but so is the surgery. The bottom line is that, with all that we know now in March 2010, there still isn't a lot of data from prospective, large-sample studies about longer-term outcomes in Syringomyelia in the CKCS. While Riley's condition is likely to deteriorate over the course of his life there is no such guarantee. Ultimately, surgery to decompress is still evolving and new additions and techniques continue to emerge. One of our hopes is that in forestalling surgical intervention we might buy Riley time until better surgical outcomes are established with newer procedures and techniques.

Another concern is that we have to live with the outcome of the decisions that we make. I know that might sound strange to say but having been through life-challenging illnesses with our other companion dogs (Blackie and Chandler) we know intimately the process that goes on in your mind after the fact. Even when you do everything "right" you still second guess yourself wondering if you "Could have done more?" or "Should I have done less?" Etc... One thing we knew for sure is that if Riley went immediately for surgery and had an undesirable outcome, we would forever be chastising ourselves for not having attempted less invasive/medical treatments, first. So with that information, we decided as a family to follow Dr. Rusbridge's protocol for treatment of SM with medication.

The first thing we noticed was that Riley was on a very low dose for Omeprazole. At that point, he had been on it for just over a week and he was still in discomfort and having yelping "episodes". We decided to take him to the higher-range of the dose for Omeperazole and doubled his 5 mg evening (once a day) dose to 10 mg. Within 24 hrs, his yelping calmed down and he began to start running around the house and acting more spry and puppy-like. It was almost too good to be true.

We left for Las Vegas for Michael's birthday weekend just 2 days into the new dose. Our dog-sitter was well briefed on what to do and what to expect. We were actually looking forward to being away so that we could see if there was a notable difference 5 days later when we came home. And what a difference there was! Our dog-sitter reported just one middle-of-the-night yelping "episode" which was quick but with no other issues and no apparent distress. We came home 5 days ago and it's been 5 yelp-free days. As we expect, he continues to scratch and do the "air guitar" though it is markedly decreased. Riley is chewing his toys, running around the yard (and our living room) chasing Phoebe, kissing, snuggling and being very delicious and puppy-like, again. He's in no apparent distress and he's just the happy ol' Riley that we know and love.

We know that there is a very good chance that this might not last. It might not last for long, even. But he's doing well now. He's had a few good days. Today was a great day. And, if at some point we have a run of bad days, then we'll follow the protocol and switch him to Cimetidine, and if that's not working, Neurontin, or Lyrica, etc... and if the day comes that we can't manage him with medication, then we'll find out what the best information on surgery is.

In the end, we're all learning about this as we go along and just doing the best we can. One major "life lesson" we learned last year when we suddenly found ourselves facing a diagnosis of severe and aggressive malignant melanoma in our dog Chandler, was that you take every day, one day at a time. You know that awful dreaded day will come at some point. But, as cliche as it sounds, none of us know how long we have here. None of us know what's in store for us tomorrow or the day after. All we can do is give gratitude that today, the Omeprazole seems to be working and Riley isn't in pain.

Today is a good day.