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Syringomyelia, Canine Massage & Pain Management

Cavalier Canine massage. Cath NicollCommonly referred to as ‘neck scratchers disease’ syringomyelia (SM) is a condition where fluid filled cavities develop within the spinal cord.

60 Seconds of Science

In a dog with SM cerebrospinal fluid is unable to shunt back and forth with arterial flow. This causes pressure waves which then obstruct the spinal cord’s normal activity. In turn an abnormal cavity is formed in the subarachnoid space (the area in the brain between the middle and the deepest protective layers) and most commonly in the foramen magnum located at the back of the brain and back of the skull. In this instance a part of the brain called the cerebellum begins to be pushed or herniated out of the skull as there is not enough space. The cerebellum is the part of the brain that coordinates and regulates muscular activity. Cysts can also form within the spinal cord affecting the flow of cerebrospinal fluid which also affects nerve transmission and can produce pain, ataxia, weakness and stiffness. In humans the condition is called Chiari malformation.

Diagnosis

Veterinary Diagnosis will confirm the presence of SM via an MRI scan.

 Symptoms in the dog 

  • Neck scratching
  • Hindlimb weakness
  • Resistant to petting/grooming
  • Dog finds it difficult to settle e.g. at night
  • Worse in temperature extremes
  • Sensitive to touch on neck/ear/chest
  • Facial nerve paralysis

 How May Canine Massage Help A Dog With SM?

1) Canine Massage May Improve Muscle Function and Mobility

The aim of massage is to enable your dog to have improved day to day comfort, mobility and ability. The most common muscular condition in dogs with SM is hypertonicity, a state in which the neck and shoulder muscles hold patterns of habitual tension and the muscles are no longer able to relax, instead holding too much tone.

Essentially the muscles are in a constant state of spasm – an involuntarily contraction of muscle – in turn leading to further irritation of the nerves. The dog will commonly find transient strokes or general petting uncomfortable so it is important that your dog’s therapist has been trained in ‘Myofascial Release’, an advanced form of massage. This aims to create space in the dog’s musculature and complex fascial system, releasing restrictions and improving the ability of the muscle to actually move.

In dogs with restrictions to the occiput how does a restricted neck decrease normal patterns of movement not just in the forelimbs and neck but also in the hindquarters and spine? Well, some muscles that attach onto the neck also attach onto the pelvis (e.g. the longissimus dorsi) so we can see how dysfunction will be caused throughout the body as tension is placed on the muscle from origin to insertion.

Extra pressure placed on the neck or cervical region of the dog should be addressed via the superficial and deep fascia of the neck, helping to release further restrictions that only serve to exacerbate the dogs existing pain.

Therapist Note: Muscles such as the splenius, cleidocervicalis, rhomboids and sternocephalicus all share insertion points onto either the nuchal crest of the occiput and / or the mastoid process of the temporal bone.

Considerations such as fascial connections onto and also into the skull, origins and insertions and myofascial lines should be taken into account when attempting to address restrictive areas of dysfunction. The therapist should also be aware that myofascial pain in the neck will also restrict mobility of the nuchal ligament and in turn neck carriage. Transmissive force of transversopinals and epaxials will also restrict hind limb function.

2) It May Improve Nerve Function In The Dog With SM

Muscles of the neck rely on adequate innervation of the nerves. Nerves penetrate muscle and fascia to communicate on 2 types of stimuli – internal (pain inside) and external (pain from outside). When the muscle becomes inhibited, tight, hypertonic or has trigger points or myofascial pain the nerves become even more irritated. This kicks the area into a state of over activity (or over excitability) and the sympathetic nervous system, the branches of nerves which are responsible for the fight or flight response, take over.

In a nutshell this mean that your dog may find it difficult to relax, is pacing around, unable to get comfortable or in a state of heightened awareness where they find it unable to relax. It will also mean that they shy away from touch in the area. The myofascial release therapist has a range of techniques at their disposal to help encourage a state of parasympathetic (rest and digest) response, to encourage nerve function and to provide pain relief and comfort.

Therapist Note:

Over excitability of the cranial nerves will lead to a sympathetic response while inhibiting parasympathetic function of these nerves. Persistent excitability of the cranial nerves will commonly result in harder more laboured  breathing, elevated respiratory and cardiovascular function placing more stress on the heart common, elevated levels of stress hormones. In fact think of the dog being in a chronic state of stress response. Associated symptoms such as w ide radiating myofascial pain are  common. Nociceptive pain will be at an all time high in the client who has never received MFR. The dog may initially shy away from touch here and common results of therapy  will be a dog who is able to and wants to be  touched in the neck or cervical region.

Commonly 3 sessions over 3 weeks are advisable for initial results to address epimysial, superficial and deep fascia. These should be followed by review periods over the year and advice on harmful ADLs which may be exacerbating the symptoms. This will also give the owner time to assess the suitability of the therapy and for the dog to respond to it.

Surroundings should be quiet and non intrusive and I recommend teaching your human owner to breathe  deeply  as you work;  this always helps the dog’ s response to massage if the dog is ‘feeding off’ the owner’ s energy levels.

Zoopharmacognosy will be a viable adjunct therapy alongside massage.

3) It Helps To Break The Pain Cycle

Breaking the pain cycle is the ultimate goal of the canine myofascial release therapist.

When muscle, fascia and nerves are in a state of irritation they will commonly over tighten causing:

  • Further restrictions and irritation including painful trigger points that like to mimic the symptoms of
  • The restriction of lymphatic pathways and the flow of lymph resulting in persistent and painful swollen lymph nodes in the area. E.g. in front of your dog’s shoulder blade and under the jaw

The therapist will look for:

  • Trigger points (these are not acupressure points but are restrictive bands of musculature that inhibit movement and cause nerve irritation and ischemia – oxygen and nutrient depri vation)
  • Areas of reduced muscular function
  • Myofascial pain

They will then aim to release or restore movement in these tissues helping to enhance the flow of oxygen, nutrients and lymph and to re-facilitate nerve impulses.

The therapist works on the whole body to address areas of overcompensation and patterns of pain referral and will have review periods with the owner to establish the efficacy of the therapy. Massage is not the silver bullet that makes the condition go away but it is a real, accessible way of providing pain management that can last for several weeks which makes it  highly suitable for  the dog who cannot tolerate NSAIDs or has renal failure.

Canine massage cavalier dogsbodyAdvice For Owners:

Respectfully may we remind you that tissue assessment and palpation is a skill for the professional who has learned the skills and trained in these disciplines. Many owners can believe incorrectly that their dog does not have tight or dysfunctional muscles. But realistically do you really know what you are feeling for in a clinical tissue assessment? Many owners simply feel the skin or if they are lucky the superficial layer of musculature. We all want the best quality of life for our beloved dogs so if your dog has been diagnosed with SM massage by a trained professional is always the best course of action along with the other advice listed below.

Massage

As you’ve read massage can be a useful weapon in the ongoing fight for your dog’s comfort. Note how I have used the word ‘ongoing’. Be realistic about your dog’ s bodywork and be prepared for your dog to have reassessments throughout the year. One massage will not ‘fix’ your dog. As with humans the general day to day stresses and wear on tear on the body mean that symptoms are bound to reoccur with this disease.

Discuss with your therapist timelines for consecutive massage e.g. one massage every 8-12 weeks after an initial set of three, but as all dogs and their lifestyles are different these timelines may vary.

There is no such thing as a magic pill or a silver bullet. Commitment to your dog’s therapy for maximum, ongoing benefits is essential.

Collar

The SM dog should never wear a collar unnecessarily. Even a loose house collar will be rubbing on the skin and irritating superficial nerves in the skin. Only walk your dog on a harness.

Slippy Floors

Pretty much like ice skating for dogs, the constant effort required to modulate grip on slippy floors mean that long lines of tension will be placed throughout the dog’ s forelimbs, shoulder and neck. The most simple way to help your dog’ s everyday comfort is placing runners on the floor.

Feeding Height

The dog with SM should be supplied with a raised feeding bowl. This prevents the neck being put into a sustained lengthening, or eccentric, contraction which inhibits the muscle to rest 

Tuggy

Dogs with SM should be banned from playing excessive tuggy, if playing any at all. The musculature of the neck will be placed in an excessive degree of stress due to the force and tension being placed on the object in the mouth which in turn leads to further inhibition of muscles and nerves. If in doubt try playing tuggy yourself to see what I’m talking about!

Don’t Scratch Your Dogs ‘Tickly’ Spot!

Many owners find it amusing to induce their dog to scratch as they tickle the middle of their back. But it’s actually an area of restricted fascia, the associated nerves of which are already inhibited and scratching it causes discomfort and further irritation. So please don’t scratch your dogs ‘tickly spot’.

Myofascial release is used to address these restrictions with commonly positive results.

Restrict Activities

Jumping off the sofa and out of the car are two harmful habits which will increase your dog’s discomfort. As the dog lands consider all of the percussive force that waves up their forelimbs and neck to absorb shock. So  lift your dog in and out of the car and t ry to restrict jumping on and off the sofa. Good luck with this one! But it’s worth a try, and if your dog objects try and train them to use specially designed steps.

Drugs

Many owners try to resist giving their dog pharmaceuticals to help with pain. This is a major no no. You should talk to your vet about the best painkiller to help manage your dog’s pain and they may wish to perform a blood test to check liver and kidney function and ensure they are giving the correct drug. And if you are considering giving turmeric or golden paste do your research as this can be contraindicated in some dogs, for example those with heart disease!

Pain is not conducive to healing or quality of life and the correct pharmaceuticals can truly help your dog.

Zoopharmacognosy

The self selection of herbs, plants and oils. This therapy can be nothing less than life changing for many dogs. Go to www.carolineingraham.com and www.myanimalmatters.co.uk for more information.

Wobble Cushions And Instability Equipment Are A No No

SM is the ultimate contraindication of this type of equipment. Tight musculature as discussed is already occurring naturally in your dog. All you are doing with wobble cushions/boards/peanut balls is causing long lines of tension in the muscle which cause it to become more dysfunctional.

Author:  Natalie Lenton

For more information please visit Natalie Lenton‘s biography

 

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