Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK.
Vet Rec. 2012 Nov 17;171(20):501. doi: 10.1136/vr.100449. Epub 2012 Oct 25.
The disease complex Chiari-like malformation (CM) and syringomyelia (SM) has been associated with the development of neuropathic pain (NeP), and commonly affects Cavalier King Charles spaniels (CKCS). This prospective cohort study followed 48 CKCSs with CM and/or SM and clinical signs suggestive of NeP for a period of 39 (±14.3) months from diagnosis. At the end of the study, 36 dogs were still alive; five dogs died of an unrelated or unknown cause, and seven were euthanased due to severe clinical signs suggestive of NeP. During the follow-up period, the clinical signs of scratching, facial rubbing behaviour, vocalisation and exercise ability were evaluated. Nine out of 48 dogs stopped scratching (P<0.001), but there was no statistically significant change in the number of dogs exhibiting exercise intolerance, vocalisation or facial rubbing behaviour. The overall severity of clinical signs based on a visual analogue scale (VAS) (0 mm: no clinical signs 100 mm: severe clinical signs) increased (from median 75 mm (interquartile ranges (IQR) 68-84) to 84 mm (IQR 71.5-91), P<0.001). A quarter of the dogs were static or improved. In general, the majority of the owners felt that the quality of life of their dogs was acceptable. Medical treatments received were gabapentin or pregabalin and/or intermittently, carprofen. The owner's perception of their animal's progress, and progress based on VAS, had strong positive correlation (Spearman's rank correlation (s(r)) 0.74, P<0.001). Overall, this study suggests that clinical signs suggestive of NeP progress in three-quarters of CKCSs with CM and/or SM.
Chiari 样畸形（CM）和脊髓空洞症（SM）复合疾病与神经病理性疼痛（NeP）的发展有关，常影响可卡颇犬（CKCS）。本前瞻性队列研究对 48 例 CM 和/或 SM 伴临床症状提示 NeP 的 CKCS 进行了为期 39（±14.3）个月的随访。研究结束时，36 只狗仍存活；5 只狗因非相关或未知原因死亡，7 只狗因严重的临床症状提示 NeP 而被安乐死。在随访期间，评估了抓挠、面部摩擦行为、发声和运动能力等临床症状。48 只狗中有 9 只停止抓挠（P<0.001），但表现出运动不耐受、发声或面部摩擦行为的狗的数量没有统计学上的显著变化。基于视觉模拟量表（VAS）的临床症状总体严重程度（0 毫米：无临床症状 100 毫米：严重临床症状）增加（从中位数 75 毫米（四分位距（IQR）68-84）到 84 毫米（IQR 71.5-91），P<0.001）。四分之一的狗处于静止或改善状态。总的来说，大多数狗主人认为他们的狗的生活质量是可以接受的。接受的治疗方法是加巴喷丁或普瑞巴林和/或间歇性给予卡洛芬。主人对动物进展的感知，以及基于 VAS 的进展，具有很强的正相关（Spearman 秩相关（s（r））0.74，P<0.001）。总体而言，本研究表明，CM 和/或 SM 的 CKCS 中有四分之三的犬出现了提示 NeP 的临床症状进展。
