That King Charles Spaniel (English Toy Spaniel) itching and scratching isn’t allergies

* Update March 6th (+1 month after surgery): It’s been about a month and Bambino is doing amazingly well. The first couple of weeks were very shaky, but in the last week, we’ve seen him remarkably improve. He’s gained back his interest in playing with toys, he’s regained his energy running around the house and he even jumped on the couch for the first time since before the surgery. The difficulty here is that while he may have his energy back, we still need to watch him and keep him confined for at least another four weeks. Still, the improvement in the last two weeks has been nothing short of amazing 🙂



My wife and I have a “son”, his name is Bambino, he’s 3 years old, has 34 friends on Dogster, has travelled to Austin, DC, Vegas, New York, Whistler, South Beach (he was even in the VIP section of Nikki Beach Club, but that’s a different story), and he’s the light of our lives. On Wednesday of last week, we got the official confirmation from an MRI scan that he has Syringomyelia (SM), a serious genetic condition where pockets of fluid develop in the brain and spinal cord that, if left untreated, could cause paralysis. It is also known as “neck scratcher’s disease”, because one of its common signs is scratching in the air near the neck.

Before his diagnosis, we assumed that his constant scratching was due to allergies.  We saw a veterinarian dermatologist and did skin allergy tests.  We found that he was, in fact, allergic to cedar and fleas, so it seemed to make sense that allergies were causing his problems since the itching was worse when we took him outside for walks.  The reality is that the itching (or tingling) would get worse when going on walks because it caused him to get excited, and he has a leash around his neck which can exacerbate the pain.  This also explained why he was itchy after a bath and why he seemed to love lying on a chillow (but then again, so do I) as the coolness relieved his pain.

This condition is very hard to diagnose because most of the symptoms are normal dog behavior (itching, scratching, panting), and it seems that most veterinarians aren’t really aware of the problem.  This is especially true if you have an English Toy Spaniel because they don’t get nearly as much attention as the Cavaliers when it comes to the medical problems that these breeds have in common.


SM symptoms include itching or air scratching, sensitivity around the neck, yelping in pain for no apparent reason, and even heavy panting.  You can see videos of affected dogs here –


The only way to actually treat this condition is through surgery, which is a bit invasive, but frankly appears to be the only option. The surgery isn’t uncommon, but any surgery has a level of risk and this is brain/spinal surgery so it’s relatively complex.  We’ve been told that there is an 80% success rate.  About half of those dogs experience a complete recovery (limb strength restored and air scratching stops), the other half show moderate improvement (usually means that limb strength is restored, but the air scratching persists).  The other 20% develop scar tissue which causes a relapse, but the dog is no worse off than before. We’re grateful we caught this before it progressed to become completely debilitating, but it’s been an emotional roller coaster.  He’s scheduled for surgery this Thursday and Angie and I will split time working from home after the surgery to make sure his recovery goes smoothly.


I wanted to blog about this to raise the awareness of SM since we’ve seen many veterinarians that weren’t aware of SM and missed all of his symptoms, allowing him to go undiagnosed for years as we kept giving him Benadryl in an attempt to stop his itching.  SM can be found in several breeds, most commonly in the Cavalier King Charles Spaniel, but also Pugs and even Yorkshire Terriers.

This whole experience has been eye opening, and we hope that this information may help others whose pets may be undiagnosed and suffering.  If you’re purchasing any variety of King Charles Spaniel, make sure to ask the breeder if they are doing MRI screening for SM on their breeding animals since that is the only way to detect this condition. The reason MRI screening is important is because some dogs don’t exhibit all or any SM symptoms and the condition tends to get worse with each generation.   It’s a red flag if your breeder has no idea about SM, or claims that their line doesn’t have that problem and cannot provide documentation that they are doing MRI screening for SM.

– Dan and Angie

Comments (28)

  1. Ignacio says:

    Did anybody tell you it’s a dog, for god’s sake? Get real!

  2. So you would let a pet just suffer and die? Or you wouldn’t want to know something that could help you save money by not spending it on allergy treatments?

    I’m guessing you’re not a dog person

  3. Jen says:

    Ignacio, you’ve clearly never had a pet you loved like a family member.

    Quite sad…

  4. AT says:

    Havent you heard of manners?

    Why go to the trouble of leaving a nasty comment that helps no one & just makes you look stupid & ignorant.

  5. Terri says:

    I love the fact that you’re helping to share this information, but to be entirely truthful, MRI or CT Scan, which are indeed the only ways to obtain a positive diagnosis of SM, are extremely difficult to come by.  It is not in all areas, and so I think ‘requiring’ breeders to do this is a bit unrealistic.

    Thankfully SM isn’t NEARLY as prevalent in English Toy Spaniels/King Charles Spaniels as it is in the Cavalier.  Also, the current literature says that using any dogs that are asymptomatic is valid, especially due to the very low numbers in the breed.  The breeders in rare breeds cannot ‘throw baby out with the bathwater’ or there would be no breed at all.  Also in the current literature, it has been found that trying to eliminate known problems in a breed by eliminating ALL affecteds and SUSPECTED affecteds only serves to bring to the forefront DIFFERENT diseases that probably would never have become prevalent if it weren’t for the discarding of these other dogs.  It’s a conundrum for breeders.  Rather than ‘requiring’ breeders to test by way of frequently unavailable technology, perhaps it should be prudent to ask for a contract with a reasonable health guarantee.  These are dogs, and things happen that are out of the control of the breeder, even those breeders who certainly look out for the welfare of the future of the breed as a whole.

    Just my humble opinion…

  6. Bev Leighton says:

    How has Bambino been doing since the surgery?  I have a 2 year old Cavalier King Charles Spaniel, Molly, who had the surgery almost two weeks ago.  

  7. Thanks Bev for asking, I went ahead and updated the post, but Bambino got his stitches removed and is doing *so* much better!!

  8. Jane Naimark says:

    I have to commend you entirely for going the full 9 yards

    for Bambino.

    I, myself, believe that English toy breeders are going to

    see a whole lot more SM.   Tragically the costs are prohibitive in order to get a true diagnosis.   There aren’t

    very many breeders who are going to spend their money

    to get a diagnosis and the problem is going to expand


    Again, I commend you in your determination to discover

    Bambino’s problem.

    Jane Naimark

  9. Renee says:

    I have a Cavalier who is 2 & she has always been sensitive about her ears, scratching often but not "air" scratching.  Occasionally yelps if her ears are touched but very inconsistently.  Since the symptoms are also normal habits how would I know when I need to worry?  At what age are you free from worry?  We would like to get another one as we just love this breed but I hear that over 50% have SM and this is very frightening to me.  I’m so glad your baby is doing well & that the surgery to this point has been successful.  Renee

  10. emily says:

    i have an 18 month old female – Bella – who exhibits all the symptoms of SM – she has been seen by the Univ of Penn School of Vet Med – Emergency Room – and the diagnosis – not certain w/o MRI – is SM.  She does not appear to be in pain – the occassional yelp if picked up the wrong way, etc – but has a healthy appetite, loves to be with other dogs and always wags her tail.  i am looking for reassurance from other KCCS w/SM owners as to what i can expect.  also, any success stories re surgery.  please respond.  

  11. Angie Fernandez says:


    In terms of what to expect, there’s no one size fits all answer.  It sounds like Bella was diagnosed very young.  Bambino wasn’t diagnosed until 3 years of age, but in hindsight I believe the symptoms appeared between 1 and 1.5 years of age.  That is considered early onset which I believe means they’re likely to have a more serious case.  The only way to know would be MRI.  The tragedy of SM is that it is a degenerative condition, which means that the symptoms are going to get worse over time.  What ultimately brought us to the neurologist was a severe weakness in the rear legs that didn’t improve after a month.  The weakness seemed to come on suddenly one weekend so we presumed it was just an injury, but he seemed to be unable/unwilling to walk.  However, after one months time on Rimadyl, he was getting by but he was no longer able to jump on the couch (it’s not a high couch) and his activity had to be limited.  The neurologist was able to diagnose it immediately after seeing him.  It was somewhat comforting to finally have an explanation for the air scratching, but it was really the rear limb weakness that was the worst part for us.  Bambino never yelped in pain or anything like that, so we considered ourselves lucky in that respect.  For us, there was never any question about surgery b/c it was simply too heart breaking to know that a 3 year old dog may never jump on the couch again and just live the remainder of his life in pain.  

    We’re about 5 months out from surgery now.  He’s fully recovered from the surgery.  Since the surgery, we have seen increased strength and stability in his hind legs.  We still see signs of air scratching which is definitely worse while wearing a harness.  He does really well at off-leash dog parks, but it’s very difficult to take him on walk down the street due to this.  If we walk long enough, it does seem like he gets over the initial excitement of the walk and sometimes improves, but it’s tough to really get that far.  He’s a happy dog and his personality hasn’t changed since the surgery.  He wags his tail all the time, likes to engage other dogs, and is a typical Charlie.

    They say it takes 6 months to find out how much they will get out of surgery and another 2 months to decide if scar tissue will reblock the opening.  I will schedule a followup with the neurologist at that time to make an assessment as to how he thinks Bambino is doing.  In all likelyhood, I will talk to him about placing Bambino on Gabapentin to help with the remaining air scratching symptoms.  However, I feel happy that he’s able to walk and run around the house like a mad-man and jump on the couch when he wants to.

    The best advice I can give you is to schedule a consult with a neurologist b/c they can tell you everything you need to know.

  12. Amy Benard says:

    How early can SM be detected? It broke my heart to see the severe case in the video. I have a 5 month old cavalier, and he seems to be scratching his neck for no reason. I told the vet and she thought it might be his collar. I really hope its not SM.

  13. Lady says:

    I have an 8yr old Cavalier King Charles, who suddenly decided not to go for walks with a collar & leash,will sit and not move,will do so only when I take off the leash,I have also tried a harness,to no avail ,can you help correct this problem ?,Hopefully you can.                                                                                               Madeleine.

  14. Marci says:

    We have a 2 year old Cavalier, Gracie, that has been experiencing the systems you have described.  We had tried several different treatments for allergies and had her checked for skin infections.  Everything we tried never seemed to really do the trick in clearing up the problem.  Our vet was at a loss other then to send her to Iowa State University for skin and allergy testing.  Before going there I decided to do additional research and found information about SM, but also on another condition called PSOM.  This is a condition that has similar symptons as SM, but involves a plug in the inner ear drum.  I’ve read that in some cases of PSOM are misdiagnosed as SM.  

    In my research I found the Ohio University Vet Hospital is currently doing a study on Cavaliers and SM.  I just contacted them yesterday via email and I hope I will hear back from them soon and maybe get Gracie in on the study.  I’m very interested to learn as much as possible about SM and PSOM and have Gracie tested for both to determine which she may have and get treatment.

    We do have another Cavalier, Winston.  He is actually Gracie’s littermate.  So far he does not display any of the symptoms and we hope that continues.

    Thank you for sharing your experience with your dog and his surgery.  I’m glad to hear he is doing so well and hope he continues to stay healthy.  This gives me hope that we can help Gracie and get her healthy.

  15. Irene says:

    There has been a television programme over here which was nightmare viewing for anyone with a Cavalier mine is 2yrs old his name is Alfie and he is adorable  and although he doesnt seem to have the symptons i am seriously considering having him scanned to know for sure.

  16. an says:

    I had my 11 year old  toy spaniel put to sleep this week with severe sm symptoms.

    it is a heartbreaking illness & as much as I love the breed I can not bear to buy another until progress has been made in testing breeding dogs , etc

  17. Fay Wright Bjorgen says:

    I want to thank you, your wife, and Bambino for this blog. Like others who have written, I have only recently learned of either SM or PSOM, when my 4 yr old English Toy, Jenny, was examined for extreme scratching last week. As horrible as the possibilites are, and as unbearable as it feels right now to consider the SM possibility, it does help so much to know that we are not alone and that Jenny’s change from a dog who loved to walk to one who can’t stop scratching long enough to make it down the shortest lane is not because of lack of flea care on our part or allegies. Jenny is our angel, and cannot be replaced. I pray now we will be able to do all that is possible for her to live as normal a life as she can. Like many who may be reading this, thousands of dollars and a "maybe" solution are beyond our means, but this week I will consult with our wonderful vet again, and see if there is a way to determine first if Jenny has PSOM. My heart goes out to all other owners and breeders of this historically loving dog. Go Bambino!!!

  18. n.m.speirs says:

    I have 7.8yr old CKCS Abbie with confirmed SM and wonder if you have any further reports on whether to have the operation or to stay with the drug treatment.

    Any advice would be appreciated.

  19. Marilyn says:

    I have a 7 month old cavalier named Coco.  We are finding she does not have a very good appetite.  We have tried different dry dog foods but she still will go very long between meals and at most on rare days will eat a standard 1cup of food.  She does not get any food scraps and very minimum treats.  We don’t know if this is normal for this breed or not?  Anyone else with this situation?

  20. Caroline says:

    Hi, I am really concerned after reading all the comments. My 8 month old king charles has just started yelping for no apparent reason, we have done the usual checks and nothing when touched, It seems to be more when she’s lay down. Could she have this awful disease your all talking about ?.

  21. I have a 4yr old King Charles Spaniel. We have not had any problems with itching but he often yelped when you touched his head or picked him up. He fell about 3 months ago when he jumped up in our truck and started limping and was unable to jump on the bed and couch. The Vet thought he hurt his back and gave him steroids. He improved, then it happened again and tonight he can not even walk, he is dragging his hind legs. I am worried about SM, My husband thinks it is a slip disk in his back and we are planning on taking him to a orthopedic Vet. My husband doesn’t want to hear about SM. What do you think?

  22. @Cindy – the best way to see if your dog does have SM is to take him to an animal neurologist and ask them to evaluate whether he/she has SM.

  23. Barbara says:

    A team of scientists have developed a site  where everyone can contribute information on symptoms, diagnostics, treatments and outcomes. Sharing information will help other owners with similar problems, but also will aid research on canine health. Please join and contribute if you have a dog (healthy dogs too, as this will show the prevalence of specific diseases):

    Everyone that has a dog has a piece of the puzzle – please share your puzzle piece so we can help find some solutions.

  24. kati says:

    Can anyone tell me how old the Cavalier has to be befor he/she can be tested for SM and the cost?

  25. Kati – I'm not a vet so I don't know, but if your dog starts to show symptoms, I would go to your vet and ask for a recommendation to see a neurologist –…/infosheet.html

    The Neurologist will give your dog an MRI which will show whether they have the condition or not.

    Best of luck

    It's now been close to four years since Bambino's surgery and he's doing just fine 🙂

  26. Emily H says:

    I have an 11 year old CKCS with this, and it drives us crazy with the scratching, although she never seems in pain. What happens if left untreated? We have witnessed this for 11 years, but she seems fine otherwise?

  27. EmilyH says:

    Our 11 year old CKCS has this, (although we haven't done any scan) and it is very annoying, but apart from the scratching, she seems fine. Does anyone know what happens if left untreated? Do not scan your dog if she doesn't have symptoms, that is silly.

  28. Emily – It really depends on how bad the itching is. It sounds like your dog has been living with this comfortably for a while so it hasn't progressed. If left untreated, it can start to cause severe itching or your dog wil start to cry out in pain, which is the big thing we noticed and that's when we discovered SM.

    If you want to see videos of dogs with SM, watch the videos here –…/videos.html