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Four-year-old Cavalier King Charles Spaniel Rags has been successfully treated at Veterinary Specialists Scotland, in Livingston, for a serious ear condition caused by a malformation of the skull.

Four-year-old Cavalier King Charles Spaniel Rags has been successfully treated at Veterinary Specialists Scotland, in Livingston, for a serious ear condition caused by a malformation of the skull.

Rags To Itches Story As VSS Solve Head-scratching Situation

5 months ago

4th May, 2023 17h07

Linnaeus Group

Vets at one of Scotland’s leading veterinary referral centres were quick to earmark the probable cause of a dog’s phantom scratching.

The four-year-old Cavalier King Charles Spaniel, called Rags, was repeatedly scratching close to his shoulder and neck without actually touching the skin. 

When the expert multidisciplinary team at Linnaeus-owned Veterinary Specialists Scotland (VSS), in Livingston, carried out examinations they confirmed their first suspicions – a serious ear condition caused by a malformation of the skull. 

To treat the issue for beloved pet, Rags, European and RCVS specialist in dermatology Debbie Gow combined with residency-trained neurology clinician Alexandra Ferreira to first correctly identify the issue and then effectively treat the problem. 

Alexandra explained: “Phantom scratching is a classic sign of a condition called Chiary Malformation (CM). 

“This is an inherited disorder which is common in flat faced breeds and caused by malformation of the skull. It can cause pain and disrupt the circulation of cerebrospinal fluid, which is the fluid surrounding the brain and spinal cord. 

“An MRI scan confirmed Rags had CM and also highlighted a problem with his middle ears, with fluid and material noted within these normally air-filled cavities. 

“Debbie then led a further investigation of Rags’ middle ear problem, which resulted in a full diagnosis of a Chiary-like malformation with syringomyelia (fluid-filled cavities) and Primary Secretory otitis media (glue ear). 

“The investigation involved a general anaesthetic before guiding a small camera down into his ears. This allowed us to make small holes in his ear drums to gain access into his middle ear cavities and remove the mucus which can cause pain, irritation and, potentially, neurological issues such as head tilt, dizziness and eye flickering. 

“After the procedure, Rags began medical treatment, including gabapentin, to control any future build-upof cerebrospinal fluid and the resulting pain. 

“With ‘glue ear’, removal of the ‘glue’ (mucus) improves the situation by reducing pain, reducing irritation and improving hearing. 

“Unfortunately, since this build-up of glue is related to flat faced breeds and the shape of their head, it can recur. Rags will be monitored by his owners for any development of signs that may require treatment. 

“His owner says he is doing well at home and is bright and happy.” 

Rags’ relieved owner, Wilna Roger, from Glenrothes, said: “He is coping well and leads a very active life, enjoys his walks and adores his ball. 

“I cannot speak highly enough of all the VSS staff we met, from receptionists, vet nurses and, of course, the two specialists in neurology and dermatology, Alexandra and Debbie, who treated both Rags and ourselves with warmth, empathy and understanding. 

“Their explanations were first class and I would certainly recommend the hospital to anybody concerned about their pet’s welfare.” 

Alexandra revealed that CM is extremely prevalent in King Charles Spaniels and other flat-faced breeds, as is “Glue ear” for these breeds also. 

She added: “It is suspected more than 90 per cent of Cavalier King Charles Spaniels in the UK are affected with this condition, although not all of them will present with clinical signs. 

“It has also been reported in Griffon Bruxellois, Affenpinschers, Yorkshire terriers, French bulldogs, Havanese, Chihuahuas, Pomeranians, Boston terriers, Maltese dogs, Yorkshire terrier, Papillons, miniature Dachshunds, Shih Tzu, Bichon Frisé and several cross breeds. 

“So, if you own one of these breeds and you think your dog has sore ears, starts scratching or head shaking, then get in touch for an assessment.” 

VSS is a specialist-led multidisciplinary referral centre offering industry-leading services in cardiology, dermatology, internal medicine (feline and canine), neurology, orthopaedics, and soft tissue surgery, supported by specialists in diagnostic imaging and anaesthesia and analgesia.  

For more information about VSS and the services it offers, visit or search for Veterinary Specialists Scotland on social media. 

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