Learning About Cysts

My dog is one in a million.  Probably more.

My Dog

And I say this both in the way that most pet owners do about their pets, but also to allude to what has turned out to be an extremely rare condition that is causing us all a lot of stress and sorrow – Moses more so than the rest of us, of course.

The diagnosis is in, and it’s a c-word, but not the one we were previously worried about for a bit there.  Moses has been diagnosed with a subarachnoid cyst.  One vet pointed out the silver lining by noting that hey, at least a cyst is probably benign.  Touché.

In the usual course, I immediately started looking for good resources on these cysts.  Because they definitely weren’t on my radar before.

The most useful resource I found was a retrospective study from the Journal of the American Animal Hospital Association.  This study looks at spinal arachnoid cysts in 17 dogs between 1987-2001 at North Carolina State University’s Veterinary Teaching Hospital.

Brace yourself for some medical jargon.

These types of cysts (though most sources take a moment to point out that they’re not technically a “cyst” because they don’t have an epithelial lining – yes there will be a quiz on this later) are broken into two groups: cervical arachnoid cysts and thoracolumbar cysts.

Moses qualifies for the first group: cervical arachnoid cyst.  Our report back made the distinction of “subarachnoid”, but I’m given to understand the added prefix doesn’t change anything; arachnoid cysts typically occur in the dorsal subarachnoid space in the cervical vertebrae.  And I can actually say I know what that means.  To see for yourself, see this diagram of the spinal cord.

These cervical arachnoid cysts, according to the study, are typical found in young, large breed dogs, and are found higher up on the spine in the neck/shoulders (in Moses’ case, the C5-C6 vertebrae).  The other kind of cyst is more commonly found in older, small breed dogs, and is found much lower on the spine – the thoracic vertebrae.

The listed symptoms are exactly what we noticed in Moses: progressive ataxia (wobbliness), reduced range of motion, scraping knuckles, but no pain.  The cysts enlarge over time, and cause nerve pinching.

In the study, surgery was performed on 15 of the 17 dogs (with both kinds of cysts), and according to this study and the other resources I came across, surgery appears to be the favoured treatment, and very little (if anything) is written about medical management options or success, or alternative/unconventional options (though our report back quickly noted hyperbaric oxygen treatment as a potential novel option).

Of the 15 dogs in the study who underwent surgery, 14 had good short term results.  12 of those dogs were followed up with, and 8 of the 12 had good long term results (67%).

6 of the 15 dogs who underwent surgery were large breed dogs with the same type of cyst we’re faced with.  The short-term post-surgery results were good in all.  The long term results were good in four of the six (67% again).  The other two dogs experienced a recurrence of the symptoms 18-26 months after surgery.

Moses' post-myelogram bald spot.

So that’s what we’re faced with: a spinal cyst that requires surgical removal in order to give Moses any real shot at going back to healthy and active (noting that carting and long day hikes are indefinitely out of the question regardless).

And odds at long-term recovery are estimated at 67% based on the study I’ve discussed, or bumped up to 70% based on the expert report we got for Moses.

The reports and our vets all note that factors influencing a good outcome are: age (3 years or younger, and Moses is 3 years and 3 months old right now), length of time symptoms are noted (4 months or less, and we’re right about at the 4 month point now), lack of other medical conditions that could impact recovery (none here), and the surgical method used (out of our hands, but our gal is the best).

So, in an ideal world, Moses would recover reasonably well and have a good shot at long term success with surgery.  And I’ve done my best to quantify “good”.

On the other hand, I can’t help but think about how long it has taken him to recover from the CT scan and myelogram from last week – it was several days before he could get up on his own and the tile floor is still a challenge.

Moses also has a bald spot on his rump from having to try the myelogram from the other direction - it's kind of like a canine tramp stamp. And, sadly, it's not growing back nearly as fast as the other one.

And although it may seem foolish to consider success rates based on one retrospective study from 2003, that brings me back to how our dog is one in a million; these cysts are very rare, and the study comments that spinal arachnoid cysts have been reported in only 28 dogs and 3 cats since 1968.

Understandably, and unfortunately, the small number of dogs studied has also meant there is no firm conclusion about the cause of these cysts.  Based on the occurrence younger dogs, they expect a congenial condition.  Another study that looked at 11 dogs with spinal arachnoid cysts hypothesized a genetic predisposition related to the dog’s confirmation (they suggest weight of the head being a possible influencing factor) noting that 6 of those 11 dogs were Rottweilers.

Moses

So that’s the situation we’re faced with.

And no, surgery is not cheap.  We will definitely max out our annual policy limit and then some (though I am pleased to report that so far insurance has paid out for our significant diagnostic costs without fuss), and it’s a question about putting Moses through an extensive procedure with long recovery and rehabilitation time, and without any real guarantee for success.

We have until next Monday to weigh all the variables in advance of another discussion with the vet.

And after all of this research and reading I’ve been doing lately on each possible diagnosis, I figure I’m probably in line for at least an honorary DVM by now.

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About ThatJenK
Writing from Calgary, Alberta, Canada. 90% pictures of my dogs; 10% miscellaneous opinions nobody asked for.

42 Responses to Learning About Cysts

  1. Tamara says:

    Oh Jen, my heart is hurting for you guys! Moses is such a fantastic guy, and it sucks that you have to make this decision. I wish there was something I could do to make it easier for you 😦

  2. 2browndawgs says:

    Best of luck with a difficult decision.

  3. lexy3587 says:

    Wow. Hopefully everything goes well, and Moses gets back on his feet, and up for your previously-usual length of walk, even if day-hikes aren’t an option anymore.

  4. kenzohw says:

    I understand your caution, a lot can go still go wrong. On the other hand it is not melignant C which would have been disastrous. Be glad you still have an option, how difficult of a choice it must be.

    Sending good thoughts and sure you will do right for what suits you AND Moses best.

    • thatjenk says:

      Thank you for the sentiments – it’s always tough when our guys aren’t at 100%, and our priority with these decisions has got to be his best interests.

  5. I don’t know how to make these decisions; if money is no object, and the surgery will not make things worse even if they don’t make it better, I would do it. But you’re not me; in fact, when it comes to doggie health, you’re so much smarter you scare me. I have complete confidence that whatever you do, it will be the right thing.

    Hug the big guy for all of us!

    • thatjenk says:

      I like this train of thought: “the surgery will not make things worse even if they don’t make it better”.
      This is the very sentiment we’re leaning towards.

  6. Wow. I am so sorry to read this about Moses. working in a vet a clinic I have heard of this type of cyst but I don’t think I have ever actually seen it. I am going to have to look more into it.
    From one Newf lover to another I wish you and Moses the best of luck in this journey.

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  8. Lula says:

    My heart goes out to you ! My family has just been faced with the same decision of wether to have surgery on our 6 year old Australian Cattle dog named Chiara. She is the love, life and soul of our home as my children put it. We have to make a decision today and I have read the same article you described 5 times in order to understand and educate our family in making this decision. She is otherwise very healthy, and we are not even sure if insurance will pay for it for various different reasons, (one of them being considered as a pre-existing condition). I would love to know how Moses is doing and praying (very hard) that everything goes well with Chiara. The children (20, 17, & 12) have sworn every penny they make will go to the surgery and our hearts are so torn. Can you please let me know how Moses has progressed with the surgery.

    • thatjenk says:

      I am very sorry to hear about Chiara’s diagnosis.

      The positive news I can tell you is that all (so far) is well with Moses and his recovery has been very good – and very steady. All things considered, I am so glad we opted to go through the surgery.

      Let me tell you, the first week after the surgery was not easy. When we brought him home, he could not even stand up on his own, or walk at all, which is extremely difficult with a 180lb Newfoundland. I suspect you will have an easier time helping Chiara up and out for bathroom breaks and whatnot.

      And the post-op “homework” we took very seriously – moving his limbs, tickling and poking his feet so he would move them himself. Having him practice getting up and walking around even when it was difficult. It felt so slow some days, but then in August, 15 days after the surgery, I was thrilled and able to post this, about his first steps:

      https://backalleysoapbox.wordpress.com/2011/08/09/a-second-time-for-first-steps/

      An update 8 weeks after the surgery, when we could start taking Moses for short walks again, is here.

      https://backalleysoapbox.wordpress.com/2011/09/19/eight-weeks-later/

      The video alone is why I would always opt to do the surgery again.

      And now, 12-ish weeks after the cyst was removed, Moses is up to 20 minute walks daily, can hop in and out of the car without help, and seems very much back to his old self. And his fur is almost fully grown back!

      I can’t tell you what to decide to do, but I can report that our experience was trying but positive overall. And our pet insurance company definitely helped (a spinal cyst was not considered a pre-existing condition, since whatever causes it might be congenital, but the cyst itself does develop over time as a build-up of spinal fluid).

      My best wishes to you, Chiara, and your family. I hope your experience turns out as well as ours has thus far.

      Jen

      • Christine says:

        Dear Jen Our 7 month old Bichon Frise puppy Milo has just been diagnosed with a subarchnoid cyst and is booked in for surgery on Monday. We have tried to search for advice so we can make an informed choice but with it being such a rare condition it is difficult to find any supportive information and we have therefore found it a very stressful making the best choice for Milo. I was wondering from your experience with Moses would you still recommend surgery? Kind regards Chris

        • ThatJenK says:

          Hi Christine,
          It has now been over 4 years since the surgery and Moses is 7 1/2 years old – that’s getting up there for a newf, whose lifespans are often quoted at 8-10 years. He is starting to show his age now, and over the past few months have notice him start to lose some mobility in his front legs again (as well as other general aging symptoms). He’s down to max 45 min daily walks, which seems to help, and he doesn’t like stairs but can still do them with hesitation.

          If I could go back in time would I do it again? Absolutely. It’s been a great 4 years and he’s a happy dog who can still do his favourite things – swim, play with us and Alma, destroy a bully stick, go to the park and on (shorter) walks.

          He was in otherwise good health and weighty and relatively young, so that helped with recovery. Pet insurance covered the bulk of the expense, which also played a factor in a pricey procedure.

          Would we do it again today for a second time if he needed it, though? Probably not. Now that he’s a senior dog, I think the recovery would be too hard on him and he wouldn’t recover fully at this age. I don’t think his quality of life would fare well (unless a vet seriously advised otherwise).

          So it’s a tough call to make and a serious surgery with a long recovery. Every dog and family is different. Your dog is young and so would probably recover well if he’s otherwise healthy – he’s got a long life ahead of him! And if you’re prepared to work on all the at-home rehab and exercise it can be a happy, active life after surgery!

          I can’t tell you what to do, but I’m a sucker for animals and occasionally an optimist, so I know what route I’d make… And did.

          Good luck with everything!

          • Sheila Churchill says:

            My dog Boo (curly coated retriever) had his surgery exactly two years ago tomorrow. He was 13 months old at the time. I was warned by the neurosurgeon that he would probably not be 100% as the cyst was both dorsal and ventral and they weren’t sure if they could get it all. But I went ahead with the surgery, and I am so glad I did. Boo will never be a competitive agility dog (which was what I was planning for him) but he has a normal happy life, he swims, dock dives, goes for 2 hour hikes, and even does some agility just for fun. We did lots of rehab, which I think really contributes to recovery. Boo is still improving in his coordination. We did have some issues with dog reactivity, since Boo was knocked over several times by out of control playful dogs. But that has improved as his balance has. The coolest thing is, Boo became so accustomed to being poked and prodded and being in strange new circumstances, that he is now a hospital visiting dog, and we visit at a facility for people with spine and brain injuries. When they see his back legs occasionally shaking, they can relate to him.

            Like Jen, if Boo started having symptoms again (the cysts can re-occur) I probably would not repeat the surgery. But I am very glad I did it 2 years ago.

            Sheila

          • ThatJenK says:

            Sheila & Christine,

            I am happy to hear Boo had a positive experience with the surgery!

            Shiela makes an excellent point about some dog reactivity – we experience a little bit of that with Moses. If an energetic dog jumps on his back or attempts to mount him, he is quick to growl and let them know that’s not appropriate (pre-cyst Moses was happy to rough-house with anyone). Most dogs take the hint and it doesn’t escalate beyond that, but sometimes a dog will not take too kindly to this (Moses is still 160lb, so rarely a dog will want to get into it with him, and he’s still capable of standing up for himself). Dogs he sees often and Alma (obviously) acknowledge he’s older and simply adjust their play style accordingly.

            But you might notice that your dog is extra sensitive or “cranky” to the energy around him or various situations during recovery and while they are not confident in their own balance and coordination. This is normal and should just mean no off leash dog park until the rehab process is far along.

            This post might be helpful: https://backalleysoapbox.wordpress.com/2011/11/19/preparing-your-dog-for-surgery/

          • Christine says:

            Thank you so much Jen and Sheila, I have found your advice extremely helpful and reassuring at such a stressful time. We have decided to go ahead with Milo’s surgery and are praying that it will be the best decision for Milo.
            Kind regards Chris

          • ThatJenK says:

            Best of luck to you and Milo! It sounds like he has an awesome family who cares a lot about him.

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  12. Sheila Churchill says:

    HI, my 13 month old curly coated retriever Boo, has just been diagnosed with an arachnoid cyst, I just wanted to tell you how helpful your blog has been for me, and also how encouraging. I hope Moses is still doing well. Hopefully we will get the surgery soon, any more tips you can give me on surviving the crate rest and helping with rehab would be great.

    • thatjenk says:

      Hi Sheila,

      I’m glad you found the blog and that it’s helpful! I’m happy to report that 2+ years since his surgery and Moses is still doing great! It’s a tough situation, but I’m glad we went forward with the surgery. I’d do it all over again, and wish you and your pup a speedy recovery!

      After the surgery, we didn’t waste any time working on getting Moses standing and walking a few steps. He’s so big, that it was better for everyone that he get up and move around on his own as soon as possible – but it was still a slow process. His drafting harness was helpful to have on him to help steady him. And we did lots of physio exercises like moving his legs around when he was laying down.

      Lots of favourite treats are good enticement for walking/standing, and raw bones and bully sticks are good to keep them busy and work on mouth/paw coordination. Food-puzzles would also be good to keep an energetic dog occupied.

      There is a “Preparing Your Dog For Surgery” post pinged above you might find helpful if you haven’t yet come across it.

      And we spent a lot of time grooming, since all the down time can result in matting easily.

      The hard part will be keeping him calm once he starts to feel better, and limiting walks and exercises even when they can walk well again, because you don’t want to go too far too fast and set back the recovery. That’ll come down to lots of calm games and exercises and a few short and slow walks in the day. If you do obedience training, sit/down stay practice is a good thing to keep busy and stimulates them.

      I hope this helps! And I hope your guy recovers as fast and as well as possible! Keep me posted.

      Jen

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  14. Christine says:

    Dear Jen
    Our 7 month old Bichon Frise Milo has just been diagnosed with a subarachnoid cyst and has been booked in for surgery on Monday. I am just wondering following your experience with Moses if you would still recommend going ahead with surgery?
    Kind Regards
    Chris

  15. Carrie says:

    We are faced with this exact scenario with our 4 yr old bullmastiff. Can you please email me any useful info and outcome of Moses. We are scheduling surgery in 2 weeks. His symptoms mirror Moses, I’m very curious how it went. Thank you so much pierce9938@comcast.net

    • ThatJenK says:

      Hi Carrie,
      Sad to hear about your bullmastiff! Good luck with everything!
      We are now >4 years since Moses’ surgery and I am glad we did it and would not change a thing. Being diligent during the first few weeks of recovery is most important, and we used an old harness to help him stand and walk, which I would recommend for you.
      If you scroll up, there are more detailed comments and updates in this thread, as well as pingbacks to other posts you might find helpful – especially the Preparing Your Dog for Surgery one.
      Let me know if you have any specific questions, though, and I’m happy to help in any way I can.
      I hope all goes well for your big guy!
      Jen

      • Carrie says:

        Thank you, I am still reading and just realized all the additional info, very nice. It’s hard to find insightful data that I can actually relate to. Packer is at day 3 from ct scan and still is very unsteady. Just wondering how long does it take these big guys to regain mobility after scan? I understand this will pale in comparison post op but still curious. Also after surgery im concerned with leaving him here alone while we are at work. Thankfully I work partime and it would only be for a few hours a day but did you have Moses in a crate while unattended? Did he have a cast or brace? I can’t thank you enough for still responding to comments, I am literally tearfully happy that I found your blog.

        • Sheila Churchill says:

          Carrie, I agree with you, this blog was a lifesaver for me too – it was so hard to find info about this condition. Jen, my vet sent me a paper on a study that was done in late 2013 on over 100 dogs with the condition – can I send attachments to you via the blog? Let me know, I can send it to you tonight.

          I kept my dog Boo (75 lbs) in a 4×4 X-pen when I wasn’t around. The big problem I had was that for a week after surgery he had to pee every hour! This was in part due to IV hydration and also Boo removed his urinary catheter himself, so there was a lot of irritation and swelling. I didn’t have to worry about him moving around too much in the pen, they are on a lot of pain killers for the first couple of weeks so they are pretty mellow. The surgery was right before Halloween though, so he would jump up and bark every time he heard fireworks, which was not good for him.

          I think the key is rehab, and if you can get your dog into water rehab that is absolutely the best! Good luck, I hope everything works out well.

          Sheila Churchill and Boo (3 year old curly coated retriever, surgery 2 years ago)

          • ThatJenK says:

            Hi Sheila,

            Of course there’s a big study after we go through it! I would love to read it – you can email me at backalleysoapbox@gmail.com – thanks so much!

            You are definitely right- the key is rehab! If ours wasn’t progressing well, we’d researched a water rehab place in the city to go to. We didn’t end up having to, but it’s nice to know it’s there and I’ve heard good things from people who’ve used it for various conditions.

            Moses didn’t have to have IV fluids at home – thank goodness! I think he spent one overnight at the vet after surgery, and then we took him home (24 hour care can be expensive).

            Also, you’re right about the drugs! He was super drugged up the first several days, and while he seemed generally content, he definitely wasn’t getting up and going anywhere on his own.

          • Christine says:

            We have just left Milo at the Vetinary Hospital, he is due for surgery tomorrow, we are heart broken about him but praying we have made the right decision for Milo and all the stress and upset will be worth the end result. I would also be keen to see the study from 2013, as yet I have found it difficult to find much information on this condition. I have found the information and support on this blog extremely informative and supportive. Kind Regards Chris

          • ThatJenK says:

            Best of luck to Milo! Let us know how it goes tomorrow. I’ve forwarded the article to the email you comment with, but let me know if there a better one to send to.

          • Carrie says:

            Yes please do! pierce9938@comcast.net thank you so much!

          • Carrie says:

            Please answer any of my questions, I value your opinions right now, gives me comfort to have first hand knowledge of the pending procedure and post op!

        • ThatJenK says:

          It was quite a while ago, so I’m not sure, exactly – maybe a week? But I do remember Moses taking some time to recover from the CT scan – might just be that the aesthetic is hard on them, together with the effects of the cyst.

          Since we had surgery in the summer, we left Moses in the back yard during the day (since he was unable to get up to go to the bathroom, it was preferable for him to be outside a lot). He couldn’t move around a bunch those first few days, so we made sure he had shade and water. I worked nearby at the time, so was able to come home at lunch and check on him, so he was only alone for 4 hours at a time (and we have nosy neighbours that kept an eye on him 😉 – he’s not a barker or anything, so he was fine out there). At night, we kept him inside per usual.

          Once he was more mobile, we we were able to leave him in the house during the day like normal, too. He’s not crated usually, but even if Packer is, I wouldn’t worry about crating him too much the first few days – he won’t be able to get up easily on his own, so will likely stay put. And it might be awkward to try to get him in and out of the crate while he needs your support.

          Moses didn’t have a cast or brace or anything – just shaved shoulders and a massive incision that we watched closely to ensure it healed. We used both an old seatbelt harness and old carting harness that didn’t go over his shoulders (not like a backpack), which served as a “handle” on him, so we could help lift him up when he tried to stand. (photo here: https://backalleysoapbox.wordpress.com/?s=second+time+first+steps)

          Let me know how things go with Packer! I know how stressful this is to go through, but it’s clear he’s got some awesome people looking out for him 🙂

          • Carrie says:

            Hope you don’t mind if I ask a few questions here and there. The vet will answer but it’s nice hearing it from someone who physically went through the process. How long from surgery until Moses was able to potty by himself? I realize every situation will differ but I’m trying to create somewhat of a timeline with kids, work and home I need to vaguely organize the long stretch ahead.

          • ThatJenK says:

            Carrie,
            No worries! I may not write new posts anymore, but I still get email notifications for comments, and am happy to answer and help when I can. Vets are still the experts, but it’s nice to hear from people who went through something similar (I relied on stories about those who treated their dogs for wobblers when we were going through it).

            It was about 2 weeks when Moses was able to stand and take a few steps on his own – and even then he needed a bit of help getting up sometimes still (e.g., on slippery floors). But that at least meant he was able to make quick bathroom breaks on his own or with minimal assistance. Luckily for you, Packer has shorter fur, so you don’t have to worry about matting, etc., from all of the down time.

  16. Tamra Henry says:

    Hi there!! My dog was recently diagnosed with a synovial cyst on his spine. I’m wondering if that is the same as yours? He was playing ball and ran too hard for it and fell backward crying out in pain. He is a three year old labrador weighing 105 pounds. We are going back and forth on whether to do surgery or not. He has lost some feeling in his hind leg. He has gone to one physical therapy session and we plan to add more. I was wondering if you had a general surgeon or a neuro surgeon perform the surgery on your dog? We are going next week for a second opinion from the neuro surgeon.
    Thank you for this blog. As with others, I could not find anything about this diagnosis on the internet. I was happy to read yours!!
    Thank you!! 🙂

    • ThatJenK says:

      I think that might be a little different since ours was a subarachnoid cyst and was causing loss of motion in his front legs. Our surgery was performed by a surgery specialist who had about 20 year experience and was trained in neurologic procedures and she did a wonderful job – nearly 5 years later and Moses is a happy dog – definitely glad we decided to go through with it!
      Good luck with your pup – it’s never easy.

  17. Linda says:

    Hi my 8 yr 11month old Rottweiler has just been diagnosed with a subarachnoid cyst on the C2-3. He is being treated medically with omeprazole and will be starting a course of steroids. It is now day 5 from scan and he is walking a lot better than he was. He has been on omeprazole since the scan and starts the steroids tomorrow, which the vets hopes will take the inflammation down. They are hoping for a good result when the steroids start. Time will tell. We think that he is too old for surgery and he has arthritis in his wrists, he’s already had a cruciate ligament operation on one back leg and the other back leg has cruciate ligament disease. The scans also showed slight disc herniation in his C5-6 and 2 other places further down his spine. Do you think that deciding against surgery is the right decision? He has always been an active happy dog and we think spinal surgery would really affect his quality of life.

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