Health Grading

Syringomyelia Grading

The only way to be sure if a dog has syringomyelia or not, is by making a MRI-scan.

For this test, I visit Dierenkliniek Den Heuvel in Best.
The name of the vet, who makes the mri, is Dhr. Erik Noorman.

In the last 10 years, there have been more than one grading-system.
The first system which we followed in the Netherlands was from C. Rusbridge (UK).

Untill 2011 all cavaliers were graded with grade A – C – D – E – F

A = no syringomyelia, ccd allowed < 2mm, dog 2 ½ years old or older
C = no syringomyelia, ccd allowed < 2mm, dog between 1 year old and 2 ½ years old
D = syringomyelia present, dog 2 ½ years old or older, without symptoms
E = syringomyelia present, dog between 1 year old and 2 ½ years old, without symptoms
F = syringomyelia present, all ages, the dog has symptoms of syringomyelia.

In 2012, our Kennelclub in co-operation with Dhr. P. Mandigers, developed a new gradingsystem in the Netherlands. A distinction was made in dogs that may or may not have ccd under 2mm. The word ccd means dilatation of the central canal. The old system is than converted to a new grading system. Currently we have a review with 3 results per dog, one under the old system, one under the current UK BVA-system and the new Dutch system.

This all makes it not easier for people to understand the results of a mri. Between the results of the UK and NL, there is an age difference. In the UK, a dog needs to be (re)scanned > 3 years. In the NL, a dog needs to be (re)scanned < 2 ½ years.

Below a brief explanation between the first UK system and the current NL system..


The following grades are used by the Dutch Cavalier club and the Dutch Kennelclub.

Old grade New grade by the Dutch Cavalier Club and the Dutch Kennelclub
A 0mm ccd SM grade 0a no ccd, dog is 5 years or older
A 0mm ccd SM grade 0a no ccd, dog is 2 ½ years to 5 years
C 0mm ccd SM grade 0b no ccd , dog is 1 year to 2 ½ years
A < 2mm ccd SM grade 1 ccd present, but less than 2mm , dog is 5 years or older
A < 2mm ccd SM grade 2 ccd present, but less than 2mm , dog is 2 ½  years to 5 years
C < 2mm ccd SM grade 2 ccd present, but less than 2mm , dog is 1 year to 2 ½ years
D > 2mm ccd SM grade 3a ccd present, but more than 2mm , dog is 2 ½ years or older
E > 2mm ccd SM grade 3b ccd present, but more than 2mm , dog is less than 2 ½ years

Depending on the age of the dog and the presence or absence of ccd , they have developed breeding-guidelines in the Netherlands. As of 01-01-2014 these new breeding rules will apply for all future parents of a litter.
If the future parents do not comply with these rules, than the puppy’s will no longer receive a pedigree.

Click here for the Dutch SM breeding-guidelines

scheiding

Heart Grading


Each year, all my cavaliers will be tested on their heart for MVD. This can be done in two ways.
The first is a colourdopplertest/ ultrasound. For this test, I visit the Animal Clinic for Companions in Eersel.
The experienced vet Hanneke van Meeuwen carries out the research.

The following classifications are used at the certificate:
A = no abnormalities
B = minimal abnormalities at the level of the mitral valve
C = mild abnormalities at the level of the mitral valve
D = moderate abnormalities at the level of the mitral valve
E = severe abnormalities at the level of the mitral valve

In Holland we are allowed to use grade A-B and grade C heartresults in our breedingprogramm. When a dog has a clear heartcertificate above the age of 4 years, than a murmer at an older age is allowed by the Dutch Kennelclub and Cavalier Club Nederland. Another way to check the heart is with a stethoscope by a veterinary Internal Medicine or cardiologist. Online there is website, where you can find a list of all internists and cardiologists who are allowed to do this investigation in Europe and who are approved by the Dutch Kennelclub. The website is:
http://www.ecvim-ca.org/diplomate-list

For this test I visit the Veterinary Specialists in Oisterwijk. Adres: Mrs. Overduin Veterinary Specialists Oisterwijk, 5061 VD Oisterwijk, Netherlands
The internist Mrs. Overduin carries out the research.

The degrees of the murmers will be graded as follows.
0 = no murmur
1 = very soft murmur that can only be heard at a quiet dog, in a quiet area, after carefully listening
2 = a soft murmur that can be heard easily in a quiet dog in a quiet area.
3 = moderately loud murmur that is heard clearly
4 = a loud murmur without perceptible vibration
5 = a loud murmur which is accompanied by a tactile vibration on the thorax at the level of the heart.
6 = a loud murmur accompanied by a tactile vibration that can be heard even when the stethoscope is slightly
       removed from the chest.

The location, timing and sound of the murmur can be described
– Systolic: during the pumping phase
– Diastolic: during the filling phase

A murmur is caused by turbulence in the blood flow. If it is not an innocent flow murmur or physiologic, than this is automatically a congenital and / or hereditary condition.

Innocent flow murmer at puppies
Each heart beat ejects a certain volume of blood, the stroke volume. Puppies have larger stroke volumes for their size than adult dogs. This means that for each heart beat, a relatively larger volume of blood is ejected out a smaller vessel when compared to an adult dog. When excited such as at a veterinairy clinic, this can increase further and so the outflow velocity from the ventricles in the aorta or pulmonary artery can increase above a certain threshold and become turbulent creating a murmer.

Typically these innocent flow murmers tent to be fairly quiet (up to grade 3), soft and blowing in character and occur at the beginning to middle of the heart heat. Also they are usually loudest over the aorta or pulmonary artery and can vary with body position.

The puppy should be re-examined in a few weeks or in 1 month. An innocent flow murmer should get quieter or disappear as the puppy grows. If it’s an innocent flow murmer, it will disappear before 6 months of age.