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Buy your puppy from a responsible, reputable
breeder to reduce the chance of health defects.

Cavalier King Charles Spaniel
Health Topics

Cavalier Health Topic: Introduction
Cavaliers can suffer from a number of severe genetic defects. Unfortunately, two possible genetic conditions, mitral valve disease and syringomyelia, can be both severe and very common. It is very important to buy from a reputable hobby breeder who screens all their breeding dogs for these conditions. It is suggested to use the reputable breeder-referral services offered by the national club(s).

To help protect the breed from mitral vavle disease, a group of veterinary cardiology specialists have set up guidelines to eliminate early-onset mitral valve disease. The guidelines are called the MVD Breeding Protocol, and are described by
  • Every breeding Cavalier King Charles Spaniel should be examined annually by a board certified veterinary cardiologist.
  • Do not breed any Cavalier who is diagnosed with an MVD murmur under the age of 5 years.
  • Do not breed any CKCS before age 2.5 years.
  • Do not breed any Cavalier under the age of 5 years, unless its parents' hearts were free of MVD murmurs by age 5 years.
Breeders sometimes MRI-screen dogs for syringomyelia (although this is as yet an extremely expensive--around 700-2000 USD--and uncommon test; some Cavalier clubs in the US are currently exploring the possibility of lower-cost MRI group clinics for breeders), to reduce the chance the puppy will have the defects described below.

Breeders who breed for health willingly supply heart, hip, eye and patella clearances for their breeding dogs, and responsible breeders choose pairings to try to reduce the incidence of all these defects in the breed. Due to the large size of the Cavalier's ears and eyes, they are prone to infections. It is most important to find a reputable breeder who tests their dogs yearly for the following health defects, to ensure the owner they are getting a puppy with a healthy background.

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Cavalier Health Topic: Mitral vavle disease
It is very common that Cavaliers eventually suffer from mitral valve disease, with heart murmurs which may progressively worsen, leading to heart failure. This condition is polygenic, and therefore all lines of Cavaliers worldwide are potentially susceptible. It is the leading cause of death of the Cavalier King Charles Spaniel and the reason the breed's expected life span is only between seven and ten years. A survey by the UK Kennel Club showed that 42.8% of Cavalier deaths are cardiac related. The next most common causes are cancer(12.3%) and old age(12.2%).

The 'hinge' on the heart's mitral valve loosens and can gradually deteriorate, along with the valve's flaps, causing a heart murmur (as blood seeps through the valve between heartbeats) then congestive heart failure, can begin to emerge at an early age, and statistically may be expected to be present in more than half of all Cavalier King Charles Spaniels by age 5. It is rare for a 10-year-old Cavalier not to have a mitral valve heart murmur. While heart disease is common in dogs generally -- one in 10 of all dogs will eventually have heart problems -- MVD is generally (as in humans) a disease of old age, but unfortunately, the Cavalier is susceptible to early-onset heart disease, at as young as age one or two. Veterinary geneticists and cardiologists have designed breeding guidelines to eliminate early-onset mitral valve disease in the breed; but it is unclear if a statistically significant number of breeders follow these guidelines.

Reputable international CKCS clubs all recommend that puppy buyers seek reputable hobby breeders who have cardiac clearances for their breeding dogs from a vet cardiologist, and who follow the MVD breeding protocol (parents should be at least 2.5 years old and heart clear, and their parents (the puppy's grandparents) should be heart clear until age 5).

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Cavalier Health Topic: Syringomyelia
Syringomyelia (SM) is a condition affecting the brain and spine, causing symptoms ranging from mild discomfort to severe pain and partial paralysis. It is caused by a malformation in the lower back of the skull which reduces the space available to the brain, compressing it and often forcing it out (herniating it) through the opening into the spinal cord. This blocks the flow of cerebral spinal fluid (CSF) around the brain and spine and increases the fluid's pressure, creating turbulence which in turn is believed to create fluid pockets, or syrinxes (hence the term syringomyelia), in the spinal cord. Syringomyelia is rare in most breeds but has become widespread in the Cavalier King Charles Spaniel, with international research samples in the past few years consistently showing nearly all (90%+) cavaliers have the malformation and that between 30-70% have syrinxes, though most dogs with syrinxes are not symptomatic.

Although symptoms of syringomyelia can present at any age, they typically appear between 6 months and 4 years of age in 85% of symptomatic dogs, according to Dr Rusbridge. Symptoms include sensitivity around the head, neck, or shoulders, often indicated by a dog whimpering or frequently scratching at the area of his neck or shoulder. Scratching is often unilateral -- restricted to one side of the body. Scratching motions are frequently performed without actually making physical contact with the body ("air scratching"). The scratching behavior appears involuntary and the dog frequently scratches while walking -- without stopping -- in a way that is very atypical of normal scratching ("bunny hopping"). Scratching typical of SM is usually worse when the dog is wearing a collar, is being walked on leash, or is excited, and first thing in the morning or at night.

Not all dogs with SM show scratching behavior. Not all dogs who show scratching behavior appear to suffer pain, though several leading researchers, including Dr Clare Rusbridge in the UK and Drs Curtis Dewey and Dominic Marino in the US, believe scratching in SM cavaliers is a sign of pain and discomfort and of existing neurological damage to the dorsal horn region of the spine. If onset is at an early age, a first sign may be scratching and/or rapidly appearing scoliosis. If the problem is severe, there is likely to be poor proprioception (awareness of body position), especially with regard to the forelimbs. Clumsiness and falling results from this problem. Progression is variable though the majority of dogs showing symptoms by age 4 tend to see progression of the condition.

A vet should be asked to rule out basic causes of scratching or discomfort such as ear mites, fleas, and allergies, and then, primary secretory otitis media (PSOM - glue ear), as well as spinal or limb injuries, before assuming that a Cavalier has SM. PSOM can present similar symptoms but is much easier and cheaper to treat. Episodic Falling Syndrome can also present similar symptoms. An MRI scan is normally done to confirm diagnosis of SM (and also will reveal PSOM).

Because of the prevalence in the breed, SM is increasingly being considered as important a health issue as mitral valve disease (MVD). Just as many breeders follow the MVD breeding protocol, many breeders are now starting to follow breeding guidelines recommended by international researchers (November 2006), to try to decrease the incidence and severity of SM in the breed. The guidelines stipulate that breeding dogs be MRI screened (again, unfortunately, the test is very expensive and not widely available yet) and graded according to whether they show the malformation, syrinxes, or both. Neurologists give scanned dogs a signed certificate noting its grade. At least one dog in a breeding pair must be graded A (clear of syrinxes). A limited breeding scheme by a group of Dutch breeders has shown so far that, encouragingly, AxA matings are consistently producing A puppies.

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Cavalier Health Topic: Episodic Falling (EF)
Episodic Falling is an 'exercise-induced paroxysmal hypertonicity disorder' meaning that there is increased muscle tone in the dog and the muscles are unable to relax. Although it is often misdiagnosed as epilepsy, the dog remains conscious throughout the episode. Severity of symptoms can range from mild, occasional falling or freezing to seizure-like episodes lasting hours. Episodes can become more or less severe as the dog gets older. Onset of symptoms is usually before five months but may be noticed only later in life.

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Cavalier Health Topic: Hip dysplasia
Hip dysplasia (HD) is a genetic disease that affects up to a third of Cavalier King Charles Spaniels. It is never present at birth and develops with age. Hip dysplasia is diagnosed by x-rays, but it usually does not appear in x-rays of Cavaliers until they mature. Reputable breeders screen all breeding animals for HD as well as luxating patellas.

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Cavalier Health Topic: Keratoconjunctivitis sicca
A common disorder among Cavaliers is keratoconjunctivitis sicca, colloquially known as "dry eye". The usual cause of this condition is an autoimmune reaction against the dog's lacrimal gland (tear gland), reducing the production of tears. According to the Canine Inherited Disorders Database, the condition requires continual treatment and if untreated may result in partial or total blindness. This disorder can decrease or heal over time. If treating with the ointments vets prescribe, pay careful attention to your pet's eyes, as they can be under- and over-medicated.

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Cavalier Health Topic: Other Eye Disorders
A 1999 study of Cavaliers conducted by the Canine Eye Registration Foundation showed that an average of 30% of all CKCSs evaluated had eye problems. They include hereditary cataracts, corneal dystrophy, distichiasis, dry eye syndrome, entropion, microphthalmia, progressive retinal degeneration, and retinal dysplasia.

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Cavalier Health Topic: Luxating patella
Cavaliers are subject to a genetic defect of the femur and knee called luxating patella. The disorder is believed to affect 20% to 30% of Cavalier King Charles Spaniels. This condition is most often observed when a puppy is 4 to 6 months old. In the most serious cases, surgery may be indicated. The grading system on the patella is grade 1-4; 1 being a tight knee to 4 which the knee cap will come out of place easily.

If your cavalier has a grade 1-2 you can use physical rehabilitation therapy and exercise to reduce the grading and potentially avoid surgery. The grades 3-4 are most severe where surgery will most likely be needed to correct the problem or they will end up with arthritis and may develop lameness.

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Cavalier Health Topic: Primary Secretory Otitis Media
Primary Secretory Otitis Media (PSOM), also known as glue ear, consists of a highly viscous mucus plug which fills the dog's middle ear and may cause the tympanic membrane to bulge. PSOM has been reported almost exclusively in Cavaliers, and it may affect up to 40% of them. Because the pain and other sensations in the head and neck areas, resulting from PSOM, are similar to some symptoms caused by syringomyelia (SM), some examining veterinarians have mis-diagnosed SM in Cavaliers which actually have PSOM and not SM.

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Cavalier Health Topic: Deafness, Congenital or Progressive
Cavalier King Charles Spaniels are predisposed to a form of congenital deafness, which is present at birth, due to a lack of formation or early degeneration of receptors in the inner ear. In addition, more recent studies have found Cavaliers which develop a progressive hearing loss, which usually begins during puppyhood and progresses until the dog is completely deaf, usually between the ages of three and five years. The progressive nature of this form of deafness in Cavaliers is believed to be due to degeneration of the hearing nerve, rather than the lack of formation or early degeneration of the inner ear receptors.

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Cavalier Health Topic: Thrombocytopenia and Macrothrombocytopenia
As many as half of all Cavalier King Charles Spaniels may have a congenital blood disorder called idiopathic asymptomatic thrombocytopenia, an abnormally low number of blood platelets, according to recent studies in Denmark and the United States. Blood platelets (also called thrombocytes) are disk-shaped blood elements which aid in blood clotting. Excessively low numbers are the most common cause of bleeding disorders in dogs. The platelets in the blood of many Cavalier King Charles Spaniels are a combination of those of normal size for dogs and others that are abnormally oversized.

Cavaliers' oversized platelets are called macrothrombocytes. Macrothrombocytosis also is a congenital abnormality found in at least a third of CKCSs. These large platelets function normally, and the typical Cavalier does not appear to experience any health problems due to either the size or fewer numbers of its platelets. There are, however, exceptions to this typical situation.

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