Pain Is Not a Belief System: Recognising and Treating Chiari Malformation and Syringomyelia in Cavaliers

Chiari malformation and syringomyelia (CM/SM) are heartbreaking conditions that many Cavalier King Charles Spaniel owners eventually face. These aren’t obscure medical terms—they describe serious, progressive neurological disorders that cause real pain. But far too often, we see owners doing… nothing.

Some genuinely don’t recognise the signs of pain. Others don’t want to face the reality. And some actively reject medical treatment because they “don’t believe in” pharmaceuticals, preferring herbal alternatives—or simply hoping for the best.

Let’s be clear: your dog’s pain isn’t a matter of belief.

They don’t need you to believe in it. They need you to see it—and to act.

Recognising Pain for What It Is

One of the most damaging myths in the Cavalier community is the idea that certain CM/SM symptoms are just quirks.

• “She yelps because she’s dramatic.”

• “He scratches like that out of habit.”

• “She’s just fussy when touched.”

• “He’s a sensitive soul.”

No. These behaviours are often classic signs of neurological pain:

• Air scratching (often one-sided, behind the shoulder)

• Scratching the back of the head or face 

• Sudden yelping, groaning or screaming when moved, picked up, or touched

• Sensitive to touch (commonly when touched on head, ears during grooming and can be head shy)

• Reluctance to walk, climb stairs, or jump

• Licking or chewing paws (often interpreted as anxiety or boredom)

• Pacing, restlessness, disrupted sleep

• General tension, avoidance, or irritability

• Behaviour changes (become timid or show aggression)

These are not quirks. They’re not signs of a dog being “spoiled,” “needy,” or dramatic. They are pain behaviours. If a human child showed signs of neurological distress, we wouldn’t brush it off—we’d act. Our dogs deserve the same.

Why Some People Avoid Treatment

There are usually two main reasons:

1. Financial constraints.

Scans, reviews, and medication aren’t cheap—and many owners simply weren’t prepared for the financial burden of a chronic condition. It’s a genuine issue, and one that deserves compassion, not judgment. But doing nothing at all because treatment is costly is not an ethical option.

2. Beliefs or denial.

Some owners don’t want to “medicate their dogs for life.” Others prefer herbal supplements or “natural” approaches. And sadly, some are in denial—convincing themselves the signs are just “normal Cavalier behaviour” or quirks that don’t need addressing.

The hard truth is: Chiari and syringomyelia cause physical, neurological pain. No amount of turmeric or CBD oil will replace the medications proven to help manage it. And pretending the signs aren’t there doesn’t make them go away—it just prolongs the suffering.

You Won’t Always Hear the Pain

Cavaliers are a stoic breed. Many don’t scream or cry. They don’t limp or whine every time something hurts. That doesn’t mean they’re fine. Watch for the subtle signs:

• Is your dog constantly changing positions while resting?

• Avoiding head touches or brushing?

• Sleeping more or becoming withdrawn?

• “Spacing out” or freezing during activity?

If so, they may not be quirky. They may be hurting.

If You’re Struggling

This article isn’t here to shame—it’s here to open eyes. If you’re struggling financially, you’re not alone. Talk to your vet—many are open to creating treatment plans that work within your budget. Most medications used for treatment are inexpensive, and there are often generic options.

If you’re unsure whether your Cavalier is in pain or you can’t afford an MRI, start with Chiari Check —a simple, free, questionnaire-based tool designed to assess the likelihood of Chiari-like pain and syringomyelia.

• It’s designed for both caregivers and vets to use

• It’s completely free and available at caninechiari.com

• It generates a risk percentage score based on your dog’s symptoms

• It helps assess whether veterinary attention or treatment adjustments are needed

• It can also track changes over time—so it’s great for monitoring treatment response

Chiari Check is constantly learning—so the more people who use it, the smarter and more helpful it becomes. It’s a powerful starting point.

If your dog is showing signs of pain, please don’t wait. Even if an MRI isn’t an option, there are ways to evaluate, treat, and improve your dog’s quality of life. You can also view the latest, vet-led treatment algorithm for Chiari and syringomyelia by Professor Clare Rusbridge right on the Chiari Check website.

But pretending CM/SM isn’t there—or treating it with “beliefs” instead of medicine—only hurts the one being silenced the most: your dog.

If You Take One Thing Away…

Pain is not a personality trait. It’s not a quirk. And it’s not a debate.

If your Cavalier is showing signs of CM/SM, they need help. Not denial. Not distraction. Not belief in “natural healing.” They need proper, veterinary-supported care that puts their comfort first.

They don’t get to choose. You do.

So choose better. Choose compassion. Choose pain relief.