Cavalier King Charles Health Issues Calgary: Mitral Valve Disease, Syringomyelia, Episodic Falling

Q: What is mitral valve disease in Cavaliers?

Mitral valve disease (MVD) is the defining Cavalier health concern. Cavaliers are the worst-affected breed of any dog. About 50% have heart murmurs by age 5, and about 98% by age 10. MVD means the heart's mitral valve degenerates and starts to leak. That leak creates the murmur a vet hears. Symptoms develop gradually over years: a heart murmur detected at a vet exam (often years before any other sign), exercise intolerance, coughing (especially after exercise or at night), rapid breathing, lethargy, fainting in advanced cases, and a distended abdomen in advanced cases. Diagnosis uses a vet exam (murmur grading), chest X-ray, and echocardiogram (the gold standard for staging). A Calgary specialty cardiology echo costs $400 to $700 at Western Veterinary Specialist Centre or VCA Canada West. Treatment by ACVIM stage works like this. Stage A (every Cavalier, no murmur yet) means baseline monitoring only. Stage B1 (murmur, no heart enlargement) means annual cardiac monitoring. Stage B2 (murmur with heart enlargement on echo) means starting pimobendan (Vetmedin) preventively. Multi-year studies show this delays heart failure. Stage C (symptoms present, including coughing and exercise intolerance) means pimobendan plus ACE inhibitors (benazepril, enalapril) plus diuretics (furosemide). Calgary cost: $60 to $200/month for meds, $400 to $700/year for monitoring. Stage D (refractory heart failure) means intensive medication management. Mitral valve repair surgery is an option at specialty cardiology, $15,000 to $25,000+. Most Cavaliers with MVD live many years with proper management. Annual cardiac echo after the first murmur is essential.

Q: How do I find an MVD-aware Cavalier breeder?

Most Cavalier breeders don't do proper cardiac testing. Verifying carefully is unusually important for this breed. Required cardiac testing for ethical Cavalier breeding looks like this. (1) Annual echocardiogram by a board-certified veterinary cardiologist (DACVIM-Cardiology), not just a GP heart auscultation. (2) Both parents must be cardiac-cleared at the time of breeding. (3) CKCSC heart and MRI scheme guidelines require that females not be bred before 30 months AND that parents are still clear at age 5. This significantly reduces puppy MVD risk. (4) MRI for syringomyelia. CKCSC also recommends this, and most breeders skip it. Red flags include: the breeder says "vet said heart sounds fine" (auscultation alone misses Stage B2), no annual cardiology echos, breeding before 30 months, no MRI for SM, and an inability to show written cardiac and MRI reports. Ethical Calgary and Alberta Cavalier breeders who follow CKCSC standards are rare. Most breeders charge $2,500 to $4,500 without proper testing. Truly health-tested Cavaliers from CKCSC-compliant breeders run $4,000 to $6,000+, often with 2 to 3 year waitlists. For most adopters, adopting an adult Cavalier from rescue is dramatically better risk management than gambling on breeder testing claims. Adult Cavaliers in rescue can be cardiac-tested by your own vet ($400 to $700 echo) before you commit.

Q: What eye problems do Cavaliers have?

Multiple. Common Cavalier eye conditions include the following. (1) Curly Coat / Dry Eye (CCDE) is a Cavalier-specific genetic condition, autosomal recessive, and DNA testable. It causes severe dry eye plus abnormal coat texture. (2) Progressive Retinal Atrophy (PRA) is gradual retinal degeneration leading to blindness, typically by age 4 to 7. PRA is DNA testable at Embark Vet ($150 to $200). (3) Cataracts are common in seniors. Calgary surgery runs $3,000 to $5,000 per eye. (4) Dry eye, also called KCS, is chronic insufficient tear production. It requires lifetime cyclosporine drops at about $30/month. (5) Distichiasis is extra eyelashes that scratch the cornea. (6) Cherry eye is third-eyelid gland prolapse. Surgical replacement runs $800 to $1,500 per eye. (7) Corneal ulcers from dry eye or trauma. Daily eye care: wipe the corners with a damp soft cloth or sterile saline pad, and book annual eye exams (especially for seniors). Calgary specialty veterinary ophthalmology: VCA Canada West, Western Veterinary Specialist Centre. CKCSC breeding requires an annual eye CERF examination.

Q: Why do Cavaliers get so many ear infections?

Cavalier ear anatomy is a perfect storm for infections. Long pendulous ears limit air circulation and trap moisture. Hair grows inside the ear canal (the Spaniel inheritance). Allergies are common in the breed, and allergies are the underlying cause of most chronic ear infections. About 40 to 50% of Cavaliers have at least one ear infection per year. Many have ongoing chronic ear disease. Symptoms include head shaking, scratching at the ears, redness, dark waxy or pus-like discharge, foul odor, and head tilt in severe cases. Calgary cost runs $200 to $400 per vet visit for diagnosis and medication. Many Cavaliers have 1 to 3 visits per year for this. Management at home: weekly ear cleaning with Epi-Otic or MalAcetic Otic, a monthly check for redness, discharge, or odor, and addressing the underlying allergy if infections recur. Plucking ear hair is controversial. Cavalier breeders and vets vary in their recommendations. For chronic cases, see Calgary specialty veterinary dermatology at Western Veterinary Specialist Centre. Allergies are often the root cause. Options include Apoquel ($60 to $100/month for a Cavalier-size dose), Cytopoint injections, and immunotherapy desensitization for severe cases.

Q: How serious is dental disease in Cavaliers?

Common but less severe than in tiny toy breeds. About 70% of Cavaliers have dental disease by age 5. That's high, but it's lower than Maltese, Yorkie, or Pomeranian (about 85% by age 3). Cavaliers often need professional dental cleanings every 12 to 18 months. Calgary dental cleaning cost: $500 to $1,500 depending on extractions. Lifetime dental care for a Cavalier often runs $3,500 to $7,500+. Prevention: daily tooth brushing with dog-safe toothpaste from puppyhood, VOHC-approved dental chews, and regular vet exams. Untreated dental disease causes systemic inflammation linked to heart disease. That matters more than usual for a breed with this much MVD prevalence. One anesthesia note: dental cleanings require anesthesia, and Cavaliers with MVD need a cardiac evaluation before any anesthesia event.

The short answer

Two health conditions define the Cavalier King Charles Spaniel. Mitral valve disease (MVD) is a degenerative leak of the heart's mitral valve. Cavaliers are the worst-affected breed of any dog. About 50% have murmurs by age 5, and about 98% by age 10. Treatment ranges across ACVIM stages A through D, with $60 to $200/month in medication and $15K to $25K specialty repair surgery for severe cases. Syringomyelia (SM) is a Cavalier-specific neurological condition where the skull is too small for the brain. About 70% are affected, with 5 to 15% symptomatic. A Calgary MRI runs $2.5K to $3.5K, and pain management is lifelong. Other Cavalier-specific conditions include episodic falling syndrome (DNA testable), eye conditions (curly coat dry eye, PRA, cataracts), ear infections, and dental disease. Pet insurance is essential. Lifetime vet costs run $25K to $50K+. Calgary insurance costs $40 to $80/month for a young healthy Cavalier. Verify MVD coverage specifically, and enrol before the first murmur is detected.

Cavaliers are the worst-affected breed for mitral valve disease

About 50% of Cavaliers have heart murmurs by age 5. About 98% by age 10. This is the highest MVD prevalence of any dog breed. Plan for an annual cardiac echocardiogram from age 2 onwards. Calgary specialty cardiology: Western Veterinary Specialist Centre or VCA Canada West. $400 to $700 per echo. Pet insurance enrolled before the first murmur is critical. Once a murmur is documented, MVD becomes pre-existing and is excluded across every Canadian provider.

What is mitral valve disease in Cavaliers?

The defining Cavalier health concern. Cavaliers are the worst-affected breed of any dog for MVD. About 50% of Cavaliers have heart murmurs by age 5, and about 98% by age 10. MVD is the degeneration of the heart's mitral valve. The valve starts to leak, and that leak creates the murmur.

Symptoms develop gradually over years. A heart murmur is usually the first sign, detected at a vet exam years before any other symptom. Later symptoms include exercise intolerance, coughing (especially after exercise or at night), rapid breathing, lethargy, fainting, and a distended abdomen.

Diagnosis: vet exam (heart murmur grading), chest X-ray, and echocardiogram (the gold standard for staging). Calgary specialty cardiology echo: $400 to $700 at Western Veterinary Specialist Centre or VCA Canada West.

Treatment by ACVIM stage:

Stage A (genetic predisposition, no murmur. Every Cavalier sits here at birth.) Baseline monitoring only.
Stage B1 (murmur, no heart enlargement). Annual cardiac monitoring.
Stage B2 (murmur with heart enlargement on echo). Start pimobendan (Vetmedin) preventively. Multi-year studies show this delays heart failure.
Stage C (symptoms present). Pimobendan plus ACE inhibitors plus diuretics. Calgary cost: $60 to $200/month in meds, $400 to $700/year in monitoring.
Stage D (refractory heart failure). Intensive medication. Mitral valve repair surgery is an option at specialty cardiology ($15,000 to $25,000+).

Most Cavaliers with MVD live many years with proper management. Annual cardiac echo after the first murmur is essential.

What is syringomyelia in Cavaliers?

Syringomyelia (SM, also called Chiari-like malformation/syringomyelia or CM/SM) is a Cavalier-specific neurological condition. It affects about 70% of Cavaliers. Most stay asymptomatic. About 5 to 15% develop clinical signs.

The cause: Cavalier skulls are too small for the brain (Chiari-like malformation). This obstructs cerebrospinal fluid flow. Fluid-filled cavities (syrinxes) then form in the spinal cord and cause pain and neurological symptoms.

Symptoms typically appear between 6 months and 3 years of age. They include scratching at the neck or shoulders without making contact (“phantom scratching”), yelping or vocalizing for no apparent reason, head tilt, weakness, sensitivity to touch around the neck and head, and difficulty going up stairs or jumping.

Diagnosis: MRI of the brain and spinal cord ($2,500 to $3,500 in Calgary at specialty neurology). Treatment: pain management (gabapentin, NSAIDs), and corticosteroids for severe cases. Surgical decompression is a rare option ($8,000 to $15,000+ at specialty referral, with mixed outcomes). SM is a lifelong condition. Treatment manages it. Treatment does not cure it.

Pet insurance enrolled before the first symptom is critical. CKCSC breeding ethics require MRI testing of parents to reduce SM rates in offspring. Most Cavalier breeders do not do this testing. Verify with any breeder. Calgary specialty neurology: VCA Canada West, Western Veterinary Specialist Centre.

How do I find an MVD-aware Cavalier breeder?

Most Cavalier breeders don't do proper cardiac testing. Verifying carefully is unusually important for this breed.

Required cardiac testing for ethical Cavalier breeding:

Annual echocardiogram by a board-certified veterinary cardiologist (DACVIM-Cardiology). Not just a GP heart auscultation.
Both parents must be cardiac-cleared at the time of breeding.
CKCSC heart and MRI scheme guidelines. Females cannot be bred before 30 months. Parents must still be clear at age 5. This significantly reduces puppy MVD risk.
MRI for syringomyelia. CKCSC also recommends this, and most breeders skip it.

Red flags:

Breeder claims “vet said heart sounds fine.” Auscultation alone misses Stage B2.
No annual cardiology echos.
Breeding before 30 months.
No MRI for SM.
Cannot show written cardiac and MRI reports.

Ethical Calgary and Alberta Cavalier breeders who follow CKCSC standards are rare. Most breeders charge $2,500 to $4,500 without proper testing. Truly health-tested Cavaliers from CKCSC-compliant breeders run $4,000 to $6,000+, often with 2 to 3 year waitlists.

For most adopters, an adult Cavalier from rescue is dramatically better risk management than gambling on breeder testing claims. Adult Cavaliers in rescue can be cardiac-tested by your own vet ($400 to $700 echo) before you commit.

What is episodic falling syndrome in Cavaliers?

Episodic falling syndrome (EFS) is a Cavalier-specific neurological condition. Dogs experience sudden episodes of muscle stiffness or seizure-like activity. Triggers include exercise, excitement, or stress. EFS is distinct from regular seizures. It affects about 1 to 3% of Cavaliers. Symptoms: stiff hindlimbs, a “deer-leaping” gait, falling over after extended exercise, and full consciousness during the episode (unlike a seizure). Recovery takes minutes. Diagnosis: clinical signs plus a DNA test for the autosomal recessive gene at Embark Vet ($150 to $200). Treatment: avoid triggers and use clonazepam for severe cases. EFS is lifelong but generally manageable.

What eye problems do Cavaliers have?

Multiple. Common Cavalier eye conditions:

Curly Coat / Dry Eye (CCDE). Cavalier-specific genetic condition, autosomal recessive. DNA testable. Causes severe dry eye plus abnormal coat texture.
Progressive Retinal Atrophy (PRA). Gradual blindness by age 4 to 7. DNA testable ($150 to $200 at Embark).
Cataracts. Common in seniors. Calgary surgery $3,000 to $5,000 per eye.
Dry eye (KCS). Lifetime cyclosporine drops (about $30/month).
Distichiasis. Extra eyelashes scratching the cornea.
Cherry eye. Surgical replacement $800 to $1,500 per eye.
Corneal ulcers from dry eye or trauma.

Daily eye care: wipe the corners with a damp soft cloth or sterile saline pad, and book annual eye exams (especially for seniors). Calgary specialty veterinary ophthalmology: VCA Canada West, Western Veterinary Specialist Centre. CKCSC breeding requires an annual eye CERF examination.

Why do Cavaliers get so many ear infections?

Cavalier ear anatomy is a perfect storm for infections. Long pendulous ears limit air circulation and trap moisture. Hair grows inside the ear canal (the Spaniel inheritance). Allergies are common in the breed. About 40 to 50% of Cavaliers have at least one ear infection per year. Many have ongoing chronic ear disease.

Symptoms: head shaking, scratching at the ears, redness, dark waxy or pus-like discharge, foul odor, and head tilt. Calgary cost: $200 to $400 per vet visit, recurring 1 to 3 times per year. Management: weekly ear cleaning at home (Epi-Otic, MalAcetic Otic), a monthly check, and addressing the underlying allergy. Allergies are often the root cause. Options include Apoquel ($60 to $100/month for a Cavalier-size dose), Cytopoint injections, and immunotherapy desensitization.

How serious is dental disease in Cavaliers?

Common but less severe than in tiny toy breeds. About 70% of Cavaliers have dental disease by age 5. That's high, but lower than Maltese, Yorkie, or Pomeranian (about 85% by age 3). Cavaliers often need professional dental cleanings every 12 to 18 months. Calgary dental cleaning cost: $500 to $1,500. Lifetime dental care often runs $3,500 to $7,500+. Untreated dental disease causes systemic inflammation linked to heart disease. That matters more than usual for a breed with this much MVD prevalence. Anesthesia consideration: dental cleanings require anesthesia, and Cavaliers with MVD need a cardiac evaluation before any anesthesia event.

What is the Cavalier anesthesia profile?

Standard small-breed risk for young Cavaliers. After the first MVD murmur, cardiac-aware anesthesia is required.

Pre-op considerations:

Cardiac evaluation is required before any anesthesia. Chest X-ray plus echo if a murmur is detected. Skipping this is dangerous in a breed with 98% MVD prevalence by age 10.
Pre-op bloodwork including renal and liver values, especially for seniors.
Stable cardiac status confirmed (Stage B1 or earlier is ideal; Stage B2+ requires careful pre-op stabilization).
IV fluid rate must be cardiac-aware. Overhydration in MVD-affected dogs can trigger congestive heart failure.
A pain management plan that includes non-cardiac-stressing options.

Calgary specialty centres (VCA Canada West, Western Veterinary Specialist Centre) handle major procedures, especially for senior Cavaliers. Anesthesia events for senior Cavaliers should be combined when possible to minimize cumulative cardiac stress.

Should I get pet insurance for my Cavalier?

Absolutely yes. Cavaliers are THE breed where pet insurance most reliably pays for itself. The MVD lifetime cost alone justifies insurance. Plan for $60 to $200/month in medications for life starting at Stage C, plus annual cardiac monitoring ($400 to $700/year), plus possible Stage D specialty care ($15,000 to $25,000+). Lifetime vet costs frequently exceed $25,000 to $50,000+.

Calgary insurance: $40 to $80/month for a young healthy Cavalier with a $300 deductible, 80% coinsurance, and $15,000+ annual limit.

Critical caveats specific to Cavalier insurance:

Verify the policy covers MVD specifically. Some Canadian insurers exclude congenital and hereditary conditions, or treat MVD as a breed-specific exclusion.
Enrol before the first MVD murmur is detected. Once a murmur is documented, MVD becomes pre-existing and is excluded. Many Cavaliers develop murmurs by age 5. Enrol early.
Choose a policy with an annual or lifetime limit of $15,000+.
Beware breed-specific exclusions. Some insurers add Cavalier-specific MVD clauses.

Top providers for Cavaliers: Trupanion (no per-condition limits, valuable for chronic MVD), Pets Plus Us, Petsecure. Avoid: any policy with per-condition limits under $5,000 or annual limits under $10,000.

The Cavalier insurance equation: about $8,000 in premiums over 12 years covers $20,000 to $50,000+ in MVD, SM, and eye care.

Why does keeping my Cavalier lean matter so much for MVD?

Obesity is one of the biggest preventable risk factors for MVD progression. And Cavaliers are notorious food thieves. Every extra pound of body fat increases the cardiac workload of an already-failing mitral valve.

Studies consistently show that overweight Cavaliers progress to clinical heart failure (Stage C) faster than lean-kept Cavaliers. The target body condition score (BCS, a 9-point body-fat scale used by vets) is 4 to 5 out of 9. You should feel ribs easily, see a defined waist from above, and see a tucked abdomen from the side. Most Calgary Cavaliers are 1 to 3 lbs overweight without their owners realizing it.

Practical management:

Weigh kibble portions on a kitchen scale. Don't eyeball cups.
Eliminate table scraps entirely. Cavaliers will manipulate every household member into “just a little.”
Cap treats at 10 to 15% of daily calories.
Swap commercial treats for low-calorie alternatives: cooked chicken, blueberries, green beans, apple slices.

Cavalier metabolism slows around age 4 to 5. Caloric needs drop 15 to 20% even before MVD progression. Plan annual weigh-ins at vet visits, and monthly home weigh-ins once Stage B2 is confirmed. The single biggest lever Calgary Cavalier owners have over MVD progression is keeping the dog lean.

Why do Cavaliers have sensitive stomachs and food allergies?

Cavaliers have meaningfully higher rates of GI sensitivity and food allergies than most breeds. About 15 to 20% develop a food allergy or chronic sensitive stomach during their lifetime.

Common GI issues: chronic loose stool, intermittent vomiting, food allergies (most often to chicken, beef, or grains), inflammatory bowel disease (IBD) in seniors, and pancreatitis (sometimes triggered by high-fat treats or table scraps).

Symptoms to watch:

Chronic soft stool or diarrhea.
Intermittent vomiting, especially yellow bile in the morning on an empty stomach.
Excessive gas and gurgling stomach sounds.
Picky eating that comes and goes.
Itchy skin or chronic ear infections. Food allergies often present as skin or ear issues, not GI.
Poor coat quality.

Workup approach: rule out parasites first, then run a strict elimination diet (single novel protein plus single carb for 8 to 12 weeks). Calgary cost: $500 to $1,500 for a full GI workup including bloodwork and stool tests, plus a prescription hydrolyzed or limited-ingredient diet ($90 to $140 per bag).

Common Cavalier-friendly diets: Hill's z/d (hydrolyzed), Royal Canin Hypoallergenic, Purina Pro Plan HA. Avoid: high-fat treats (rawhide, pig ears, cheese), abrupt food changes, and table scraps.

Cavaliers with both food allergies AND MVD need a diet that is both hypoallergenic AND low-sodium. Work with your cardiologist and GI specialist to find a compatible option.

What should I keep on hand for a Cavalier emergency?

Cavalier-specific emergency kit:

Cardiac history documentation. Current murmur grade, last echo results, current cardiac medications. The most important item for ER intake.
Pet first aid kit.
Phone numbers programmed: regular vet, Calgary 24-hour emergency clinic, Pet Poison Helpline 1-855-764-7661, Calgary specialty cardiology contact.
Current photo with weight and microchip number on a physical card.
Carrier or harness within easy reach.
Pet insurance card or vet financing info (CareCredit, ScratchPay). Specialty cardiology procedures often run $5,000 to $25,000+.
MVD medication if your dog is diagnosed. Bring it to the ER.
Pain medication if syringomyelia is diagnosed.
Eye flush solution and clean gauze.

Frequently Asked Questions

Mitral valve disease?

The worst-affected breed of any dog. About 50% have murmurs by age 5, and about 98% by age 10. Treatment runs across ACVIM stages A through D. A Calgary echo costs $400 to $700. Medications cost $60 to $200/month. Stage D specialty repair runs $15K to $25K.

Syringomyelia?

Cavalier-specific. About 70% are affected, with 5 to 15% symptomatic. Signs include phantom scratching and yelping. A Calgary MRI runs $2.5K to $3.5K. Pain meds (gabapentin) are lifelong. Surgery is a rare option ($8K to $15K).

MVD-aware breeders?

Look for an annual cardiologist echo (not just GP auscultation), CKCSC breeding ethics (no breeding before 30 months), and MRI for SM. Most breeders don't do this. An adult rescue Cavalier with a cardiac echo by your own vet is often better risk management.

Episodic falling syndrome?

Cavalier-specific, about 1 to 3%. Stiff hindlimbs, deer-leaping gait, dog stays conscious during the episode. DNA test costs $150 to $200 at Embark. Avoid triggers, and use clonazepam for severe cases.

Eye problems?

Curly coat dry eye (Cavalier-specific), PRA, cataracts, dry eye (KCS), distichiasis, and cherry eye. Book annual eye exams. CKCSC requires eye CERF.

Ear infections?

About 40 to 50% have at least one per year. Long pendulous ears plus canal hair plus allergies drive it. Calgary cost $200 to $400 per visit. Allergies are often the root cause. Apoquel runs $60 to $100/month.

Dental disease?

About 70% by age 5 (lower than tiny toys). Cleanings run every 12 to 18 months ($500 to $1,500 in Calgary). The heart-disease connection makes dental care more critical than usual.

Anesthesia profile?

Cardiac-aware anesthesia is required after the first MVD murmur. That means pre-op chest X-ray plus echo, careful IV fluids, and cardiac-stable status before the procedure. Combine procedures when possible.

Pet insurance for Cavaliers?

Absolutely yes. THE breed where insurance pays for itself. Lifetime costs run $25K to $50K+. Calgary insurance costs $40 to $80/month. Enrol before the first murmur. Pre-existing exclusion applies after that. Look for $15,000+ annual limit minimum.

Why does lean weight matter for MVD?

It's the biggest preventable lever for slowing MVD progression. Target BCS 4 to 5 out of 9. Most Calgary Cavaliers are 1 to 3 lbs over without owners realizing. Weigh kibble on a kitchen scale, eliminate table scraps, and cap treats at 10 to 15% of daily calories. Metabolism drops 15 to 20% at age 4 to 5.

Sensitive stomach and allergies?

About 15 to 20% of Cavaliers develop food allergies or chronic GI issues. Signs: loose stool, morning bile vomiting, itchy skin or ears (allergies often present as skin, not GI). An elimination diet runs 8 to 12 weeks. Common diets: Hill's z/d, Royal Canin Hypoallergenic, Pro Plan HA. With MVD, the dog needs a diet that is both hypoallergenic AND low-sodium.

Emergency kit?

Cardiac history documentation, first aid, ER vet numbers, specialty cardiology pre-programmed, microchip and weight, harness, MVD meds, SM pain meds, and eye flush.

Related Guide

Cavalier King Charles Health Issues