6 Common Cavalier King Charles Spaniel Health Issues and What to Do About Them

Written by Dr. Marcelle Landestoy, DVM

Cavalier King Charles Spaniels are known to be easygoing, loving, and affectionate dogs.

They are not as playful and energetic as golden retrievers, so it may not always be obvious when they’re not feeling well.

Fortunately, many health issues for this breed have tell-tale signs, so you can give them the necessary medical attention.

The most common health issues for Cavalier King Charles Spaniels are Mitral Valve Disease, Episodic Falling Syndrome, and Syringomyelia. Not every condition has a cure, but regular exercise and monitoring go a long way in giving your furry friend a long and healthy life. 

Read on to learn more about common health problems with cavalier King Charles spaniels.

This article will cover specific disorders, symptoms, and treatments to help you give your tail-wagger the care they need.  

Mitral Valve Disease (MVD)

Charles Cavalier King Spaniel

Mitral Valve Disease (MVD) is a terminal heart condition that is the leading cause of death among cavalier King Charles spaniels.

More than fifty percent of cavaliers have MVD by age five, and the illness is almost inevitable by age ten.  

A dog with MVD essentially has a degrading mitral heart valve.

The mitral valve sits between the left atrium and left ventricle; it divides the two chambers and opens and closes countless times to direct blood to the left ventricle and keep blood from flowing back to the left atrium.  

As the mitral valve degrades, it struggles to close fully, causing blood to flow backward.  

MVD starts as a heart murmur, but as the condition worsens, more blood is allowed to backflow, eventually leading to heart failure.  


Unfortunately, there are no early symptoms of MVD.

A dog with MVD will eventually experience shortness of breath or rapid breathing after exercise, but this occurs as they get closer to heart failure.

The earliest signs of MVD are heart murmurs characterized by a whooshing or swishing sound and heart enlargement due to swelling in the left chambers.

None of these signs are outwardly evident, so it’s crucial to have your pet checked by a vet regularly.   

Diagnosis and Treatment

Cavalier King Charles Spaniel

Cavaliers should be screened for MVD at least once a year so the vet can check for heart murmuring, which indicates abnormal blood flow.

Heart murmuring can be detected using a stethoscope while swelling or enlargement of the heart is determined with multiple x-rays or echocardiogram scans.

One x-ray or scan is not enough to confirm the heart is getting larger.

There is no cure for MVD, although a vet may prescribe medication such as Vetmedrin to delay heart failure and help the dog cope with the condition.

Drugs used to address MVD may also have side effects on internal organs, so monitoring the dog’s blood chemistry is imperative if they are under medication.   

Episodic Falling Syndrome (EFS)


Episodic Falling Syndrome (EFS) is characterized by a sudden and temporary contraction of muscles that causes the dog to twist, lose coordination, and pose abnormally.

The dog can sometimes collapse or lose consciousness, but the condition is rarely life-threatening.  

EFS is unique to Cavalier King Charles Spaniels due to an inherited gene, so it is neurological and not a muscular disorder.

The episodes are temporary and non-progressive, although some dogs may suffer brain damage.  

Cavaliers may experience seizures related to EFS from 13 weeks to 4 years of age.

Attacks are usually triggered by stress, anxiety, excitement, or strenuous exercise.


Dogs suffering from EFS will exhibit abnormal movements due to their muscles being unable to relax.

These episodes will happen spontaneously, mostly during physical activities.  

Below are specific symptoms of EFS:

  • Muscle spasms
  • Abnormal and stiff posture
  • Extending and retracting limbs
  • Poor coordination
  • Stretching of forelegs and paws over the head
  • Collapsing
  • Yelping
  • Arching of the back

Here’s a video of a Cavalier experiencing an attack related to EFS. (WARNING: Video may be heartbreaking to watch. Viewer discretion is advised.)

The symptoms may last between thirty seconds and thirty minutes, with the dog acting completely normal between attacks.  

Diagnosis and Treatment

Diagnosing EFS is based purely on the dog’s symptoms and its DNA.

The disorder cannot be detected with blood tests, biopsies, or magnetic resonance imaging (MRI), so it’s best to capture the symptoms on video to help the vet isolate the issue.  

Symptoms of EFS may be similar to other disorders. Knowing what the dog was doing before the attacks and how it acted after the episode can greatly help the diagnosis.  

EFS is a lifelong condition that can be stabilized with medication or muscle relaxants.

Clonazepam is commonly prescribed for mild to moderate cases, but stronger medication might be necessary for more severe instances.

It’s always best to consult a vet for the most appropriate treatment for your dog. 



Syringomyelia is a rare neurological condition in most dog breeds but more common in Cavalier King Charles Spaniels.  

The condition occurs when cerebrospinal fluid (CSF) is forced down from the brain, which causes tissues to bloat and cavities to form in the spinal cord.

It can be triggered by trauma, a tumor, congenital malformation, or any abnormality at the back of the neck.  

Since bones surround the spinal cord, the swelling can lead to significant pain, especially when the swelling tissues and increasing cavities have nowhere left to expand.    


Dogs with syringomyelia will exhibit various signs, and their actions will not always indicate the severity of the condition.

Cavaliers may develop syringomyelia between six months to three years of age.

A dog may be suspected to have syringomyelia if it displays the following symptoms:

  • Neck and back pain
  • Phantom scratching near the neck and shoulder
  • Yelping
  • Reluctance to jump or climb
  • Weakness
  • Inability to walk straight
Dog sleeping

Diagnosis and Treatment

The symptoms of syringomyelia are common to other conditions like primary secretory otitis media (PSOM), which is also a common condition among Cavalier King Charles Spaniels.

Hence, the most accurate way to diagnose this condition is with specialized x-rays or MRIs.  

Syringomyelia can be treated by medication to relieve pain, reduce CSF pressure, or decrease swelling.

Additional relief can be provided for the pet by raising the placement of food bowls and using a harness instead of a collar to avoid neck pressure.

Surgery is a more effective option and involves reshaping the back of the neck to lessen any obstruction to the CSF.

However, surgery will not always work, and there is no guarantee that the symptoms will be gone for good if the patient’s condition improves.

Primary Secretory Otitis Media (PSOM)

King Charles Spaniel

Primary Secretory Otitis Media (PSOM) is another disease mainly affecting Cavalier King Charles spaniels.

Also known as “glue ear,” PSOM is an inflammation of the dog’s middle ear consisting of highly viscous mucus that can cause the eardrum to bulge.  

Theories suggest PSOM is more common with Cavaliers since their skulls are shorter than other breeds.

The shape of the skull may prevent proper drainage, causing the build-up of mucus.     


Not all dogs with PSOM will display symptoms, and some signs of the disease can easily be construed as normal behavior.

As mentioned earlier, other traits of PSOM can also be misdiagnosed as syringomyelia.

Below are the symptoms that dogs with PSOM may exhibit:

  • Neck and head pain.
  • Tilting of the head.
  • Wobbliness when walking.
  • Itching around the ears.
  • Twitching of the eyes.
  • Excessive yawning.
  • Hearing Loss.
  • Drooling.
  • Fatigue.

Diagnosis and Treatment


Diagnosing PSOM can be done manually with an otoscope or through x-rays if the eardrum has reached a point where it is bulging.

However, PSOM can remain undetected if the top portion of the eardrum remains flat.  

A Computer Tomography (CT) scan or an MRI can be done to diagnose PSOM, but a CT scan is the preferred and most reliable method since it is more sensitive to changes to the middle ear’s structure.  

The most common treatment for PSOM is by performing a myringotomy which involves making an incision in the eardrum and flushing the middle ear to remove the mucus plug.  

Hip Dysplasia

Hip dysplasia is a genetic disease where the ball and socket of the hip do not grow equally.

This abnormal hip development occurs during puppyhood and can result in the hip joint becoming loose.

King charles spaniel

The bones will adjust to this to provide additional stability, which may result in degenerative joint disease or osteoarthritis.

Factors associated with hip dysplasia include:

  • Environment.
  • Body weight.
  • Diet.
  • Muscle Mass.
  • Growth rate.
  • Hormones.
  • Floor Surface.
  • Type of exercise.

Hip dysplasia is commonly seen in big breed dogs, but approximately 1 in 5 Cavalier Charles King Spaniels acquire it.

The disease is painful and can be debilitating.  


Despite hip dysplasia occurring during puppyhood, signs may not be visible until the dog is one to two years old.

Symptoms tend to surface later in the dog’s life since it takes a while for the joints to degrade enough to become outwardly evident.

The following behaviors are symptoms of hip dysplasia:

  • Limping.
  • Bunny hopping.
  • Difficulty climbing stairs.
  • Struggling to get up.
  • Debilitation.

Hip dysplasia is not always characterized by a lack of strength or inability to move around.

Some dogs with severe cases of hip dysplasia show no signs of pain or discomfort. 

Diagnosis and Treatment

Dog Sleeping

Hip dysplasia can be diagnosed with a hip x-ray, although it may not be detected during its early stages.

The disease can be diagnosed earlier with PennHIP screening, which involves measuring hip laxity through a series of x-rays. 

Treatment for hip dysplasia may include medication, therapy, and surgery, depending on the symptoms and severity of the pain.

Weight loss through a low-calorie diet can also provide relief since increased weight puts additional strain on the dog’s joints.

Medication for this disease primarily aims to relieve pain and restore function because hip dysplasia is irreversible.

Light exercise can also be helpful as long as it takes the severity of the dog’s osteoarthritis into consideration.  

Always consult your vet before engaging your dog in physical activities.

You should also ask your vet about physical rehabilitation and physiotherapy since it significantly improves the dog’s quality of life.  

There are also many surgical procedures for hip dysplasia. Surgery may be considered for dogs with extensive joint damage.  

Below are the different types of surgery:

  • Hip replacement.
  • Femoral head ostectomy.
  • Triple pelvic osteotomy.
  • DARthroplasty.
  • Juvenile pubic symphysiodesis.

The type of surgery recommended by your vet will depend on the dog’s condition, lifestyle, and age.  

Patellar Luxation


A luxating patella is a hereditary disorder where the kneecap becomes loose.

This condition is prevalent with small dog breeds and affects one in five Cavaliers.  

The kneecap usually sits in the center of a groove, where it slides up and down each time the thigh muscles contract.

Dislocation of the kneecap may occur due to the groove being too shallow, weak ligaments, and misaligned ligaments or muscles.  

Misaligned ligaments and muscles can compound the issue by pulling the kneecap to one side, causing the groove wall to wear out.

The tendency for the kneecap to become dislocated increases as the track becomes wider.

Sometimes the kneecap can spontaneously return to its normal position, but there are instances where realigning the kneecap requires manual intervention.

The kneecap cannot be reinserted in severe cases, even with manual intervention.

There are four grades of patellar luxation depending on the severity:

  • Grade 1: The kneecap is frequently in the correct position and is easily put back in place when it becomes misaligned.
  • Grade 2: The kneecap is generally in the proper position but pops out more frequently and can be realigned through manual intervention.  
  • Grade 3: The kneecap is generally out of place and may still pop out after manual intervention.
  • Grade 4: The kneecap is out of place, and the chances of manual realignment are slim.

If unaddressed, patellar luxation can worsen since the ridges of the kneecap become thinner and the groove becomes wider.

This condition can lead to complications such as premature arthritis, joint pain, and compromised mobility.  



A dog with a luxating patella will find standing on the affected leg difficult.

The severity of patellar luxation varies from mild cases where dogs show little to no discomfort to more severe instances in which the dog becomes exceptionally lame.  

Below are the symptoms of Patellar Luxation:

  • Leg stiffness.
  • Difficulty walking or walking with the affected leg raised.
  • Hopping and skipping.
  • Whimpering or crying.

Diagnosis and Treatment

Treating patellar luxation during its early stages offers the most favorable prognosis for the dog.

If your dog displays any of the symptoms associated with patellar luxation, take them to a vet who will be able to diagnose the issue with a physical examination.

The vet may also request an x-ray to confirm the condition.

A vet can prescribe medication to minimize swelling and pain associated with patellar luxation.

Physical therapy and weight management also go a long way in helping dogs cope with the condition.

Surgery may be necessary for dogs with grade 3 and 4 patellar luxation to eliminate lameness and intense pain.

The procedure aims to fix the kneecap in its proper place by making the groove deeper or moving the joint. Consult your vet on the best course of action based on your dog’s condition.

Final Thoughts

There are health issues that are very common among Cavalier King Charles Spaniels, some of which are even unique to the breed.

It may seem like cavaliers are prone to certain health conditions, but every dog breed has its susceptibilities.  

Prevention is the best cure for any illness, so it pays to have your pet checked by a vet regularly to avoid complications.  

King charles spaniel


  • The Spruce Pets: Cavalier King Charles Spaniel: Dog Breed Characteristics & Care
  • Canna-Pet: Cavalier King Charles Spaniel Health Problems & Issues
  • Spot Pet Insurance: 5 Common Cavalier King Charles Spaniel Health Problems
  • PetMD: Cavalier King Charles Spaniel
  • Bubbly Pet: The Actual Lifespan of a Cavalier King Charles Spaniel
  • Cavalier Health: Mitral valve disease in the Cavalier King Charles Spaniel
  • Cavalier Health: Episodic Falling Syndrome (Muscle Hypertonicity): Cavaliers Collapse Suddenly After Exercise
  • Cavalier Health: PSOM in the Cavalier King Charles Spaniel
  • Cavalier Health: Hip dysplasia in the Cavalier King Charles Spaniel
  • Cavalier Health: Patellar Luxation (Loose Knees) in the Cavalier King Charles Spaniel
  • VCA Animal Hospital: Mitral Valve Disease in Dogs
  • VCA Animal Hospital: Hip Dysplasia in Dogs
  • VCA Animal Hospital: Luxating Patella in Dogs
  • Wag Walking: Cavalier Episodic Falling Syndrome in Dogs
  • Veterinary Partner: Syringomyelia in Dogs
  • North Downs Specialist Referrals: Syringomyelia
  • MSPCA-Angell – Kindness and Care for Animals: Primary Secretory Otitis Media (PSOM)
  • Universities Federation for Animal Welfare: Cavalier King Charles Spaniel – Primary Secretory Otitis Media
  • Sharon Lakes: Osteoarthritis in Dogs: Causes, Symptoms & Treatment 
  • Veterinary Surgical Specialists: PennHIP Screening
  • TPLO Info: What is Luxating Patella in Dogs?

Veterinary Hospital Director at UCE
Dr. Marcelle is a general veterinarian with a Small Animal Medicine Specialty | Director of the UCE School of Veterinary Medicine | Certified by the International Veterinary Acupuncture Society

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