The Cockalier is a cross that lives or dies by the health testing of its Cavalier King Charles Spaniel parent. The Cavalier contributes the warmest, most consistently gentle temperament in the toy spaniel world — and a hereditary disease profile that veterinary cardiologists describe as among the most challenging in the AKC. Mitral valve disease (MVD) affects essentially all Cavaliers by age 10; Chiari-Like Malformation (CM) and Syringomyelia (SM) affect a significant proportion of the breed. The CKCS parent of any Cockalier should have been health-tested under the Cavalier Health Inc./AKC MVD protocol AND MRI-screened for CM/SM. The Cockalier whose Cavalier parent was fully tested represents a genuinely worthwhile cross; the one from untested parents carries health uncertainty that is difficult to accept for any price.