WOBBLER SYNDROME

(Cervical Vertebral Instability) 

What is Wobbler Syndrome? 

"Wobbler syndrome" is a term used to describe disorders involving compression of the cervical spinal cord (the portion of the spinal cord located in the neck) in large- and giant-breed dogs. Basically two types of compressive disease are included: 1) disk-related disease in mature dogs with thickening of the ligaments and instability of the joints between the cervical vertebrae (bones of the neck) and 2) disease of the cervical vertebrae in young dogs resulting from developmental abnormalities which cause malformation of the cervical spine. Another name for wobbler syndrome is "cervical vertebral instability." 

What causes Wobbler Syndrome? 

The causes of wobbler syndrome include cervical intervertebral disk disease, abnormalities of the cervical vertebrae, and malformation of the cervical vertebrae due to poor nutrition. Large, fast-growing dogs are at risk for vertebral-related disease. 

What are the signs of Wobbler Syndrome? 

Clinical signs vary widely depending on the amount of spinal cord compression caused by the cervical vertebral instability. Signs may have a rapid and sudden onset or they may progress slowly. The signs may or may not worsen. The dog may have neck pain, difficulty rising to a standing posture, wasting of the muscles (especially in the forelimbs), worn toenails, unsteady gait, and general difficulty in maintaining normal postures. 

How is Wobbler Syndrome diagnosed? 

The veterinarian will obtain a medical history and perform physical and neurological examinations. The breed of dog is important in suggesting a diagnosis of wobbler syndrome. This syndrome is reported in large- and giant-breed dogs, especially in older Doberman pinschers and young Great Danes. If wobbler syndrome is suspected, the veterinarian will perform additional tests. Diagnosis is made through radiographs (X-rays) of the spinal column. Myelograms (special contrast X-rays) may be needed to evaluate the spinal cord. Additionally, an analysis of the cerebrospinal fluid may be performed. Cerebrospinal fluid is obtained by inserting a needle into the spine and withdrawing fluid. 

How is Wobbler Syndrome treated? 

The treatment for wobbler syndrome is determined by the age of the dog, the type of cervical instability, and the severity of clinical signs. The dog's activity is restricted. For growing dogs with vertebral related disease, the veterinarian may discontinue excessive use of dietary supplements (if these have been used) and may control food intake. Neurological (relating to the nervous system) problems may continue. In these dogs, the veterinarian will try to stop the progression of the disease. Physical therapy usually is required to help the pet regain lost function. Generally these dogs are surgical candidates. Surgical procedures may include decompression of the spinal cord, fenestration to attempt to prevent other disks from causing disease, and stabilization or fusion of the spine. Some veterinary surgeons and neurologists consider fusion of the vertebrae to try to stabilize the spine controversial. The use of steroids in combination with surgery is usually the most effective treatment. The use of steroids alone is helpful only in mildly affected patients. 

What is the prognosis for dogs with Wobbler Syndrome? 

The prognosis (outcome) for dogs with wobbler syndrome is variable. The earlier in the course of disease that surgery is performed, the better the outcome. Paralysis is always a possibility in dogs with wobbler syndrome; frequently these dogs cannot be helped. 

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