Wobblers Syndrome (Cervical Spondylomyelopathy )

CERVICAL SPONDYLOMYELOPATHY (WOBBLER SYNDROME)

Cervical spondylomyelopathy is a disorder that is recognized in many large breeds of dog, particularly the Great Dane and Doberman Pincher. The clinical and neurological signs result from compression of the cervical spinal cord.

The compression is caused by the developmental malformations of the vertebrae, vertebral instability or instability associated changes to the vertebrae or associated tissues.

The cause is likely to be multifactoral with genetic, nutritional and biochemical influences. The presence of a large, heavy head on a long neck may create abnormal forces that contribute to abnormal vertebral development.

Nutritional studies in Great Danes have shown that ad libitum feeding of balance diets in young dogs can increase the prevalence of the disorder. Additionally, chronic, excessive calcium intake in young dogs can result in hypercalcitonism, which disturbs skeletal remodeling and ossification and may contribute to abnormal vertebral development.

Compression of the spinal cord may arise from any of the following act in individually or in combination -stenosis of the vertebral canal -malformation of the processes where they join -disc disease -enlargement of the ligament holding the vertebra together -vertebral malalignment

The above changes produce constant compression of the spinal cord. This may result from pressure on the spinal cord and usually caused by buckling of the ligament stabilizing the cervical vertebrae or from abnormal alignment if the vertebra in younger dogs.

Pressure on the spinal cord results in neurological signs, most commonly affecting the hind limbs. Compression may be present an single or multiple sites along the spinal cord and there is variation among breeds as to the level of the vertebral column that is most commonly affected .Chronic compression of the spinal cord may result in damage to the nerve tracts descending down the spinal cord.

Clinical signs:

The disorder is seen more commonly in males than females and the age a presentation may vary from around eight weeks to ten years or older.

There is variation among breeds in the age of onset of clinical signs.

Clinical signs vary considerably in their severity and speed of onset by is usually chronic and progressive.

There is usually the slow onset of paresis and ataxia of the hind limbs, which may progress to involve the forelimbs.

Dogs can present acute onset quadrapariesis or quadriplegia.

Cervical pain may be present.

Diagnosis:

X-rays of the cervical spine may show a number of abnormalities

-tipping of the vertebra into the spinal cord

-stenosis (narrowing) of the vertebral canal

-malformation of the vertebral bodies

-narrowing of the intervertebral disc spaces with arthritic changes

Myelograms are required to localize the lesions

MRI is also of value

Treatment:

Dogs with mild or intermittent signs may be treated conservatively (restricted activity), corticosteroids, feeding from a height and the use of a chest harness rather than a collar and lead.

Dietary adjustment,if necessary, in young dogs

Surgical treatments including decompression of the spinal cord, fusion of the spinal cord, and the placement of screws through the vertebra.

Prevention:

This is likely to be a genetic component to the disorder, but correct nutrition during growth and development is important, particularly in giant breeds of dog.

Avoid over feeding and excessive mineral supplementation during growth.