Understanding this devastating condition

Cervical Spondylomyelopathy, commonly known as Wobblers Syndrome, is a neurological condition predominantly affecting large and giant breed dogs, like Great Danes and Dobermans. The disease affects the neck region and creates a characteristic wobbly walk, especially in the hind limbs. The disease is unfortunately degenerative and, therefore, progresses with time.

What is Wobblers Syndrome?

Wobblers Syndrome results from a malformation in the cervical vertebrae in the neck, leading to intervertebral disc protrusion and degeneration. These discs then compress the spinal cord, interrupting neurological communication between the brain and the body, resulting in neurological effects and pain. The majority of affected dogs show signs of spinal cord compression as young to middle-aged adults, but in dogs with severe deformities, the problems develop when they are immature (five to ten months old).

The exact cause of Wobblers is not entirely understood. However, the high incidence in certain dog breeds suggests a sizeable genetic component.

Signs of Wobblers Syndrome

Clinical signs in dogs with Wobblers Syndrome are progressive and can take months or even years to develop/show, but they may also appear suddenly after a traumatic episode or very strenuous exercise. The clinical signs seen will vary according to the severity and duration of spinal cord compression.

Signs of the disease include:

• Weakness and uncoordinated gait (known as ataxia), usually first seen in the hind limbs.
• Lameness/stiffness in the front limbs
• Wide limb stance
• Muscle wasting in the pelvis and shoulders
• Worn toenails from the dog dragging their feet
• Stumbling
• Difficulty climbing steps
• Difficulty getting up from lying down
• Neck pain and/or stiffness and/or spasms with reluctance to raise or lower the head
• Partial or complete paralysis

Diseases with a similar clinical presentation to Wobblers Syndrome include:

• Spinal fractures
• Tumours of the spinal cord
• Congenital abnormalities
• Clotting disorders
• Metabolic diseases (like hypothyroid and Cushing’s Disease)
• Meningitis
• Parasitic infections

Diagnosis

After a full examination by your vet, including a neurological exam, your dog will likely need:

• An MRI scan to examine the spinal cord and discs between the cervical vertebrae
• A CT scan to look at the shape of the bones of the vertebral column. In some instances, myelography may be performed, where a small volume of a dye (contrast agent) is injected around the spinal cord to see if the flow of dye is interrupted due to the pressure on the spinal cord.
• In some dogs, extra tests such as blood tests or spinal fluid collection may be indicated to help confirm the diagnosis.

Treatment

The treatment for Wobblers Syndrome is determined on a case-by-case basis.

Non-surgical management

Non-surgical management may allow some stabilisation of the condition, at least in the short term. It is only recommended for dogs with mild pathology (minor disc bulges) and very slow disease progression. The following non-surgical treatments are available:

• Exercise modification – absolute rest in the short-term and modified exercise in the long-term such as avoiding jumping or climbing the stairs.
• Harness walks
• Anti-inflammatory medication
• Physical therapies – massage, physio, laser.
• Hydrotherapy

Surgical management

The aim of the surgery performed is to relieve the compression of the spinal cord. There are a variety of techniques used to achieve this, and the specific surgery that is right for your dog will be discussed with you by your veterinary surgeon. After surgery, activity restriction must be complete and consistent for at least 2-3 months following the procedure in order to facilitate fusion of the involved cervical segments.

Prognosis

The outlook for dogs with Wobblers Syndrome is very variable and really depends on the individual case.

In severe cases that are managed conservatively (i.e. without surgery) the progressive spinal cord compression usually results in a deterioration in strength and coordination, leaving some of the dogs completely paralysed. The progression in these cases may be gradual or acute.

In milder cases, conservative management and structured rehab can be very effective in staving off further degeneration. However, these dogs treated medically will need management for the rest of their lives, and their treatments will change according to their symptoms.

Did you know?

Physiotherapy may contribute to maintaining muscle mass and speeding recovery in mildly affected dogs.

In surgical cases, the success rate depends on the nature of the compression, the number of areas of compression and whether or not the compressions respond to traction (stretching). Your vet will be best able to advise you on the situation with your dog.

NOTE: As the spinal cord compression has likely been present for some time in most dogs affected by Wobblers Syndrome, a degree of weakness and incoordination is likely to persist even after surgery.