wobblersOURS

What is cervical vertebral instability?

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related terms: Wobbler syndrome, cervical spondylomyelopathy, cervical vertebral deformity

Anatomy of the vertebral column and spinal cord: The vertebral column, or backbone, is made up of a series of small bones, the vertebrae. These bones surround and protect the spinal cord, the large collection of nerves through which information is transmitted between the body and brain. The spinal cord must be intact and undamaged in order to feel sensations (including touch and pain), and for normal movement of the body and limbs. The individual vertebrae are separated by intervertebral disks. These soft tissue structures allow for normal movement between the vertebrae, and also act as shock absorbers.

In cervical vertebral instability, there is compression of the spinal cord in the neck (cervical) region. There are seven vertebrae in the neck which surround and protect the spinal cord. Movement between these bones allows normal movement of the neck. With this condition, there are abnormalities in the structure of the vertebrae, of the ligaments that connect them, and/or of the disks between them. The reasons for these abnormalities are not clear; inheritance is a factor, and overfeeding in rapidly-growing large breed dogs is also thought to play a role.

The result is instability between adjacent vertebrae, narrowing (stenosis) of the spinal canal, and pressure on the spinal cord. The consequences of compression of the spinal cord in the neck region are weakness and incoordination in all 4 legs - hence the name "wobbler".

How is cervical vertebral instability inherited?
Unknown. It has been suggested to be autosomal recessive in the Great Dane, Doberman pinscher, and borzoi.

What breeds are affected by cervical vertebral instability?
This disease is most common in the Great Dane, where the signs are first seen between 3 and 18 months of age, and the Doberman pinscher, where problems develop later, between 3 to 9 years. Cervical vertebral instability is also seen in most other large breed dogs, including the St. Bernard, Weimaraner, Labrador retriever, German shepherd, boxer, Rhodesian ridgeback, dalmatian, samoyed, old English sheepdog, bull mastiff, Borzoi, rottweiler, chow chow, golden retriever, Irish setter, Irish wolfhound, and Great Pyrenees, and in the basset hound, fox terrier, and beagle.

For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.

What does cervical vertebral instability mean to your dog and you?
The main signs with this disease are weakness and incoordination (ataxia); these signs begin insidiously and worsen slowly over several months. It may look like your dog doesn't know where his or her feet are. This will be most obvious when s/he is rising from lying down, or negotiating a turn or stairs. Over time, your dog may develop a stiff, high-stepping, exaggerated gait that gradually worsens.

The signs are bilateral and symmetrical (meaning they occur equally on both sides). All 4 legs are eventually affected, with the hind legs affected first, and more severely. Sometimes there is a sudden change for the worse as a result of minor trauma. Doberman pinschers often experience severe neck pain (as a result of disk herniation- see intervertebral disk disease) and may develop rigid front legs.

This is a chronic, progressive disease (ie. it gets worse with time). Without treatment, your dog's condition will gradually deteriorate. With therapy (either medical management or surgery) the prospect for recovery remains guarded.

How is cervical vertebral instability diagnosed?
Your veterinarian will suspect this disease if your large-breed dog displays the characteristic clinical signs: slowly progressive, bilateral, symmetrical hind leg weakness and ataxia. The front legs are affected after the hind legs, and usually less severely. Your dog’s neck may be painful, and may be held flexed slightly downward. Plain x-rays are taken to show structural abnormalities in the vertebrae, but myelography is necessary to determine if there is spinal cord compression. In order to do a myelogram, your dog is anesthetized, dye is injected into the spinal canal, and x-rays are taken which will show the exact location(s) of spinal cord compression. This information is essential in considering treatment options, especially if surgical repair is to be attempted. Other imaging techniques, such as CT scans and MRI, may also be used. Your veterinarian may refer you to a veterinary referral centre for these specialized radiographic techniques, and for potential surgery.

For the veterinarian: The two most commonly affected breeds have characteristic lesions; older Doberman pinschers frequently show ventral spinal cord compression, while young Great Danes show dorsal spinal cord compression. Lesions are more common at the more caudal cervical segments (C5-6 and C6-7). Underlying systemic or metabolic diseases may also be present. "Traction" myelograms can be used to demonstrate the dynamic component of this disease (instability between vertebrae). Forced extension of the neck may exacerbate spinal cord compression.

How is cervical vertebral instability treated?
The type of treatment chosen for this condition will depend on a number of factors, including the severity and duration of your dog’s signs, and the extent of spinal cord compression apparent on radiography. The goals of medical management are to minimize neck movement (through confinement and use of a neck brace) and use anti-inflammatory medications to prevent further damage to the spinal cord. Medical management may be effective for weeks to years, although it does not address the underlying problem of spinal cord compression. A variety of surgical techniques have been developed (and more are being developed) which attempt to both alleviate the spinal cord compression and stabilize the vertebrae. Surgery is not without risk, including a variety of potentially severe postoperative complications. Ultimately, the prospects for recovery depend on a number of factors, including duration and severity of clinical signs, and whether the spinal cord is compressed at a single site or at multiple sites.

Because of the requirement for both specialized radiographic and surgical techniques in treating this condition, your veterinarian may provide initial neck stabilization and anti-inflammatory therapy for your dog, and then refer you to a veterinary referral centre for further treatment.

Breeding advice
Although the exact mechanism of inheritance is not known, dogs with cervical vertebral instability should not be bred. (Unfortunately, because this condition often has a later onset, dogs may be bred before any problems appear). It is best to avoid breeding their parents or siblings as well, who are considered potential carriers of the trait.

The best ways to avoid this condition in a large breed dog are to inquire before purchase if there is any family history of vertebral instability, to refrain from providing mineral supplements to the diet, and to feed several small meals daily (rather than ad libitum feeding).

FOR MORE INFORMATION ABOUT THIS DISORDER, PLEASE SEE YOUR VETERINARIAN.

Resources
LeCouteur RA, Child G. 1995. Diseases of the spinal cord. In EJ Ettinger and EC Feldman (eds) Textbook of Veterinary Internal Medicine, p. 629-696. WB Saunders Co, Toronto.

This database is a joint initiative of the Sir James Dunn Animal Welfare Centre at the Atlantic Veterinary College, University of Prince Edward Island, and the Canadian Veterinary Medical Association.

reprinted with kind permission from:-
Alice Crook, DVM,Coordinator, Sir James Dunn Animal Welfare Centre, Atlantic Veterinary College,University of Prince Edward Island, 550 University Ave.Charlottetown, PEI C1A 4P3

http://www.upei.ca/cidd

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A Wobbler's Tale

Treating Wobbler's via Acupuncture

http://www.wobblerstale.bravehost.com/

In February of 2003, my 5 year old Doberman, Lorelei, was diagnosed with Wobbler’s Syndrome. I knew nothing about Wobbler’s, and turned to the internet to try and educate myself about this condition. I found very little info, and what I did find dealt mainly with treating Wobbler’s via conventional methods, such as surgery. In the end, we treated Lorelei via acupuncture, and with great success. It is my hope that Lorelei’s story will help anyone who finds themselves in the same situation in which Lorelei and I found ourselves in February 2003.
Lorelei came to me by way of the humane society/animal control facility where I worked. She was about 5 months old. She was picked up by animal control, running loose. No one ever came for her. So she became my girl in January 1998. I named her Lorelei after the song by Styx.

All was well until that February, when I began to hear her cry out in pain in the night. Then I noticed that she was unable to raise her head high enough to drink out of the water dish that I kept on a small table on the deck outside, elevated in order to keep the dogs from splashing all the water out. On further observation, I realized that she could raise her head no higher than straight out. I knew we had a problem. I took her to her vet, who observed her and suggested to me that she could possibly have Wobbler’s. He offered me several options, such as X-rays, a myelogram, or just observing her to see how she did. We went home to think it over, with some medication to help ease Lorelei’s pain.

I immediately got on the internet, where I found very little information. In the meantime, Lorelei began slipping on slick floors – her feet would just splay out in all four directions. After about three days, I decided to go ahead have the X-rays done to see if that would shed any light on the problem. It did not. After further searching on the internet, I learned that surgery for Wobbler’s often includes a long and painful recovery process, and that it sometimes only has about a 50% success rate. This didn’t sound too good. Then came the “straw that broke the camel’s back” – I learned that the cost of surgery for Wobbler's can be upwards of three thousand dollars!! Upon learning this, I knew I had to find another way. Then I came across Christy Waehner’s site, detailing her experience in treating her beautiful Doberman, Sylvia, for Wobbler’s by way of gold bead implants. Christy very kindly shared her insight and suggestions with me, and was very helpful. After hearing about her successful experience with the implants, which is based on acupuncture, I became a lot more open to the idea of some sort of alternative treatment for Lorelei.

reprinted with kind permission from Terry
http://www.wobblerstale.bravehost.com/

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What is cervical vertebral instability?

A Wobbler's Tale