Wobbler disease

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Wobbler disease is a condition of the cervical vertebrae that causes an unsteady (wobbly) gait and weakness in dogs and horses. The term wobbler disease refers to a number of different conditions of the cervical (neck) spinal column that all cause similar symptoms. These conditions may include malformation of the vertebrae, intervertebral disc protrusion, and disease of the interspinal ligaments, ligamenta flava, and articular facets of the vertebrae.[1] Wobbler disease is also known as cervical vertebral instability, cervical spondylomyelopathy (CSM), and cervical vertebral malformation (CVM). In dogs, the disease is most common in large breeds, especially Great Danes and Dobermanns. In horses, it is not linked to a particular breed, though it is most often seen in tall race-bred horses. It is most likely inherited in dogs, it may be hereditary to some extent in horses.

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[edit] Wobbler disease in dogs

Wobbler disease is probably inherited in the Borzoi, Great Dane, Dobermann, and Basset Hound.[2] Instability of the vertebrae of the neck (usually the caudal neck) causes spinal cord compression. In younger dogs such as Great Danes less than two years of age, wobbler disease is caused by stenosis (narrowing) of the vertebral canal.[3] This narrowing of the canal is related to degeneration of the dorsal articular facets and subsequent thickening of the associated joint capsules and ligaments.[1] A high protein diet may contribute to its development.[4] In middle aged and older dogs such as Dobermanns, intervertebral disc disease leads to bulging of the disc or herniation of the disc contents, and the spinal cord is compressed.[3] In Great Danes the C4 to C6 vertebrae are most commonly affected; in Dobermanns it is the C5 to C7 vertebrae.[5]

The disease tends to be gradually progressive. Symptoms such as weakness, ataxia, and dragging of the toes start in the rear legs. Dogs often have a crouching stance with a downward flexed neck. The disease progresses to the front legs, but the symptoms are less severe. Neck pain is sometimes seen. Symptoms are usually gradual in onset but may progress rapidly following trauma.[6] X-rays may show malaligned vertebrae and narrow disk spaces, but it is not as effective as a myelogram, which reveals stenosis of the vertebral canal. MRI has been shown to be more effective at showing the location, nature, and severity of spinal cord compression than a myelogram.[7] Treatment is either medical to control the symptoms, usually with corticosteroids and cage rest, or surgical to correct the spinal cord compression. The prognosis is guarded in either case. Surgery may fully correct the problem, but it is technically difficult and relapses may occur. Types of surgery include ventral decompression of the spinal cord (ventral slot technique), dorsal decompression, and vertebral stabilization.[8] One study showed no significant advantage to any of the common spinal cord decompression procedures.[9] Another study showed that electroacupuncture may be a successful treatment for Wobbler disease.[10]

[edit] Commonly affected dog breeds

[edit] Wobbler disease in horses

Wobbler disease is also found in horses, and refers to several conditions beyond those listed above, including equine wobbles anemia. Some forms, such as CVM are not thought to be hereditary, but rather a condition of the horse's growth. Other forms such as Equine wobbles anemia are concentrated in certain breeds and may be hereditary to some extent. Horses with wobbler disease often knuckle over in their fetlocks. With advanced stages of the disease they are prone to falling. While some cases are successfully treated with nutritional and medical management, surgery is also used. One method is the use of Titanium baskets, placed to fuse the vertebrae, thereby preventing compression. Some horses are able to return to work, with a few able to reaching competitive levels. There is currently no complete "cure" for the condition.

[edit] Commonly affected horse breeds

[edit] References

  1. ^ a b Bagley, Rodney S. (2006). Acute Spinal Disease (PDF). Proceedings of the North American Veterinary Conference. Retrieved on February 19, 2007.
  2. ^ Spinal Cord Disorders: Small Animals. The Merck Veterinary Manual (2006). Retrieved on February 19, 2007.
  3. ^ a b Chrisman, Cheryl; Clemmons, Roger; Mariani, Christopher; Platt, Simon (2003). Neurology for the Small Animal Practitioner, 1st ed., Teton New Media. ISBN 1-893441-82-2. 
  4. ^ a b Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine, 4th ed., W.B. Saunders Company. ISBN 0-7216-6795-3. 
  5. ^ Danourdis, Anastassios M. (2004). The Diagnostic and Therapeutic Approach to Cervical Spondylomyelopathy. Proceedings of the 29th World Congress of the World Small Animal Veterinary Association. Retrieved on February 19, 2007.
  6. ^ Braund, K.G. (2003). Degenerative and Compressive Structural Disorders. Braund's Clinical Neurology in Small Animals: Localization, Diagnosis and Treatment. Retrieved on February 19, 2007.
  7. ^ da Costa R, Parent J, Dobson H, Holmberg D, Partlow G (2006). "Comparison of magnetic resonance imaging and myelography in 18 Doberman pinscher dogs with cervical spondylomyelopathy". Vet Radiol Ultrasound 47 (6): 523-31. PMID 17153059. 
  8. ^ Wheeler, Simon J. (2004). Update on Spinal Surgery I: Cervical Spine. Proceedings of the 29th World Congress of the World Small Animal Veterinary Association. Retrieved on February 19, 2007.
  9. ^ Jeffery N, McKee W (2001). "Surgery for disc-associated wobbler syndrome in the dog--an examination of the controversy". J Small Anim Pract 42 (12): 574-81. PMID 11791771. 
  10. ^ Sumano H, Bermudez E, Obregon K (2000). "Treatment of wobbler syndrome in dogs with electroacupuncture". Dtsch Tierarztl Wochenschr 107 (6): 231-5. PMID 10916938. 
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