Wobbler Disease in Dogs: Diagnosis & Treatment
DR. UDAY KUMAR, CANINE CONSULTANT
Wobblers Syndrome (or Wobblers, Wobblers disease) is a painful and debilitating neurologic disease in dogs that affects the spine in the neck or cervical region. This condition has about 14 different names in veterinary literature. The name most used is cervical spondylomyelopathy (CSM), a disease of the neck vertebrae that affects the spinal cord. Other common names are:
- Cervical vertebral instability (CVI)
- Cervical vertebral malformation (CVM)
- Cervical vertebral malformation-malarticulation (CVMM)
- Cervical spondylopathy
There are two forms of Wobblers: Disc-Associated Wobbler Syndrome (DAWS) and Bony-Associated Cervical Spondylomyelopathy (BACS).
- DAWS: In this form, a dog experiences a “slipped disc.” In medical terms, this means an intervertebral disc herniation occurs. This form is commonly seen in large-breed dogs older than 3 years of age.
- Bony-Associated Cervical Spondylomyelopathy: As the name implies, a bony malformation leads to compression of the spinal cord (and in some cases the nerves). This compression causes issues with gait and if nerve roots are affected, a dog can experience a great deal of pain.This form of Wobblers is most common in giant-breed dogs, usually young adults that are less than 3 years of age. Dobermans and Great Danes are the breeds most commonly affected.
Dobermans and other large-breed dogs usually have the classic form of the disease characterized by disk herniations, while Great Danes have the typical form seen in Giant breeds (bony changes). Dobermans usually have the disease when they are middle-aged to older (mean age 6 years), whereas Great Danes are typically younger. Small breed dogs occasionally get the disease, but it is very uncommon.
Any large or giant breed can develop the condition, but breeds that appear to be predisposed to Wobblers include:
- Borzoi, Rottweiler
- Mastiff
- Weimaraner
- Irish Wolfhound
- German Shepherd
- Bernese Mountain dog
- Swiss Mountain dog
- Basset Hound
SIGNS OF WOBBLER DISEASE
Spinal cord disorders in dogs cause a loss of motor function and coordination in the legs and/or a loss in their sense of position. Motor function is an activity or movement controlled by motor nerves. For both forms of Wobblers, signs can occur slowly, or they appear suddenly.
Dogs with Wobblers typically have a “wobbly” gait mostly in the back legs. This wobbly gait may only be visible on slippery floors and when the dog walks slowly. They may walk with their head down, which is usually a sign of neck pain. In the more advanced stages of Wobblers, the symptoms become noticeable in all four legs. Dogs may have trouble getting up, appear very weak and even “buckle over” in the front legs. Approximately 5 percent of dogs with Wobblers may become suddenly paralyzed in all four legs.
The most common clinical signs noticed in a dog with Wobblers Syndrome are:
- Strange wobbly gait
- Neck pain, stiffness, holding head down and crying when shaking head
- Weakness
- Short-stride walking, spastic or very weak in the front limbs
- Muscle loss near the shoulders
- Worn or scuffed toenails from uneven walking
- Increased extension of all four limbs
- Difficulty getting up from a lying position
- Partial or complete paralysis
DIAGNOSIS
Wobbler disease is typically diagnosed with an MRI. This type of advanced imaging will show soft tissue structures, neural structures (spinal cord and nerves), and bones of the spine. MRI can help your veterinarian know the severity and extent of the disease, eliminate other possible causes of clinical signs, and determine treatment options.
Treatment
Treatment options for Wobbler disease include both medical and surgical options:
- Medical Management
- Medical management includes a combination of neuropathic pain medications and anti-inflammatories. With this option, it’s important to limit certain activities. While these treatments do not fix the structural abnormalities seen with Wobbler disease, they can significantly improve comfort and neurologic function. Physical therapy can be an excellent additional therapy.
- Surgical Treatment
- Surgical treatment typically involves relieving compression of the spinal cord to improve neurologic function and/or delay progression of signs. Various techniques can be used to accomplish this, depending on the nature of the disease. It is important to understand though that Wobbler disease is a progressive disease, meaning that clinical signs can return in the future even after surgery.
Deciding the best treatment for your dog depends on a variety of factors, including the severity of signs and MRI findings.
What are the breeds most commonly affected?
Dobermans and Great Danes are the breeds most commonly affected. A recent survey of the Veterinary Medical Database showed that 4.2% of Great Danes have wobblers, whereas the disease is present in 5.5% of Dobermans. Dobermans usually have the classic form of the disease in large breed dogs whereas Great Danes have the typical form seen in Giant breeds. Other breeds are Rottweilers, Mastiffs, Weimaraners, German Shepherds, Bernese Mountain dogs, Swiss Mountain dogs, but any large or giant breed dog can have the disease.
What is the prognosis for a wobbler dog?
The prognosis for a dog with wobbler disease depends greatly on the severity of the malformation and the amount spinal cord compression. Dogs that are severely affected to the extent that they are unable to stand or walk have a guarded prognosis even with surgical intervention. Some of these dogs will be able to walk with surgery, however, they often require months of physical therapy and always maintain an abnormal gait. Dogs that are mildly uncoordinated have a much greater chance of recovery.
The goal of surgery is to stop the progression of clinical signs. Because the spinal cord compression has been occurring over a long period of time, there is typically permanent spinal cord damage. Most dogs never walk normally even with surgery, however, many will improve to be able to have a good quality of life. Treatment of wobbler disease requires very dedicated owners with ability to do the intensive post-operative care and physical therapy.
