Cervical Vertebral Instability (Wobbler syndrome )

Cervical vertebral instability is also known as Wobbler Syndrome, caudal cervical spondylomyelopathy, cervical vertebral malformation, cervical spondylolisthesis, cervical stenosis and cervical spondylopathy. Wobbler syndrome is a term loosely used to encompass compressive spinal cord lesions affecting the caudal cervical spine (the spinal cord at base of neck) in large- and giant-breed dogs. The cause is likely to be the result of genetic, nutritional and biochemical influences. 

What to Watch For 

Neck pain – variable

Difficulty rising to a standing position

Worn toenails, scuffed paws

Incoordinated gait caused by decreased proprioception 

Variable muscle atrophy, especially in forelimbs

Occasionally, the presence of Horner's Syndrome

Worsening of signs when the neck is flexed

There are two distinct diseases described as Wobbler Syndrome. 

The first disease is seen in young dogs (particularly Great Danes) arising from developmental abnormalities causing malformation and malarticulation of the spinal column – all cervical joints may be affected.

The second disease syndrome is seen in adult dogs (particularly Doberman pinschers) arising from type II disk herniation with accompanying vertebral ligamentous hypertrophy caused by vertebral instability.

Dogs that have been diagnosed with Wobblers Syndrome should not be used for breeding or working.

Diagnosis

Your veterinarian will perform a complete physical and neurological examination to assess the location and severity of the problem. Additional tests may include:

Complete blood count, chemistry profile and urinalysis

Survey cervical radiographs

CSF tap

Myelogram, CT-myelogram or magnetic resonance imaging

Anesthesia for CSF tap and neuro-imaging

Treatment

These patients usually require surgery to treat the spinal cord compression. Surgical treatment is aimed at decompression (relieving the impingement of the spinal cord) and depending on the nature of the lesion, fusion or stabilization may be recommended.

Medical treatment consisting of glucocorticosteroids and rest may alleviate some signs of disease but effects may be temporary and may cause gastroenteritis and cystitis. 

Home care

Physical therapy is an important aspect of home care for Wobbler's syndrome. Your pet may be placed in a neck brace and will need to be confined for a set amount of time (usually 4 to 8 weeks). Limit jumping and leaping off of elevated areas and reduce obesity.