Wobbler Syndrome in Dogs

What is Wobbler Syndrome in Dogs?

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

Symptoms of Wobbler Syndrome in Dogs

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

Causes of Wobbler Syndrome in Dogs

Veterinarians do not know exactly what causes Wobbler Syndrome.

There is a genetic basis for the disease, but the evidence for genetics is still unclear. Nutrition has been suggested in some cases when Great Danes ingest too much protein, calcium and calories in their diet. However, nutrition does not appear to play a role in the development of Wobbler Syndrome in giant-breed dogs.

How Veterinarians Diagnose Wobbler Syndrome in Dogs

If your dog appears to show any of these symptoms, especially difficulty walking — or any signs of neck pain—a trip to your veterinarian’s office is highly recommended. During the visit, your vet will obtain a complete medial history and perform both a physical and a neurological examination to see if the symptoms can be attributed to a neck/neurologic problem.

A physical exam consists of taking a dog’s weight, body temperature, and heart rate, as well as the breathing rate, listening to the chest, and feeling the abdomen/belly. Your vet will assess range of motion in all joints and detect any abnormalities in the way that the dog walks/runs.

 A neurologic exam checks the following:

• Head and neck

• Cranial nerves - which help dogs taste, smell, hear and feel sensations; also help to make facial expressions, blink eyes and move tongue

• Gait - the way a dog walks and runs

• Front and hind legs

• Torso - main part of the body that contains the chest, abdomen, pelvis and back

• Anus – assessing muscle tone

• Tail

Some baseline lab tests are performed, including bloodwork (complete blood count and chemistry panel), urinalysis and stool testing to rule out conditions causing similar symptoms.

X-rays and myelogram (imaging done on the spinal canal) can help rule out other conditions such as diskospondylitis, tumors and inflammatory spinal cord disease. Advanced imaging such as an MRI or CT are preformed to visualize the spinal cord compression caused by the disc herniation or the bony changes.

Typically, these tests are done by veterinary specialists in larger animal hospitals, universities or specialty clinics and require the dog be under general anesthesia to ensure complete stillness during exam.

Treating Wobbler Syndrome in Dogs

Treating Wobbler Syndrome depends on the location and severity of the problem. Cervical (neck) surgery is typically recommended for the best chance of improvement, but as with any surgery, there is always a risk of complications.

For affected dogs in which surgery is not appropriate, medical management is another reliable treatment option. This can include:

• Anti-inflammatory drugs (steroids, such as Prednisone, or non-steroids, such as Carprofen) to reduce the pressure on the spinal cord and spinal nerve roots

• Pain medication

• Limiting activity for a period

Medical management may be suggested for dogs with few clinical signs, dogs with spinal cord compression in several places or those that have other health concerns that make surgery risky. 

Because dogs with this condition have a neck problem, neck leashes should not be used, and chest harnesses are strongly recommended. Dogs that are not able to walk should be kept on soft bedding and rotated frequently to avoid sores.

Some dogs also require help emptying their bladder and their bowels on a regular basis if they are not able to do so on their own, because these are functions controlled by the affected nerves. Dogs with continuing signs that are not responding to medical management are advised to undergo surgery, if they are a good candidate. 

The goal of surgery is to relieve pressure on the spinal cord and prevent further damage. It cannot correct damage that has already occurred and most dogs will never walk normally. However, the surgery can improve quality of life. As with any surgical procedure there are risks that your veterinarian will discuss with you depending on your dog’s diagnosis.

Following surgery, activity should be restricted for at least 2-3 months to allow the spinal cord and the vertebral bones to heal.

Other treatment methods are being investigated, including artificial disc replacement (the gold standard surgical treatment for people with a very similar disease called cervical spondylotic myelopathy).

Recovery and Management of Wobbler Syndrome in Dogs

The prognosis for a dog with Wobblers depends on three factors: the severity of spinal lesions, neurologic damage and the type of treatment used.  

For dogs unable to stand or walk, it is not clear how much a surgical intervention will help. Dogs with mild symptoms have a much greater chance of recovery. Even after surgery and medical management, some dogs with Wobbler Syndrome may never walk normally again. However, when combined with physical therapy and post-operative care, treatments can provide a significant chance of improving your dog’s general quality of life.