Wobbler's Syndrome    by Antonia Baker

Wobbler's syndrome or cervical vertebral instability (CVI) tends to affect large breeds and fast-growing dogs. This syndrome has been described in Dobermanns and has been attributed to both genetic and environmental causes.

In Dobermanns, Wobbler’s syndrome is more commonly seen in older dogs rather than in younger dogs. The syndrome is due to rupture of vertebral discs (like a slipped disc in humans) which causes pressure on spinal cord and leads to weakness (causing the wobbly gait) and pain.

Some of the symptoms the dog may have include:

              1.   Ataxic (wobbly) gait due to weakness in the muscles

                 Often more pronounced in the back legs when compared to the front.

              2.   Difficulty getting up

              3.   Low head carriage due to neck pain

              4.   Yelping out in pain with movement

              5.   Loss of bladder and/or bowel control

              6.   Sudden collapse and an inability stand (with sudden rupture of disc)

An intervertebral disc effectively is a cushion between the vertebral bodies that protect the spinal cord. Discs absorb stresses and pressures put on the spine when the dog runs and jumps around. When a disc ruptures, it can cause pressure on the spinal cord. The contents of a disc are of similar consistency to that of toothpaste, and like toothpaste, once it has been pushed out of the tube it is very difficult to push back in.

Wobbler’s syndrome is a diagnosis of exclusion. Which means that other, more common causes of the dog’s symptoms need to be investigated. For example, a wobbly gait can be caused by a middle ear infection, viral infection, eye problems, poisoning, snake and spider bites etc.

When other causes have ruled out and CVI is a possibility the dog usually has x-rays taken of the whole spine to assess the boney structures. Often these X-rays are normal unless the disc disruption is so severe that it has caused the vertebral bodies to shift in relation to one another. The discs and spinal cord do not show up on X-rays and Magnetic Resonance Imaging (MRI) is the “gold standard” in assessing these structures. However, these scans are not available everywhere and will cost about $1500 to perform. Often a CT scan or a CT myelogram is done. This involves injecting a radio-opaque dye around the cord, tipping the dog in various directions to see where the dye goes under X-rays. From the path that the dye takes a disc prolapse can be detected however that amount of pressure caused on the spinal cord cannot be seen.

Once the diagnosis has been made there are several treatment options, which are similar to way that back pain and disc prolapse is managed in humans.  

Non-operative Options:

1.   Prolonged rest, which in dogs often means confining them to a crate for 4-6weeks.

2.   Analgesia and Anti-inflammatories.

3.   Steroids to reduce inflammation and swelling.

4.   Hydrotherapy and physiotherapy to maintain muscle strength and joint flexibility.

Surgical Intervention

The type of surgery offered depends on the type of problem, the experience of the veterinarian and availability of equipment and cost. Some of the advanced surgical techniques such as micro-discectomies are only offered in large centres by specialists and can cost upwards of $5000 (which does not include cost of tests and the rehabilitation after surgery).

Surgery usually involves the removal of the disc that has ruptured and may also require fusion or stabilisation of the vertebra.

It is important to note that the aim of treatment reduce and hopefully alleviate pain and also to restore function in terms of continence and mobility. Once a dog has developed this problem surgery is not going to “cure” him. Owners also need to realise that there is an extensive physical rehabilitation that they must be willing to do for the dog if the surgery is going to produce maximal benefits