Wobbler disease is a catchall term referring to several possible malformations of the

cervical vertebrae In tetrapods, cervical vertebrae (singular: vertebra) are the vertebrae of the neck, immediately below the skull. Truncal vertebrae (divided into thoracic and lumbar vertebrae in mammals) lie caudal (toward the tail) of cervical vertebrae. In ...

that cause an unsteady (wobbly) gait and weakness in

dog The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the wolf. Also called the domestic dog, it is derived from the extinct Pleistocene wolf, and the modern wolf is the dog's nearest living relative. Do ...

s and

horse The horse (''Equus ferus caballus'') is a domesticated, one-toed, hoofed mammal. It belongs to the taxonomic family Equidae and is one of two extant subspecies of ''Equus ferus''. The horse has evolved over the past 45 to 55 million y ...

s. A number of different conditions of the cervical (neck) spinal column cause similar clinical signs. These conditions may include malformation of the vertebrae,

intervertebral disc An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the vertebrae, to act as a ligament to hold t ...

protrusion, and disease of the interspinal ligaments,

ligamenta flava The ligamenta flava (singular, ''ligamentum flavum'', Latin for ''yellow ligament'') are a series of ligaments that connect the ventral parts of the lamina of the vertebral arch, laminae of adjacent vertebrae. They help to preserve Bipedalism, upr ...

, and

articular facet A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...

s of the vertebrae. 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 Dane The Great Dane is a large sized dog breed originating from Germany. The Great Dane descends from hunting dogs from the Middle Ages used to hunt wild boar and deer, and as guardians of German nobility. It is one of the largest breeds in the world ...

s and

Doberman Pinscher The Dobermann (; ), or Doberman Pinscher in the United States and Canada, is a medium-large breed of domestic dog that was originally developed around 1890 by Louis Dobermann, a tax collector from Germany.Thoroughbred The Thoroughbred is a horse breed best known for its use in horse racing. Although the word ''thoroughbred'' is sometimes used to refer to any breed of purebred horse, it technically refers only to the Thoroughbred breed. Thoroughbreds are c ...

Standardbred The Standardbred is an American horse breed best known for its ability in harness racing, where members of the breed compete at either a trot or pace. Developed in North America, the Standardbred is recognized worldwide, and the breed can trace i ...

ancestry. It is most likely inherited to at least some extent in dogs and horses.

Wobbler disease in dogs

Wobbler disease is probably inherited in the

Borzoi The Borzoi or Russian Hunting Sighthound is a Russian breed of hunting dog of sighthound type. It was formerly used for wolf hunting, and until 1936 was known as the Russian Wolfhound. Etymology The system by which Russians over the ages ...

, Great Dane, Doberman, and

Basset Hound The Basset Hound is a short-legged breed of dog in the hound family. The Basset is a scent hound that was originally bred for the purpose of hunting hare. Their sense of smell and ability to ''ground-scent'' is second only to the Bloodhound.Har ...

. Instability of the vertebrae of the neck (usually the caudal neck) causes

spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spi ...

compression. In younger dogs such as Great Danes less than two years of age, wobbler disease is caused by

stenosis A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' ...

(narrowing) of the vertebral canal related to degeneration of the

dorsal Dorsal (from Latin ''dorsum'' ‘back’) may refer to: * Dorsal (anatomy), an anatomical term of location referring to the back or upper side of an organism or parts of an organism * Dorsal, positioned on top of an aircraft's fuselage * Dorsal co ...

articular facets and subsequent thickening of the associated

joint capsule In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.herniation A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Various types of hernias can occur, most commonly involving the abdomen, and specifically the groin. Groin herni ...

of the disc contents, and the spinal cord is compressed. In Great Danes, the C₄ to C₆ vertebrae are most commonly affected; in Dobermans, the C₅ to C₇ vertebrae are affected. Doberman C6-C7 and C5-C6 traction responsive myelopathy A

Doberman C6-C7 and C5-C6 traction responsive myelopathy A

The disease tends to be gradually progressive. Symptoms such as weakness,

ataxia Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicating dysfunction of ...

, 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.

X-ray An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...

s may show misaligned vertebrae and narrow disk spaces, but it is not as effective as a

myelogram Myelography is a type of radiographic examination that uses a contrast medium to detect pathology of the spinal cord, including the location of a spinal cord injury, cysts, and tumors. Historically the procedure involved the injection of a radioco ...

, which reveals stenosis of the vertebral canal.

Magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...

has been shown to be more effective at showing the location, nature, and severity of spinal cord compression than a myelogram. Treatment is either medical to control the symptoms, usually with

corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involv ...

s and cage rest, or surgical to correct the spinal cord compression. The

prognosis Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stabl ...

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 Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Th ...

decompression of the spinal cord (

ventral slot The ventral slot technique is a procedure that allows the surgeon to reach and decompress the spinal cord and associated nerve roots from a ventral route in veterinary medicine. There are also alternative ways to open the spinal canal from dorsal by ...

technique), dorsal decompression, and vertebral stabilization. One study showed no significant advantage to any of the common spinal cord decompression procedures. Another study showed that

electroacupuncture Electroacupuncture is a form of acupuncture where a small electric current is passed between pairs of acupuncture needles. According to some acupuncturists, this practice augments the use of regular acupuncture, can restore health and well-bein ...

may be a successful treatment for Wobbler disease. A new surgical treatment using a proprietary

medical device A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...

has been developed for dogs with disc-associated wobbler disease. It implants an artificial disc (cervical arthroplasty) in place of the affected disc space.

Commonly affected dog breeds

Doberman The Dobermann (; ), or Doberman Pinscher in the United States and Canada, is a medium-large breed of domestic dog that was originally developed around 1890 by Louis Dobermann, a tax collector from Germany.St. Bernard *

Weimaraner The Weimaraner ( ) is a large dog that was originally bred as a hunting dog in the early 19th century. Early Weimaraners were used by royalty for hunting large game such as boar, bear and deer. As the popularity of large game hunting began to d ...

German Shepherd Dog The German Shepherd or Alsatian is a German breed of working dog of medium to large size. The breed was developed by Max von Stephanitz using various traditional German herding dogs from 1899. It was originally bred as a herding dog, for he ...

Boxer Boxer most commonly refers to: * Boxer (boxing), a competitor in the sport of boxing *Boxer (dog), a breed of dog Boxer or boxers may also refer to: Animal kingdom * Boxer crab * Boxer shrimp, a small group of decapod crustaceans * Boxer snipe ee ...

Rhodesian Ridgeback The Rhodesian Ridgeback is a large dog breed bred in the Southern Africa region. Its forebears can be traced to the semi-domesticated ridged hunting and guardian dogs of the Khoikhoi. These were interbred with European dogs by the early colonist ...

* Dalmatian * Samoyed *

Old English Sheepdog The Old English Sheepdog is a large breed of dog that emerged in England from early types of herding dog. Obsolete names for the breed include Shepherd's Dog and . The nickname ''Bob-tail'' (or ''Bobtail'') originates from how dogs of the breed ...

Bull Mastiff The Bullmastiff is a British breed of dog of mastiff type and large size, with a solid build and a short muzzle. It was developed as a guard dog in the nineteenth century by cross-breeding the English Mastiff with the now-extinct Old English ...

Newfoundland Newfoundland and Labrador (; french: Terre-Neuve-et-Labrador; frequently abbreviated as NL) is the easternmost province of Canada, in the country's Atlantic region. The province comprises the island of Newfoundland and the continental region ...

Greyhound The English Greyhound, or simply the Greyhound, is a breed of dog, a sighthound which has been bred for coursing, greyhound racing and hunting. Since the rise in large-scale adoption of retired racing Greyhounds, the breed has seen a resurge ...

Rottweiler The Rottweiler (, ) is a breed of domestic dog, regarded as medium-to-large or large. The dogs were known in German as , meaning Rottweil butchers' dogs, because their main use was to herd livestock and pull carts laden with butchered mea ...

Doberman C6-C7 and C5-C6 traction responsive myelopathy B

T2 weighted MRI in neutral (A) and linear traction (B) of a seven-year-old Doberman with a two-year history of cervical pain treated with NSAIDs and presented acutely tetraplegic: A C6-C7 and C5-C6 traction responsive myelopathy are evident on MRI. The spinal-cord hyperintensity seen at the C5-C6 is suggestive of chronic lesion and most likely responsible for the chronic history of cervical pain, while the C5-C6 lesion was most likely responsible for the acute tetraplegia. Doberman post surgery following double implant A

Doberman post surgery following double implant A

Doberman post surgery following double implant B

Same dog (A) treated with double implant (B) three days after surgery: The dog became ambulatory three days after surgery. Four weeks after surgery, it had ataxia without conscious proprioceptive deficits, and three months after surgery, the dog was neurologically normal. The owner reported it had been two years since the dog was able to hold its neck in an elevated position.

Wobbler disease in horses

Wobbler disease or wobbler's syndrome is a broad category of cervical disorders in the horse, including the conditions listed above, as well as equine wobbles anemia and cervical vertebral myelopathy, spinal cord compression (sometimes referred to colloquially among horse owners as " cervical arthritis" due to the arthritis that accumulates in facets). Within the horse community, any neurological problem that causes limb

proprioception Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...

issues or decreased performance in the horse that is suspected to be rooted in the neck is considered a type of wobbler disease. Most forms of wobbler disease have a root cause in cervical vertebral myelopathy (CVM), which causes inflammation and arthritis in the joint and is painful to affected horses. At this time it is believed to possibly be a

congenital A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...

condition. Mounting evidence is growing that points to CVM and other cervical and vertebral disorders (like Kissing Spine) as hereditary and found in populations of specific families. Other forms, such as cervical arthritis and equine wobbles anemia, are concentrated in certain breeds and demonstrate possible hereditary factors. Horses with wobbler disease often exhibit

(implying dysfunction of parts of the nervous system), show weakness in the hindquarters, or may knuckle over in their

fetlock Fetlock is the common name in horses, large animals, and sometimes dogs for the metacarpophalangeal and metatarsophalangeal joints (MCPJ and MTPJ). Although it somewhat resembles the human ankle in appearance, the joint is homologous to the ba ...

s, particularly in the rear. They also may show overall stiffness especially in the neck and back and may not move fluidly. A common ataxic symptom is the horse will list to one side behind. They also may demonstrate uneven strides with one leg intermittently shorter in step. Horses with wobbler disease or cervical anomalies can demonstrate difficult to diagnose lamenesses that come and go, and often are not resolved by veterinary blocks to the limbs. With advanced stages of the disease, affected horses are prone to falling due to extreme listing behind and often demonstrate difficulty getting up from lying down, or reluctance to lie down at all. While some cases are successfully treated with nutritional and medical management, surgery is also used. One method is the use of

titanium Titanium is a chemical element with the symbol Ti and atomic number 22. Found in nature only as an oxide, it can be reduced to produce a lustrous transition metal with a silver color, low density, and high strength, resistant to corrosion in ...

baskets, placed to fuse the vertebrae, thereby preventing compression of the spinal cord. Some horses are able to return to work, with a few able to reach competitive levels. No complete cure for the condition is known. Famous horses known to have completed basket surgery include

Seattle Slew Seattle Slew (February 15, 1974 – May 7, 2002) was a champion American Thoroughbred horse racing, racehorse who became the tenth winner of the Triple Crown of Thoroughbred Racing (United States), American Triple Crown (1977). He is one of only ...

. Seattle Slew underwent two basket surgeries and has sired multiple offspring that have cervical arthritis. He is one of many Thoroughbred stallions to have undergone basket surgery and still be used for stud. Because wobbler disease is the best known of the neurological conditions that affect horses, other, unrelated conditions, such as

kissing spine Baastrup's sign is an orthopedic and radiographic disorder that often occurs in elderly humans. It is characterized by enlargement of the posterior spinous processes of the lumbar spine, with normal intervertebral disc height and neuroforamina. ...

equine protozoal myeloencephalitis Equine protozoal myeloencephalitis (EPM), is a disease caused by the apicomplexan parasite '' Sarcocystis neurona'' that affects the central nervous system of horses. History EPM was first discovered in the 1960s by the American biologist Dr. Ji ...

and cerebellar abiotrophy, are sometimes misdiagnosed as wobbler disease, though the causes and symptoms differ.

Clinical Presentation

Including the symptoms listed above, clinical presentations of "wobblers" can also include neck pain and stiffness, difficulty tracking up or gait abnormalities, decreased performance, intermittent or swapping lameness particularly in diagonal pairs, forelimb lameness, abnormal head and neck posture, defensiveness or change in behavior, and abnormal sweat patterns.

Diagnosis

Wobbler disease is definitively diagnosed by x-ray,

nuclear scintigraphy Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitting ...

or bone scan. X-rays will show channel widening or filling the easiest and are often most cost-effective to horse owners. X-rays will also show any structural anomaly, arthritis, facet remodeling, or bone spurs present. Preliminary diagnosis can be made by ultrasound but x-rays are needed to measure the true depth of facet involvement. For extent of damage to associated structures, veterinarians may opt to have the horse undergo a bone scan or nuclear scintigraphy.

Commonly affected horse breeds

Warmblood Warmbloods are a group of middle-weight horse types and breeds primarily originating in Europe and registered with organizations that are characterized by open studbook policy, studbook selection, and the aim of breeding for equestrian sport. ...

https://www.colovma.org/wp-content/uploads/sites/8/2016/09/Story_CervicalDisorders.pdf *

American Quarter Horse The American Quarter Horse, or Quarter Horse, is an American breed of horse that excels at sprinting short distances. Its name is derived from its ability to outrun other horse breeds in races of a quarter mile or less; some have been clocked at s ...

American Paint Horse The American Paint Horse is a breed of horse that combines both the conformational characteristics of a western stock horse with a pinto spotting pattern of white and dark coat colors. Developed from a base of spotted horses with Quarter Horse ...

Thoroughbred The Thoroughbred is a horse breed best known for its use in horse racing. Although the word ''thoroughbred'' is sometimes used to refer to any breed of purebred horse, it technically refers only to the Thoroughbred breed. Thoroughbreds are c ...

References

External links

{{commons category
Video of a dog with wobbler syndrome treated with the artificial disc replacement
Dog musculoskeletal disorders Horse diseases