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CERVICAL STENOSIS (WOBBLER SYNDROME)

(CERVICAL  VERTEBRAL INSTABILITY)

What is cervical stenosis?

Cervical stenosis is  known as cervical vertebral instability,  cervical spondylopathy or Wobbler syndrome.  It is due to the compression of the spinal cord, usually at the base of the neck.

How does it affect the dog?

Although the compression occurs in the neck the hindlegs may sometimes be affected first.   All that is often seen in its mildest form is that the dog stumbles when walking. This can progress to a wobbly gait.  In severe cases there may be total paralysis involving all four limbs and this may be sudden rather than gradual in onset.

What causes it?

It may be due to an instability of one or more of the vertebrae at the base of the neck (cervical vertebrae) or it may be due to deformity of these particular vertebrae which causes pressure on the spinal cord.  This causes damage to some of the nerves transmitting information to the limbs and thus paralysis can occur.

My dog suddenly became paralysed. How can this be part of the disease?

Initially the pressure affects your dog's ability to move naturally and sometimes this is virtually imperceptible.  The incoordination,  however slight, can put extra stress on the intervertebral discs which act as shock absorbers.   If these rupture excess pressure is put upon the spinal cord and then that paralysis can affect all four limbs.

I am told that only large breed dogs are affected.  Is this true?

Yes, the condition is most prevalent in the Great Dane and the Dobermann but Basset Hounds, St Bernards, Old English Sheepdogs, Borzois and Pointers are among those that can  be affected.

Depending on the breed there does appear to be variation of the age of onset.  For example Great Danes are usually affected when they are young, about 1-3 years of age) whereas Dobermanns and other breeds are sometimes approximately 6-9 years of age before any signs are apparent.

How is the condition diagnosed?

Breed, together with clinical signs (if gradual in onset) are good pointers.  Plain x-rays of the neck with the dog anaesthetised and correctly positioned will often reveal abnormalities affecting the cervical vertebrae at the base of the neck.  Definite diagnosis depends upon myelography.  This is a diagnostic technique employing a special radiopaque solution which is injected into the spinal canal of an anaethetised dog.  Then a series of x-rays are taken of the spine.  The area of pressure is indicated by a thinning of the column of dye at the pressure points.

What is the treatment?

Anti inflammatory drugs and analgesics are frequently used at the outset but by far the greatest chance of success lies with surgery, particularly if carried out at an early stage.  Although some dogs respond very well with medication alone, continued long term use can have side effects.

What does surgical treatment involve?

It is important that pressure on the spinal cord should be relieved as soon as possible.  Medical treatment involving anti inflammatory drugs reduces any pressure due to inflammation but clearly this will not cure the problem if the pressure is due to a deformed vertebra or disc material extruded into the spinal canal, pressing on the spine. 

There are several surgical techniques which can be used to relieve this pressure and provided an experienced surgeon is able to carry out the procedure at an early stage, before irreversible damage has been caused to the spinal cord, the outlook can be quite good.

Is there a lot of nursing involved?

Each case has to be assessed individually.  Most surgeons insist on some hospitalisation.  It is important that the dog receives help with walking and must not be allowed to climb steps or stairs for some time once at home.

We will be happy to discuss specific nursing problems if you would call us.

Is the condition likely to occur again after surgery?

This again can only be discussed after x-rays and myelography.  If there is an inherent weakness in the spine it is possible for the condition to recur at a later date. However with modern surgical techniques this is not common.