Cervical Spondylomyelopathy - Osseous Associated (Wobbler’s Syndrome)
Cervical spondylomyelopathies encompasses a number of cervical vertebral abnormalities. These include vertebral malarticulation/malformation, intervertebral disk extrusion and protrusion, articular facet disease, and spinal ligamentous disease. These abnormalities often result in ataxia or a “wobbly” gait, hence the clinically descriptive term used. The constellation of these pathologic alterations contribute to the diverse clinical and pathologic conditions grouped together under the heading “wobbler syndrome”. Hence, wobbler syndrome does not describe a single specific disease entity.
While the pathophysiologic processes associated with these clinical abnormalities are complex, two general clinical manifestations predominate: an osseous-associated form in younger large to giant breed dogs and a disc-associated form in older large breed dogs.
Younger, large-breed dogs, such as the Great Danes, Mastiffs, and Saint Bernards, have a similarly named disease, but apparently differing underlying pathophysiologic and clinical forms of “Wobbler syndrome”. In these younger and larger dogs, there is disease and degeneration primarily of the dorsal articular facets with secondary hypertrophy of the associated joint capsules and supporting ligaments. This hypertrophied tissue results in a more dorsal and lateral anatomical arrangement of spinal compression. The articular facet joints may inherently degenerate or may be damaged due to ineffectual ability to support the weight of the head. Some animals may have congenital bony malformations of the articular facets predisposing to a stenotic vertebral canal associated with bony compression of the spinal cord. In still other instances, small portions of synovial tissue containing synovial fluid may become entrapped and "pinched off." These sacs of inspissated synovial fluid are known as synovial cysts. These cysts may compress the spinal cord, either statically or with vertebral movement (dynamic compression).
Development of osseous-associated cervical spondylomyelopathy may be associated with excess energy intake. If clinical signs are recognized early on, disease progression may be able to be mitigated by diet restriction.
While the pathophysiologic processes associated with these clinical abnormalities are complex, two general clinical manifestations predominate: an osseous-associated form in younger large to giant breed dogs and a disc-associated form in older large breed dogs.
Younger, large-breed dogs, such as the Great Danes, Mastiffs, and Saint Bernards, have a similarly named disease, but apparently differing underlying pathophysiologic and clinical forms of “Wobbler syndrome”. In these younger and larger dogs, there is disease and degeneration primarily of the dorsal articular facets with secondary hypertrophy of the associated joint capsules and supporting ligaments. This hypertrophied tissue results in a more dorsal and lateral anatomical arrangement of spinal compression. The articular facet joints may inherently degenerate or may be damaged due to ineffectual ability to support the weight of the head. Some animals may have congenital bony malformations of the articular facets predisposing to a stenotic vertebral canal associated with bony compression of the spinal cord. In still other instances, small portions of synovial tissue containing synovial fluid may become entrapped and "pinched off." These sacs of inspissated synovial fluid are known as synovial cysts. These cysts may compress the spinal cord, either statically or with vertebral movement (dynamic compression).
Development of osseous-associated cervical spondylomyelopathy may be associated with excess energy intake. If clinical signs are recognized early on, disease progression may be able to be mitigated by diet restriction.
Age of Onset: Less than 2 years of age
Sex Predisposition: Any sex of animal can be affected
Clinical Course:
Signs usually progress relatively slowly over weeks to months. Occasionally, acute exacerbation of clinical signs may occur
Signs usually progress relatively slowly over weeks to months. Occasionally, acute exacerbation of clinical signs may occur
Clinical Signs:
Posture and Appearance
Scuffing of nails on weight bearing digits of the pelvic limbs
Head may be held in a flexed position
Movement
Truncal ataxia
Hypermetria
Spastic, stiff, or floating gait
Mild paraparesis to tetraparesis
“paws of the thoracic limbs are “flipped” forward at the carpus prior to impacting the ground”
Proprioception
General proprioceptive deficits
Muscle Atrophy
Atrophy of the supraspinatus and infraspinatus muscles
Posture and Appearance
Scuffing of nails on weight bearing digits of the pelvic limbs
Head may be held in a flexed position
Movement
Truncal ataxia
Hypermetria
Spastic, stiff, or floating gait
Mild paraparesis to tetraparesis
“paws of the thoracic limbs are “flipped” forward at the carpus prior to impacting the ground”
Proprioception
General proprioceptive deficits
Muscle Atrophy
Atrophy of the supraspinatus and infraspinatus muscles
Spinal cord - Cervical
Multiple cervical segments caudal to C2
Multiple cervical segments caudal to C2
Unknown
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