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Cervical Vertebral Instability

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What is cervical stenosis?
Cervical stenosis is also known as cervical vertebral instability, cervical spondylopathy, or Wobbler syndrome. It is caused by compression of the spinal cord, usually at the base of the neck.

How does it affect the dog?
Although the spinal cord compression occurs in the neck, the hind legs often are affected first. The mildest form of cervical stenosis results in stumbling or irregular walking or running. This can progress to a wobbly gait, hence the term “Wobbler syndrome.” In severe cases there may be sudden total paralysis of all four limbs.

What causes cervical stenosis?
It may be due to 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 vertebrae, which causes pressure on the spinal cord. This compression damages the nerves transmitting information to the limbs and thus paresis (weakness) or paralysis can occur.

My dog suddenly became paralyzed. Is this part of the disease?
Initially the pressure affects your dog’s ability to move naturally and may be difficult to detect. The incoordination, however slight, can put extra stress on the intervertebral discs that act as shock absorbers. If these rupture, excess pressure is put upon the spinal cord and sudden paralysis may result.

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 Doberman, but Basset Hounds, Saint Bernards, Old English Sheepdogs, Borzois, and Pointers are also commonly affected.

There appears to be variation with regard to the age of onset based on breed. For example, Great Danes are usually affected when they are young, about one to three years of age, whereas Dobermans and other breeds are usually six to nine years of age before any signs are apparent.

How is the condition diagnosed?
Breed and clinical signs are good indicators of cervical stenosis. With your dog anesthetized or sedated, radiographs of the neck will often reveal abnormalities affecting the vertebrae at the base of the cervical spine. Definitive diagnosis requires myelography, computed tomography (CT) scans, or magnetic resonance imaging (MRI). Myelography is the most common diagnostic test performed. A special radiopaque solution is injected into the fluid surrounding the spinal cord. A series of x-rays are then 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 of Wobbler syndrome?
Anti-inflammatory drugs and analgesics are frequently used at the outset but the greatest chance of success lies with surgery, particularly if performed early in the course of disease. Although some dogs respond very well with medication alone, continued long-term use may create undesirable side effects.

What does surgical treatment involve?
It is important that pressure on the spinal cord be relieved as soon as possible. Medical treatment with anti-inflammatory drugs reduces the pressure due to inflammation, but this will not resolve the problem if there is a deformed vertebra or disc material pressing on the spinal cord.

There are several surgical techniques that can be used to relieve this pressure and if the surgery is performed at an early stage, before irreversible damage has occurred, the outlook can be quite good.

Is there a lot of post-operative care involved?
Most surgeons insist on hospitalization for several days following this surgery. It is important that the dog receive help with walking and must not be allowed to climb steps or stairs for some time once at home. Physical therapy is also highly recommended during the initial healing phase.

Your veterinarian will discuss the specific nursing care of your dog with you.

Is the condition likely to occur again after surgery?
This is dependent on your pet’s specific condition. 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 and most pets enjoy a relatively normal lifestyle following surgery.

Based on material written by Ernest Ward, DVM. and modified with permission from Lifelearn Inc.
© Copyright 2005 Lifelearn Inc.

 
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