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The Wobbler Syndrome (“Wobbles”)

By: Dr. Philip Johnson

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Wobbler syndrome should be high on the list of likely diseases that cause signs of spinal ataxia in young horses (mostly males) between 6 months and 4 years of age. Other important possible causes of similar symptoms include neck trauma, EPM, viral (herpes) myeloencephalopathy, and equine degenerative myeloencephalopathy. The positive diagnosis of Wobbler syndrome relies on radiography of the affected horse's neck. Radiographic images of the cervical vertebrae may reveal specific characteristic changes that occur in this disease. Sometimes it is necessary to resort to a myelographic (dye) study in order to isolate the exact location or locations of spinal cord compression. This is always necessary if surgical treatment is being considered.

A myelographic study entails the injection of a radiographic contrast into the spinal canal in order to highlight the width of the spinal cord on X-ray. Clearly, myelography can only be performed with the horse under anesthesia. Using myelography, the radiographic images are used to pin-point areas of compression of the spinal cord when the neck is moved into different positions, typically flexed and extended positions.

It is important to consider the risks associated with general anesthesia and myelography prior to undertaking this diagnostic procedure. There is risk of injury during recovery from general anesthesia for horses affected with neurological disease. The performance of myelography itself may cause further compressive damage to the spinal cord and result in worsening of the neurological signs. Furthermore, it has been suggested that myelography may increase the risk of exacerbation for EPM. Before undertaking a myelographic study, the horse owner should have a grasp of the risks as well as a clear understanding of the implications of the result.

Treatment

The primary short-term treatment for Wobbler syndrome is directed against the spinal cord inflammation that is caused by cord compression. Along with rest, various different anti-inflammatory strategies are used. In the long term, some veterinarians have advocated surgical treatment of affected horses. This treatment involves the surgical fusion (arthrodesis) of affected and adjacent vertebrae.

Clearly, it is imperative that any and all sites of spinal cord compression have been identified by myelography, which is not always possible. Under general anesthesia, the two adjacent cervical vertebrae are surgically fixed together to prevent any movement at sites of spinal compression. Those veterinarians who perform this surgery claim a high rate of success, meaning that horses generally improve, but do not always become normal.

At present, there are no controlled studies comparing surgery with conservative medical treatment in sufficient numbers of horses to make a conclusion. Many veterinarians believe that this type of surgery should not be done because the horse may be sold to someone else who would not be aware that the horse is neurologically incompetent. The surgery may give a false sense of security for owners who are anxious to ride their horse, whereas most horses with Wobbles, surgery or not, should never be ridden again.

Another treatment strategy for Wobbler syndrome involves a strict reduction in the affected horse's ration. This will probably only be effective in foals. It is well established that rapid growth increases the risk for the development of Wobbler syndrome. By reducing the ration to that just satisfactory for growth, the risks associated with Wobbler syndrome may be substantially reduced. Dietary reduction is especially important for the purposes of reducing the risk of this condition in young growing horses.

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