December 04, 2020 4 min read
Equine wobbler syndrome is the common term for cervical vertebral stenotic myelopathy (CVSM). This condition is characterized by a narrowing or instability of one or more vertebral canals within the cervical spine which in turn causes compression of the spinal cord. This compression results in irritation and swelling of the spinal cord.
CVSM is generally a slowly developing condition with early clinical signs often being very subtle and easy to miss. The typical scenario for a wobbler case is a horse with no apparent abnormalities in the early years. Over time, as they grow, they gradually begin to exhibit signs of uncoordinated gaits, stumbling, or dragging or improperly using one or more limbs. The age of onset of signs is generally between 6 months and 3 years. Upon observation, all other physical, mental, and behavioral aspects appear normal, with no obvious signs of illness.
In general, CVSM is more often diagnosed in young males than in females. The theory behind the development of this condition is that larger, heavier youngsters go through rapid stages of growth, leading to narrow regions in the neck vertebrae and compression of the spinal cord. Certain breeds such as Thoroughbreds, Warmbloods and Quarter Horses appear to be affected more frequently than other breeds. An estimated 2-3% of all Thoroughbreds exhibit some degree of CVSM. There is some evidence that there may be a genetic component in this syndrome. Research is underway to determine what, if any genetic aspects are involved. A combination of a high plane of nutrition, rapid growth and abnormal biomechanical forces through the limbs may also contribute to the development of Wobblers syndrome.
CVSM is also seen in horses as a result of some kind of trauma to the neck/spine during training, in play out at pasture, or even during shipping. In the act of twisting the neck or falling, the spinal cord may be compressed and sustain damage. Frequently such traumatic events may not have been witnessed, and owners only become aware of an issue as clinical signs are exhibited.
In addition to growth issues and injuries, another segment of the equine population may develop clinical signs of Wobblers syndrome at an older age as arthritic changes occur in the neck vertebrae, leading to impingement of the spinal cord at one or more levels.
Whether this syndrome develops secondary to abnormal growth patterns, trauma, or arthritic changes, the common outcome is a spinal canal which is narrow at rest and/or becomes narrow when the neck moves and the vertebrae shift relative to one another. This narrowing compresses the nerves which are carried via the spinal cord from the brain to the limbs as well as nerves that are carried from the limbs back to the brain. These are the nerves which transmit information on limb position. Proprioception is the unconscious awareness of limb, head, and body condition. In horses suffering from CVSM, compression and damage to the spinal cord leads to sensory ataxia and loss of proprioception.
Often the first clinical signs of CVSM are detected either while the horse is simply walking or being worked under saddle, and include stumbling and toe dragging. Signs may be apparent only in the hind limbs or may be observed in the front limbs as well. Over time, abnormal wear patterns of the hooves/shoes may become apparent (i.e. chipping, squared-off toes). While at rest, an affected horse may exhibit a wide-based stance. As well, Wobblers patients may have a delayed corrective response when their limbs are placed in abnormal positions. When asked to turn in a tight circle, the affected horses frequently exhibit circumduction (swinging the outer hind limbs very wide) and pivoting on the inside limb. In severe cases, wounds may be apparent on the forelimbs or heel bulbs from overreaching with the hind limbs. Additional signs in more severe cases include a stiff neck, difficulty in rising, and a susceptibility to falling.
CVSM can be presumptively diagnosed through a combination of clinical signs, a detailed history, the breed and age of the horse, and a thorough veterinary neurologic exam. Radiographs will often show abnormal vertebral structures and/or joint spaces. Computed Tomography (CT) and myelograms may also be useful in detecting the location and severity of any malformations or areas of compression of the spinal cord.
In cases of acute lesions, anti-inflammatory drugs are essential to reduce any swelling around the spinal cord. In certain cases, a combination of corticosteroids and hyaluronate injections administered into the intervertebral joint spaces may reduce swelling and ongoing bony changes. In young horses, stall rest combined with appropriate dietary changes (decreased protein and carbohydrate levels) may slow growth rate and reduce the development of CVSM. Vitamin E and selenium are essential nutrients which should be included at appropriate levels in the diet to support the health of nervous tissue Incorporate.Spine & Nerve with Lions mane as the lead for anti inflammation of the nerve.
Surgical management via fusion of unstable cervical joints may help to stabilize affected levels of the cervical spine and gradually allow the bones and spinal canal to remodel. This treatment option is only indicated in certain cases where the patient is young, has abnormalities at only 1 or 2 cervical levels, is otherwise healthy, and is exhibiting mild to moderate clinical signs. The recovery period following surgery may take up to a year or longer and the long-term prognosis for return to a normal work-load varies from case to case.
No matter what the underlying etiology of the CVSM is in any horse, and what treatment protocol is to be implemented, a key aspect to the success of recovery is the overall health of the horse. Proper nutrition is essential for any horse to be able to have the strength to maximize their healing potential. ImmuBiome Spine and Nerve formulation contains a variety of high quality ingredients which, in combination, provide support for the nervous system of the horse. The most important ingredient in this nerve health formula is the mushroom Lion’s Mane (Hericium erinaceus). Lion’s Mane has been shown to aid in the repair of damaged nerves, as well as providing strong anti inflammatory, antioxidant and immune-boosting activities. When combined with powerful polysaccharides, antioxidants, prebiotics and specific probiotics to encourage a healthy gut microbiome and support the immune system, Lion’s Mane works to strengthen the overall well being of the horse and support them along their healing pathway.
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