Page 94 - July 2015

A proper diagnosis will do more to help the client and the patient in the long run.
by Heather Smith Thomas
The term wobbler refers to a horse that might have one of several different disease conditions; there are numerous disorders affecting the musculo- skeletal and neurological systems. The problem most commonly associated with the term is called cervical vertebral malformation (CVM), in which malforma- tion of the cervical vertebra results in compression of the spinal cord. This is also called cervical vertebral stenotic myelopathy. Impairment of the spinal cord can lead to ataxia and incoordination.
Barrie Grant, DVM, MS, Dipl.ACVS, MRCVS, has worked with wobbler syndrome horses since 1977 and has a consulting practice in Bonsall, California. “One thing that’s confusing is that people talk about wobbler syndrome and wobbler disease. In current terms, any horse that is showing neurologic signs, espe- cially if related to the spinal cord, would be considered to have wobbler syndrome, EPM, EHV-1 or vitamin
E deficiency. Many of these various problems all look the same. Wobbler disease generally refers to horses that have compression of the spinal cord—which can be caused by several different things (injury, congenital malformation, tumors, arthritic vertebrae when the horse gets older, and so on),” says Grant.
“If your veterinarian says your horse might be a wobbler, this can be confusing until he/she explains that there needs to be a differential diagnosis to figure out which of these things it might be. Without a
good diagnosis, simply treating the symptoms won’t
Barrie Grant, DVM, MS, Dipl.ACVS, MRCVS, who has worked with wobbler syndrome horses since 1977 and has a consulting practice in Bonsall, California,
and Dr. Steve Reed, who has been looking into the genetics, diagnosis and treatments of the syndrome at Rood and Riddle Equine Hospital in Lexington, Kentucky.
do much good. Although, most of these horses will respond temporarily to small doses of phenylbutazone (which relieves swelling and inflammation),” he says.
“This is why it is important for horse owners to have a good understanding of the different things that can cause a horse to act wobbly. My practice continually gets calls from clients who say their horse was diagnosed as a wobbler and were told that this is a dead end for the horse, but they don’t want to put the horse down,” says Grant.
Some owners have the impression that a myelo- gram, which is often used in obtaining a definitive diagnosis, is expensive and painful for the horse. They also don’t think a wobbler has much chance
for recovery. “There are misconceptions. The most important thing is to get an accurate diagnosis rather than just shooting in the dark. The owner might only have $200 to spend on the horse, and choose to pay for a chiropractor to see if that helps. A person can keep trying different things, and pretty soon will have spent more money than the cost of a good diagnosis.”
A proper diagnosis will do more to help the client and the patient in the long run. “The types of wobblers I generally work on surgically are horses that have a mechanical compression of the spinal cord. The com- pression may be caused by a developmental abnormality in a young horse, osteoarthritic vertebrae in a middle- aged or older horse (putting pressure on the spinal cord), a tumor that’s growing and creating pressure, or from trauma to the spinal column. I have to be sure of the actual diagnosis, and this usually begins with a good neurologic and lameness exam,” says Grant.
“Some horses are lame as well as being neurologic. Horses can be severely lame on one front leg (espe- cially with weight on their back), yet the veterinarian can’t find anything wrong in the lower legs even when blocking the fetlock, carpus, shoulder, elbow, etc. Some of these horses have a degenerate cervical disk (at C6/C7 or C7/T1) causing pain in the area and that’s why they are lame on that side. Radiographs of the neck and doing some neurologic tests can make the diagnosis a lot easier,” he explains.
“Many of these horses can be successfully treated with surgery, rather than just giving up on them
and putting them down. While the horse is being evaluated, many veterinarians also take blood samples and check titers for EPM to see if that’s a possibility because this is another common disease that causes a horse to look like a wobbler since it destroys areas in the spinal cord,” he says.
Wobbler Syndrome In HorSeS
92 SPEEDHORSE, July 2015
equine health