Page 97 - July 2015

Wobblers syndrome is considered a multi-factorial disease and the Gluck Center at the University of Kentucky, is taking a broad look into the role genetics may play, as well as to diet and new diagnostic and imaging techniques.
distinct determination that anyone could see regarding how bad the compression is,” he says.
“Surgical intervention has been refined and there are now only a few places that are doing it in the U.S.,” says Reed. “On the west coast, the surgeries are being done by Dr. Barrie Grant in California, and on the east coast Dr. Brett Woodie and myself are doing it here at Rood and Riddle. We have some reasonably long-term follow-ups now on some of these surgeries. We’ve now done about 150 surgeries since I came here. If you include my time at Ohio State University, I have been in on more than 500 of these surgeries.” This procedure is being utilized to help a lot of horses.
“What Dr. Woodie and I are trying to do is work on some follow-ups so we can answer the questions people ask about the outcomes after the surgery. At this point, it looks like the pro- cedure probably works a little better for show horses than racehorses, but part of the rationale behind this comparison is time,” says Reed.
Often the racehorses have to make all of their career progress within 2 and 3 years of age. In contrast, the show people can often be more patient, knowing that the horse could have a career lasting 10 to 15 more years. “People are learning that nervous tissue heals slowly and that it will take some time, and we need to be patient.” That horse can still be in a successful career when he’s 10 years old or older.
“Another thing that needs to be mentioned
is that the acquired form of wobblers syndrome (which occurs with arthritis in the mature horse) is now being recognized in a number of stallions. If we are going to be repairing stallions with this problem, this comes right back to needing a better understanding of the role of genetics,” says Reed.
There is a lot of progress in this direction from a clinical point of view. “We are now seeing horses that are a couple years out after surgery and still making good clinical improvements. The fact they are improving and not develop-
ing any new sites of compression and are able to become athletic again is very exciting. Optimism and hope are important, and patience is very important. I remind people that Payton Manning had an implant screwed into his neck after the first surgical techniques the doctors tried didn’t work. Then, they put an implant in very similar to what we do on the horses. It took him almost 2 years after that implant to get back to being an elite athlete again. So, we need to be patient when it comes to spinal injury healing,” explains Reed.
Some people are also looking at treatment with stem cells. “This is an area in humans where we think stem cells might help if you get them into the area of damage,” says Grant. “In horses, if this could be paired with scoping and surgery, you might be able to do this. We can actually run a needle-scope through the disc at the time of surgery and take a look. If you see something, you could put another needle in and inject stem cells right into the cord.”
He has been working on research with stem cells, injecting them into the spinal cord at the time of surgery. “We actually did this in France in March of 2015 at the University of Lyon,” says Grant.
“Dr. Reed, Dr. Woodie and I also did one horse that a client had given us, that was a wob- bler, and we injected the stem cells recently and so far the horse is doing well. We wanted to be able to tell people that we tried this on our own horse first, without causing harm. So, stem cells might be another option,” Dr. Grant says.
Many people underestimate what can be done for some of these horses and how beneficial it can be once you make the proper diagnosis and institute proper treatment.
Grant thinks horses with wobbler disease— those with chronic cord compression—would be good models for human research. “It’s
not like having to create wobblers in order to study this. We already have a lot of them and they don’t cost that much for a research study. Many people can’t afford treatment for them. Most owners would prefer to send them some- where for research rather than to put them down,” he explains.
People are looking into treating wobblers syndrome with stem cells, by injecting stem cells right into the cord at time of surgery.
“We have also continued trying to improve our techniques for working clear back at the base of the neck at C7 T1, in the chest cavity. Due to improvements in technique with better x-ray machines, better quality x-rays and more awareness, we recognize that there can be com- pressions of the cord way down there. We have done surgery on 8 cases and it is tricky, but it can be done, and some horses have actually done well afterward,” says Grant.
“Another new thing that is quite exciting
is the advent of two types of CT scans. One was developed in Italy, and the first machine is now in place in Hamburg, Germany. Rood and Riddle will have theirs put in on June 22, 2015. We want to be able to do standing CT images of the caudal neck since a lot of the compres- sion in the caudal neck is laterally, and those are difficult to see when you do a myelogram. You don’t get to see all around the neck like we can with a CT scanner,” he explains.
This would encourage more people to try for diagnosis since the horse doesn’t have to
be anesthetized. “You simply need to put their head and neck in there, standing, and take a look, and you could see if there is narrowing
of the spinal canal. The company that makes these machines sold 15 or 16 of these at the AAEP last year to various clinics and veterinar- ians who want to use this technology. It will be useful, not only for checking the spinal cord, but also for head lesions, bad teeth, sinus, etc.”
For more information, check Dr. Grant’s website at www.equinewobblers.com. The website will help answer questions, go through basic dif- ferentiation of various types of cases, and let horse owner know what they might need to do to figure this out. Dr. Grant’s purpose in this website is to try to help educate people and facilitate proper diagnosis and treatment.
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