Equine wobbler syndrome, scientifically known as Cervical Vertebral Myelopathy (CVM) is a common neurological disease in horses. It is estimated that CVM affects 10 per cent of Thoroughbred horses. The wobbly gait and other neurological signs are caused by narrowing of the spinal canal and compression of the spinal cord from malformed vertebrae. CVM occurs frequently in foals under 1 year of age, but the predominant age group is 1 to 4 years.
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CVM does not have one specific cause. There are genetic predisposing factors, but CVM does not follow a simple hereditary pattern. Nutritional factors contribute to the development of disease, especially feeding a high-energy diet to foals, which stimulates rapid bone growth. Foals with CVM have a higher incidence of osteochondrosis, suggesting that CVM may be one of the developmental orthopaedic diseases. Trauma, viral and protozoa infections, and biomechanical stresses are also important factors in some cases.
Typical signs of CVM include progressive ataxia--incoordination--of the hindquarters or all four limbs, characterised by clumsiness and wobbling, and a peculiar walk like that of a toy soldier. The neck is usually held stiffly. The horse frequently stumbles and scuffs his toes, or gets his legs crossed and then trips over them and falls. Backing up can be awkward. Symptoms may be made worse when the horse goes up or down a hill.
X-rays, spinal fluid testing and a complete neurological exam are used to confirm the diagnosis. However, when X-rays are not conclusive, a myelogram--contrast study of the spinal cord--may be necessary for a more detailed study.
Medical treatment is directed at minimising inflammation at the site of spinal cord compression. Anti-inflammatory drugs are used, including corticosteroids, phenylbutazone, NSAIDS and DMSO, either singly or in combination. Stall rest for prolonged periods is mandatory for most affected horses. Food and water should be provided at a height of 2 to 3 feet above the floor to minimise neck movement. Foals with mild x-ray changes may stabilise or improve when placed on a low-energy diet. In most cases, CVM is a progressive neurological disease and medical treatment alone is often unsuccessful.
Surgery may be considered in selected individuals. Two procedures are used for surgical stabilisation: the most often used is dorsal laminectomy, in which excess bone pressing on the spinal cord is removed; the other is intervertebral fusion, in which two or more adjacent vertebrae are joined together to stabilise the spine. These operations are difficult and may result in complications. The results are best when the surgery is performed on young horses with mild symptoms of short duration. A small number of horses return to athletic performance.
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