What is CSM?
Cervical spondylomyelopathy (CSM) may also be referred to as “wobbler syndrome” is an uncommon disease of the cervical vertebral column (neck). We typically see this disease in large and giant breed dogs. It is a complex disease characterised by narrowing of the vertebral canal leading to compression of the spinal cord. There are two main forms of CSM identified – osseous associated CSM (OA-CSM) and disc associated CSM (DA-CSM).
OA-CSM is more commonly seen in young giant breeds (such as Great Danes or Bull Mastiffs). Changes to the bones in the neck during development lead to compression of the spinal cord.
DA-CSM is more commonly seen in older large breed dogs such as Dobermans. We generally see a combination of changes to the bones in the neck and protrusion of one or more intervertebral discs leading to compression of the spinal cord.
What signs are associated with CSM?
Spinal cord compression can lead to ataxia (wobbliness) and paresis (weakness). We may see dogs that tend to scuff their paws and drag the nails. The front legs can have a short choppy gait. We may also see neck pain (including spasms of the neck) and a reluctance to move in dogs with CSM. Some dogs with CSM may have an inability to walk and have incontinence.
How do we diagnose CSM?
CSM is typically diagnosed by a combination of history, neurological and advanced imaging.
Advanced imaging typically may be either an MRI, CT or a combination of these imaging modalities. MRI provides better soft tissue detail (such as the spinal cord), whilst the CT provides better information about the bones of the spine (vertebrae).
What is the treatment for CSM?
Treatment is depended on the cause and the severity of the patient’s clinical signs. The neurologist will be able to discuss different options with you once they have made a diagnosis.
Treatment options are divided into medical and surgical options. Medical management is generally recommended for dogs with mild pathology and often included exercise modification, anti-inflammatory medication, physiotherapy and hydrotherapy. There are a number of different surgical options available and the suitability of these is depended on the exact diagnosis.
What is the treatment for CSM?
The prognosis is highly variable depending on the severity of the disease and clinical signs, and response to treatment.