Short- and Long-Term Outcome in 63 Dogs Treated Conservatively or Surgically for Disc Associated Wobbler Syndrome
Disc associated wobbler syndrome (DAWS) is the most typical and predominant wobbler syndrome. There is little known about the results and risk factors associated with non-surgical treatment of this specific wobbler syndrome.
Medical records of dogs with DAWS treated conservatively or surgically (ventral slot) were retrospectively analyzed. Diagnosis was confirmed by myelography in all dogs. Sixty three dogs were included. Fifty one dogs were treated conservatively and 12 surgically. Follow-up information was obtained by recheck examinations or telephone questionnaire. A success score of 1 to 10 was given and a successful outcome was defined as a success score of 8 or higher. This definition included only dogs that did not show worsening of clinical signs after DAWS was diagnosed. In the conservatively treated group the following potential risk factors were evaluated: age, duration and severity of clinical signs, number of protruded intervertebral discs, and additional radiographic abnormalities. Because of the limited number of dogs, these factors were not evaluated in the surgically treated group. Statistical analysis was performed using the Fischer exact test or the Wilcoxon rank sum test.
A successful outcome was achieved in 45% of conservatively treated dogs. Seventy-five percent of surgically treated dogs achieved an initial successful outcome. Due to recurrence of clinical signs in 66% of these dogs, only 42% of the surgically treated dogs obtained a definitive successful outcome. Although not significant, surgically treated dogs had a longer life expectancy (mean, 19 months) than conservatively treated dogs (mean, 9 months). Eighty five per cent of conservatively treated dogs, who had to be euthanized because of DAWS, were so in the first year after diagnosis. Outcome of conservatively treated dogs was negatively influenced by severity of clinical signs and additional radiographic abnormalities and not by age, disease duration and number of protruded intervertebral discs.
The results of this study suggest that conservative treatment of DAWS can be considered in mildly affected cases without additional radiographic abnormalities and that the first year after diagnosis is a critical period to obtain a successful outcome.