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Fibrocartilaginous Embolic Myelopathy (FCE)

By: Dr. Erika De Papp

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Fibrocartilaginous embolic myelopathy or FCE is a condition involving necrosis (cell death) of a region of the spinal cord secondary to infarction (obstruction) of the blood supply. The infarction is caused by fibrocartilage, which arises from part of the intervertebral disc (the shock absorbing material located between bones in the spinal column) and enters a spinal artery or vein.

The cause of FCE is unknown. It is also unclear as to how the fibrocartilaginous material enters the bloodstream. Giant and large breed dogs are most commonly affected. It may also occur in smaller dogs, with an apparent predisposition in Shetland sheepdogs and miniature schnauzers. Most affected animals are 3-6 years of age and male dogs are slightly more prone to FCE than females.

Although FCE has been reported in cats, the condition is very rare.

What to Watch For

  • Lack of coordination
  • Lameness
  • Dragging of limbs
  • Complete inability to walk
  • Sudden onset of weakness or paralysis in one, several or all limbs

    Diagnosis

  • History and physical exam
  • Spinal radiographs (X-rays)
  • Myelography (specialized X-ray using agents to highlight the spinal cord)
  • Cerebrospinal fluid (CSF) analysis
  • Complete blood count, biochemical profile and urinalysis

    Treatment

    Intravenous corticosteroid therapy may be useful if administered within 6-8 hours of onset of clinical signs. Additional treatment includes:

  • Supportive care
  • Physical therapy

    Home Care and Prevention

    Recovery may be a slow process, requiring continued supportive medical care at home. Some affected animals may lose the ability to urinate normally. This may necessitate manual emptying of the bladder and frequent cleaning of the hind end to avoid urine scalding.

    Pressure sores are a common complication of prolonged paralysis. Frequent turning of paralyzed animals, soft bedding, and management of any sores is also necessary.

    There are no known measures to prevent FCE.

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