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Fibrocartilaginous Embolic Myelopathy (FCE)

By: Dr. Erika De Papp

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FCE is a disease most commonly seen in large dogs. The onset of clinical signs often occurs following exercise or some form of mild trauma. It is generally considered to be a non-painful condition, although owners often report apparent pain or vocalization when the signs first occur.

The onset of signs is very acute (sudden). The type of problems seen depend on which part of the spinal cord is involved. If the infarcted portion of spinal cord is in the neck, both front and hind legs may show abnormalities. If the infarcted portion of spinal cord is behind the front legs, there may only be a problem with the hind legs. Additionally, the signs are usually asymmetric, meaning they are worse on one side of the body than the other.

The degree of neurologic deficit may range from a mild lameness to complete paralysis of one or more legs. There may be some worsening of signs over the first 12-24 hours, but the deficits do not progress beyond this time period. Other diseases that may cause signs similar to FCE include:

  • Vertebral fracture (or other spinal trauma). Fracture of one of the vertebrae may result in compression of the spinal cord with resulting limb weakness or paralysis. Fractures of this nature are usually sustained following major trauma (such as being hit by a car) and the animal would be expected to exhibit continuous pain. Neurologic deficits are most often symmetric in this instance.

  • Intervertebral disc disease. Rupture or herniation of one of the discs that sit between the vertebrae ("slipped disc") can cause a sudden onset of paralysis similar to FCE. Animals suffering from this condition are very painful and tend to have more symmetric signs as well. Acute rupture of intervertebral discs is also more common in small dogs, whereas FCE is more common in large dogs.

  • Diskospondylitis. This is an infection of the intervertebral disc. This is yet another painful disease process and the animals often show other signs of illness such as fever and lethargy. Depending on the severity of the infection, the animal may or may not have neurologic deficits.

  • Spinal tumor. Cancer of the spinal cord or of the vertebrae may produce a non-painful and asymmetric weakness or paralysis of the limbs, but this usually follows a gradual course, with slowly progressive signs.

  • Myelitis. Myelitis is an inflammatory condition of the spinal cord. This also generally has a slower onset of signs and is a progressive disorder.

  • Spinal cord hemorrhage. Certain bleeding disorders may cause hemorrhage in and around the spinal cord, which may also interrupt normal neurologic function. Most animals with bleeding disorders show evidence of bleeding elsewhere in the body rather than strictly associated with the spinal cord.
                                                                            

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