Fibrocartilaginous Embolic Myelopathy (FCE) in Dogs

Overview of Canine Fibrocartilaginous Embolization

Fibrocartilaginous embolic myelopathy, commonly referred to fibrocartilaginous embolization and abbreviated as 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

Signs of Fibrocartilaginous Embolic Myelopathy (FCE) in dogs may include:

Diagnosis of Fibrocartilaginous Embolic Myelopathy (FCE) in Dogs

Treatment of Fibrocartilaginous Embolic Myelopathy (FCE) in Dogs

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

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.

In-depth Information on Fibrocartilaginous Embolization in Dogs

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:

In-depth Information on Diagnosis of FCE in Dogs

A thorough history and physical exam are imperative to making an appropriate diagnosis. Detailed information about the onset and progression or lack of progression of clinical signs, as well as the possibility of trauma may be useful in developing an accurate list of potential diagnoses. A careful neurologic exam will localize the area of the spinal cord that is abnormal, as well as assess the degree of neurologic compromise. Assessment of mobility as well as the animal’s ability to feel a stimulus applied to the limbs also helps determine the prognosis for recovery. More specific tests include:

In-depth Information on Therapy of FCE in Dogs

The mainstay of therapy for FCE is supportive care. FCE cannot be definitively diagnosed in a living patient, therefore all other diseases that may present with similar clinical signs must be ruled out using the aforementioned diagnostic tests. There is no surgical procedure to repair the infarcted portion of the spinal cord, so healing must occur on its own. Some treatments may include:

Follow-up Care for Dogs with Fibrocartilaginous Embolization

Optimal treatment for your dog requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your dog does not rapidly improve.

Many dogs will recover from FCE, but it can be a slow process. The patient should be evaluated by your veterinarian 10-14 days after discharge from the hospital and approximately once a week thereafter, until marked improvement is noted.

Many animals will start to show signs of improvement in the first 7-10 days. If there is no improvement within three weeks, the prognosis is guarded.

Regularly scheduled re-exams are important for full neurologic evaluation. Subtle changes in your dog’s status may go unnoticed until a full exam is performed.

Supportive care started in the hospital must be continued at home. If your dog appears to be getting worse, this should be brought to your veterinarian’s attention immediately.