Fibrocartilaginous Embolic Myelopathy (FCE) in Dogs

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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: 

  • Lack of coordination
  • Lameness
  • Dragging of limbs
  • Complete inability to walk
  • Sudden onset of weakness or paralysis in one, several or all limbs
  • Diagnosis of Fibrocartilaginous Embolic Myelopathy (FCE) in Dogs

  • 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 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:

  • 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.

    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:

  • 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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