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Fibrocartilagenous Embolism "FCE"
By Dr. Ed Mapes, Stonebridge Animal Hospital
Fibrocartilagenous Embolism, a real mouthful in anybody's book, most often simply referred to as "FCE", is a condition involving the spinal canal that causes severe weakness or even paralysis of. rear legs in dogs. They can be playing as usual one minute and severely impaired the next.
The spinal cord is a bundle of nerves that extends from the brain to an animal's tail. It is housed and protected in a series of bones called the vertebrae, which together constitute the vertebral column.
Each vertebra is separated from the next by an intervertebral disc, which functions as a cushion between the bones and allows some normal movement within the canal. The discs are composed of a tough outer wall and a jelly-like substance within - the nucleus pulposa.
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When an embolus blocks blood flow in a dog's spinal blood vessel, cell death occurs to tissue that no longer receives blood. Since the spinal canal is largely composed of nervous tissue, the interrupted nerve transmission to rear legs results in the symptoms of severe weakness (paresis) or paralysis we know as FCE.
The affected nerve tissue does not regenerate, and damage that occurs within the first 24 hours is thought to be permanent. Traditional or even digital X-rays do not show the affected tissue; MRI scans are needed to actually demonstrate the damage.
We diagnose FCE by consideration of the clinical symptoms, manner in which the signs appeared, close examination of the patient, and a lack of any other pathology visible on radiographs. In spite of the marked symptoms, the patients are not in pain that would be expected with many other conditions.
Acute spinal cord trauma without vertebral fracture or rupture of the discs will not be radiographically obvious either, so treating acute cases as spinal cord trauma is the standard of treatment. Those patients usually show some degree of early improvement when swelling and inflammation are controlled; FCE cases do not.
Unfortunately there is no specific treatment for this condition. Once there is no recovery after giving acute therapy for spinal trauma, we must realize that any improvement will come over weeks or months of time and will most likely not result in resumption of normal function.
Rehabilitation can be helpful in maintaining muscle strength and flexibility, joint range of motion, and improving nerve function to at least partially compensate for that which is lost. Various modalities are available, including massage, Cavaletti poles, wobble boards, hip stretch on incline, electrical stimulation, and underwater treadmills.
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