other names: FCE, ischemic myelopathy
Overview
Fibrocartilaginous embolism (FCE) is a sudden, stroke-like condition that affects the spinal cord. While the underlying cause remains unclear, the condition results from an abrupt blockage of blood supply to part of the spinal cord. This lack of blood flow to the spinal cord results in neurological deficits.
FCE most commonly affects young to middle-aged, large-breed dogs, though smaller breeds and cats can also be affected.
Clinical Signs
The condition typically has an abrupt onset, often occurring during vigorous activity such as jumping or rough play. Symptoms typically progress over several hours before stabilizing, with no further worsening of neurologic function.
In many cases, one side of the body is more severely affected with manifestations ranging from mild incoordination (ataxia) to complete paralysis. Symptoms may involve a single limb, both hind limbs, or all four limbs, depending on the location and extent of spinal cord involvement. In severe cases, urinary or fecal incontinence may also be seen.
Unlike many other spinal cord injuries, FCE is generally not associated with persistent or significant pain.
Diagnosis
MRI is the preferred diagnostic tool, as it is the only imaging technique capable of directly visualizing changes within the spinal cord.
However, in some rare cases, abnormalities may not be apparent on MRI. Consequently, a diagnosis is often made based on a combination of the pet’s history, clinical signs, and the absence of other problems on imaging.
Treatment
There is no specific medical treatment for fibrocartilaginous embolism (FCE); however, supportive care and physical rehabilitation are critical to recovery. Management focuses on attentive nursing care, time, and a structured physical therapy program. While most animals show some degree of improvement, the extent of recovery varies based on the severity of the condition and individual response.
The most important factors in recovery are consistent supportive care and a committed physical therapy routine—both professionally guided and at-home exercises. Preventing the pet from dragging its limbs during the early stages is crucial, as it can lead to injury, particularly to the toes. Protective booties can help minimize this risk. For larger dogs, slings or harnesses are often useful tools to assist with mobility throughout the recovery process.
Depending on the clinical signs and MRI findings, anti-inflammatories and other supportive medications may be prescribed to aid in recovery.
Prognosis
Recovery largely depends on the severity of the spinal cord injury. While every pet’s journey is unique, most patients have a favorable prognosis and regain enough function to enjoy a good quality of life. In cases where sensation is absent, the likelihood of regaining motor function or continence is significantly reduced.
Most patients show the greatest improvement within the first few weeks, though maximum improvement is typically achieved over 9-12 months.