Fibrocartilagenous embolism or FCE of the spinal cord is defined as an infarction of the tiny blood vessels that supply a section of the spinal cord. It is comparable to a myocardial infarction or "heart attack" to the heart. The basic pathology is due to a fragment of intervertebral disc or blood clots that "clog" up the blood vessels supplying a particular section of the spinal cord. What results is neurologic dysfunction of that particular portion of the cord. It can affect any portion of the cord including the neck, thoracic, lumbar or sacral sections. What this translates to in your pet is that anything from all four limbs or just one limb could be involved. There are varying degrees of how badly the neurological function of the cord has been damaged. The neurological exam to the affected limb may show weakness and retains the ability to move by the patient's own volition or it could have no pain perception (no feeling) in the toes.
The typical pet affected by this disease is a young to middle age dog that is active. Usually the owners report that their dog was running or playing at the time of the incident. Their pet may cry out in pain initially but then does not seem painful. Usually the pet is worse on one side of the body than the other and the neurologic signs do not worsen with time. On examination by the veterinarian a tentative diagnosis of FCE can be supported by the historical findings and the neurological exam. Other disease processes must be considered before final diagnosis can be rendered such as intervertebral disc disease and less likely things such as tumors, infectious or inflammatory meningitis.
The definitve dianosis of FCE can only be made with the help of a special radiographic procedure known as a myelogram. A myelogram uses an iodine based agent that adds contrast to the fluid that surrounds the spinal cord. This therefore allows the normally invisible spinal cord to be seen with x-rays. The spinal cord that has suffered a FCE would appear normal or swollen with a myelogram. There would not be any compressive lesion pushing up on the cord. A sample of the cerebrospinal fluid is usually taken for analysis if possible.
Once the definitive diagnosis of FCE has been made the treatment consists mainly of corticosteroid therapy and supportive care. FCE is not a surgical disease. Prognosis and recovery time are dependent on a few things:
In general most patients that are in good health that have deep pain sensation or feeling in the affected limb(s) will make a recovery with the time and patience of loving owners.
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