Fibrocartilaginous Embolism
(Also called FCE )
Your dog
is happily playing in the yard, jumps up to catch a ball, lands badly,
and comes up not just lame but able to use a back leg normally. The
toes knuckle under. Perhaps the dog even sort of
tilts downward unable to rise up properly in the back end. After
checking the dog over, you find no indication of any injury. There are
many conditions that might fit, however, neuroligical knuckling and
absence of a sore spot, suggests FCE
To
understand FCE, you must also understand how the vertebral column
works. It consists of many small bones called “vertebrae” which are
linked together by special joints called “intervertebral discs.” The
discs are similar to the joints that connect arm or leg bones together.
They allow flexibility between the vertebrae enabling the animal to arch
or twist the back voluntarily. The discs are unique because they are
more like a cushion between the end plates of the vertebrae. They are
round thus the name “disc” and they are fibrous on the outside with a
soft gelatinous material inside to absorb the forces exposed to the
bones. This soft gelatinous, jelly-like material is called the “nucleus
pulposus” and it is this material that makes up the fibrocartilaginous
embolus.
The
spinal cord is the cable of all nerve connections that transmit messages
to and from the brain and also controls the reflexes of the body. The
spinal cord is fed by a network of arteries. In FCE, the material from
the nucleus pulposus enters the arterial system and is carried to the
spinal cord where it becomes a blood vessel obstruction: an “embolism”.
It is this area of the spinal cord that dies. The process is not
painful but generally recovery is not very likely. The neurological
loss that has occurred within the 1st 24 hours is likely to
be permanent.
Most FCE
dogs are between 3 and 6 years of age. There may initially be a yelp at
the time of trauma but the injury itself is not painful usually. There
is a 50:50 chance that the lumbar area of the spinal cord will be
affected which will affect the hind legs only. The loss of function
will not get worse as after the 1st 24 hours, the maximum
function loss has already occurred. Maximum improvement has been seen
by 2 weeks following injury or trauma. Some dogs end up completely
paralyzed. Some are simply weak in the affected limbs and may or may
not need assistance in getting around, depending on how severe the
embolism was and where in the spinal cord it occurred.
Acute
neurological weakness after trauma could also be caused by Type 1 Disc
Herniation or by spinal cord trauma. In Type 1 Disc Herniation, a
mineralized intervertebral disc “slips” upward
pressing on the spinal cord. The pressure may be relieved by
medication or surgery may be needed. The spot where the disc is pressing on
the spinal cord is very painful. X-rays or a myelogram will
show any abnormalities. If there is an area of compression of the disc,
it will be visible with a myelogram.
In FCE, there is no compression. |