Fibrocartilaginous embolism is a relatively common cause of walking difficulties in dogs.
Clinical Signs and Examination
Fibrocartilaginous embolism (FCE) can affect any breed of dog, however, large breed dogs are over-represented. There are a handful of small breed dogs that are known to be affected by FCE, including the Miniature Schnauzer and the Shetland Sheepdog. The most common presentation is a pet that was being active (such as chasing a ball or running in the park) that acutely became unable to walk. Examination suggests asymmetrical spinal cord dysfunction. Any part of the spinal cord can be affected, but the thoracolumbar (mid-back) and cervical (neck) spinal cord are most frequently affected. The signs are typically non-painful, although many pets will cry out at the time of the incident. Signs typically do not worsen over time.
Differential Diagnosis
There are many causes of spinal cord dysfunction in dogs, including slipped discs, meningitis/myelitis, tumors, infections, cysts and malformations, stenosis, and instability to name a few. A thorough neurological examination by your veterinarian or by a veterinary neurologist can help to narrow the list of possible causes.
Schnauzer with FCE diagnosed at Southeast Veterinary Neurology
Cause
Fibrocartilaginous embolism in dogs is caused by a small fragment of intervertebral disc material that migrates into the blood vessels of the spinal cord. This blocks off the blood supply to the spinal cord causing a ‘stroke’. One side is usually affected more than the other, causing the asymmetric clinical signs.
Diagnostics
FCE can be suspected based on history and physical examination findings; however, diagnostic testing is necessary to confirm this and rule out other causes of spinal cord disease. In addition to blood work and radiographs, magnetic resonance imaging (MRI) of the spine and a cerebrospinal fluid (CSF) analysis are often indicated. Computed tomography (CT) scans and myelography are useful in ruling out other causes such as slipped discs and tumors; however, the spinal cord is not able to be directly visualized. MRI is able to visualize the inside of the spinal cord and assess the degree of involvement in the spinal cord. This can provide some prognostic information, allowing the veterinary neurologist to predict the likelihood of the pet’s recovery. CSF analysis (“spinal tap”) may also provide valuable information in diagnosing FCE.
Treatment and Prognosis
Surgery is not necessary. Nursing care and physical therapy are the cornerstones of treatment. Prognosis depends on the severity of clinical signs as assessed by the veterinarian or veterinary neurologist as well as certain aspects of the MRI. Most dogs with FCE have a good prognosis.