Fibrocartilaginous Embolus (FCE)


FCE is a ‘stroke-like’ event within the spinal cord: signs (symptoms) are very sudden in onset and vary with the location of the FCE. Small particles of fibrocartilage believed to come from the discs between the vertebrae (bones of the spine) block blood vessels within the spinal cord.
FCE commonly occurs while dogs are active (e.g., playing, running) but occasionally occurs when they are quiet (even during sleep). The onset is usually very painful and the dog will cry out and may fall down: owners often think that the dog has broken its leg or even its back. Pain is present initially, although not usually very severe after the onset, and tends to resolve within minutes to hours. Rarely, some pain seems to persist for as long as 24 hours. After 24 hours FCE is NOT painful: continuation of any spinal pain indicates that a different nametion must be present. Weakness or paralysis may occur in a single limb, both hind limbs, or all four limbs. Signs are frequently much more severe on one side than the other, but they can be symmetrical. The severity of signs can vary from mild weakness to complete paralysis.
Diagnosis depends on the history and clinical signs, and on ruling out other diseases that can cause similar signs (e.g., disc herniations, spinal fractures). MRI may reveal areas of fluid swelling (edema) within the spinal cord in the first few hours after FCE occurs. Spontaneous recovery also can increase the suspicion of FCE rather than other spinal cord diseases.

Fortunately, most dogs with FCE will recover spontaneously. Physical therapy (e.g., underwater treadmill) can be helpful to facilitate recovery and build strength. Patience is needed while recovery is occurring.
Prognosis depends on the severity of the signs and, to some extent, the location of the FCE within the spinal cord. Most dogs with FCE will begin to show improvement within 24-48 hours. Full recovery may take many weeks to months. A number of dogs may have some permanent disability, but this is usually manageable and in most cases won’t severely impact quality of life. In a minority of animals the deficits after FCE will have a major negative impact on quality of life.