Todayโs path rounds are on ๐๐ข๐๐ซ๐จ๐๐๐ซ๐ญ๐ข๐ฅ๐๐ ๐ข๐ง๐จ๐ฎ๐ฌ ๐๐ฆ๐๐จ๐ฅ๐ข๐ฌ๐ฆ (FCE)! This was a request 
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐
๐ข๐๐ซ๐จ๐๐๐ซ๐ญ๐ข๐ฅ๐๐ ๐ข๐ง๐จ๐ฎ๐ฌ ๐๐ฆ๐๐จ๐ฅ๐ข๐ฌ๐ฆ is when a piece of ๐๐ข๐๐ซ๐จ๐๐๐ซ๐ญ๐ข๐ฅ๐๐ ๐ (the main component of the discs between our spinal vertebrae) breaks off and enters the blood stream. From there, it forms an ๐๐ฆ๐๐จ๐ฅ๐ฎ๐ฌ, or a foreign material in the blood, which can block blood flow.
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Technically any species can get this, but we most commonly think of it in large breed dogs. In particular, Miniature Schnauzers and Shetland Sheepdogs may be predisposed to this condition.
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
There isnโt a specific cause of FCE, however it has been associated with exercise or trauma. It is generally considered to be a ๐ฌ๐ฉ๐จ๐ซ๐๐๐ข๐ (randomly occurring) event.
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
The major problem with FCE is that the vessels the embolus will obstruct are typically those that supply the spinal cord. This can lead to ๐ข๐ง๐๐๐ซ๐๐ญ๐ข๐จ๐ง (death of tissue due to inadequate blood supply) of the spinal cord. As you can imagine, this can cause a variety of neurologic symptoms in the poor dog! These signs can include weakness, paralysis, irregular gait and lack of pain perception.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
The veterinarian will initially complete a ๐ง๐๐ฎ๐ซ๐จ๐ฅ๐จ๐ ๐ข๐ ๐๐ฑ๐๐ฆ to assess the animalโs nervous system. There are so many things that can cause neurologic signs in dogs, so it is important to be thorough! In particular for this condition, dogs will have asymmetric signs, and most commonly the hind limbs are affected. The clinical signs also have an ๐๐๐ฎ๐ญ๐ (sudden) onset, and the signs do not progress or get worse after about 12 hours. Based on these clues, the veterinarian may request ๐ฆ๐๐ ๐ง๐๐ญ๐ข๐ ๐ซ๐๐ฌ๐จ๐ง๐๐ง๐๐ ๐ข๐ฆ๐๐ ๐ข๐ง๐ (MRI) in order to directly visualize the embolus. This will confirm the diagnosis!
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
Unfortunately there isnโt a specific treatment for FCE, so these patients are often allowed to rest with supportive care. This allows time for the embolus to become ๐ซ๐๐๐๐ง๐๐ฅ๐ข๐ณ๐๐ (have a hole drilled through it) by the body and restore blood flow. These patients often require extensive rehabilitation after their initial rest period in order to restore full use of the limb. This recovery process can take weeks to months, but does have a fairly good prognosis!
๐๐ก๐จ๐ญ๐จ๐ฌ
1-2) Examples of spinal cords showing areas of infarction from an embolus. It is very uncommon to actually see these lesions on necropsy!
3-4) Examples of what we might see on histology in cases of FCE.
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Thomas, W.B. Vascular diseases of the spinal column and cord. Merck Veterinary Manual 2013.
Fibrocartilaginous embolism (FCE). Veterinary Health Center, University of Missouri.
Photos 1-4 courtesy of Noahโs Arkive.
