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Fibrocartilaginous Embolism (or FCE) occurs due to a sudden blockage or obstruction of a vein or artery supplying bloody to a specific segment of the spinal cord.

Whilst the cause of this condition is not completely known, it is thought to be linked to the intervertebral discs. The spinal column is comprised of numerous bones called vertebrae that are linked together. Between each vertebra is an intervertebral disc, that allow joint movement and shock absorption. An intervertebral disc acts like a cushion between each vertebra and is comprised of two components. The first is an outer segment called the annulus fibrosis. The second is the inner section of the disc called the nucleus pulposus. The material that blocks the blood vessel, or the embolising material has been found to be identical to fibrocartilage found in the nucleus pulposus of the intervertebral disc.

Whilst the condition can affect dogs of all ages, it is more common in young to middle aged dogs. It is also most common in non-chondrodystrophic breeds. A chondrodystrophic breed is one that has limbs that are disproportionately shorter than the length of the body and are often curved. A non-chondrodystrophic breed is therefore all other breeds of dog, typically medium to large breed dogs. Miniature Schnauzers are very commonly represented among these dogs.

Blockage of the blood supply to a specific segment of the spinal cord can result in a loss of oxygen supply there, causing subsequent nerve dysfunction and sometimes nerve cell death. Clinical signs of an FCE are acute (sudden) in onset, and non-progressive. They can range from sudden weakness and ataxia to complete paralysis. The condition generally occurs during physical activity, such as chasing a ball or jumping, but it is also known to occur whilst the dog is undertaking light exercise. Whilst the dog may yelp and feel pain initially, there is typically no pain associated with the condition. The condition is often lateralised, meaning it occurs on both sides of the body, but usually one side is affected more severely than the other.

An FCE is diagnosed using radiographs, in order to eliminate any other spinal injuries such as a spinal fracture. MRI’s are used to confirm a diagnosis as well as to suggest a prognosis based on the size of the stroke area.

As there is no way to remove the fibrocartilage from the blood vessel, there is no direct treatment. Instead, time is required to allow new blood vessels to redirect the blood flow. As well as this, rehabilitation through physiotherapy and hydrotherapy is key to recovery. At Hainault Hydrotherapy our aims for rehabilitating a patient with an FCE involve increasing sensory awareness, building hindlimb muscle mass and strength as well as aiding in gait re-education.

The warmth of the water as well as the buoyancy provide an optimum environment for this, as it allows the dog to exercise in a non-weightbearing environment, reducing the muscle work required. The warmth of the water also improves blood circulation, improving nutrients flow and allows tense and sore muscles to relax. Furthermore, the gentle current of the water over the paws of the dog stimulates a swimming reflex that the dogs may not be able to replicate consciously on land, allowing the dog to build or maintain muscle mass whilst nerve repair is occurring.

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