Fibrocartilaginous Embolic Myelopathy in Dogs
Fibrocartilaginous embolic myelopathy in dogs is a condition in which an area of the spinal cord is not able to function properly and eventually atrophies as a result of a blockage, or emboli, in the blood vessels of the spinal cord. The cause of this disorder is typically the result of an injury to the spine. The injury may be the result of jumping and landing in the wrong way, vigorous exercise, fighting, or any accident that leads to a spinal injury.
The highest number of cases tends to occur in giant and large breed dogs. Miniature schnauzers and Shetland sheepdogs are reported to be more prone to this injury. The reason has not been determined for why this is, but a suspected underlying condition of hyperlipoproteinemia that is commonly seen in these breeds is considered. Most cases occur between the ages of three and five years.
Symptoms and Types
The symptoms appear suddenly and usually follow what appears to be a mild injury or vigorous exercise.
- Sudden, severe pain, dog may cry out at time of injury
- Pain may subside after few minutes to hours
- Paresis (signs of weakness or partial paralysis)
- Lack of pain response (after initial pain response)
- Dog may stabilize within 12-24 hours
- Wobbly, uncoordinated or drunken gait (ataxia)
The exact cause is still unknown, but it is thought that a seemingly minor injury to the spine can force intervertebral disc material into the spinal cord, causing an embolism, or blockage of blood flow through the spinal cord. Other suspected predispositions to this disorder may be related to underlying hyperlipoproteinemia, and it is more often diagnosed in male dogs than in female.
You will need to provide a thorough history of your dog's health leading up to the onset of symptoms, the type of activities your dog engages in, and any injuries that you suspect to have recently occurred. Your veterinarian will rule out other causes, such as spinal tumor, intervertebral disc disease, or fracture before settling on a diagnosis. The above mentioned conditioned are very painful, therefore, a lack of pain can be indicative of an embolism in the spinal cord. Keep in mind that though there may be a lack of pain, the condition can be progressive and may affect long-term damage to the spine and neurological system. Immediate and supportive care is essential.
Routine laboratory test results, such as urinalysis and complete blood counts, are usually unremarkable. A sample of cerebral spinal fluid (CSF) may be taken for analysis, and a sample of blood from the veins and arteries of the spinal cord may show microscopic fragments of fibrocartilage. Radiographic imaging studies may help in diagnosis. Apart from routine radiography, magnetic resonance imaging (MRI) remains the best diagnostic technique for viewing the spinal cord. In the later stage of fibrocartilaginous embolic myelopathy, swelling may be present at the site of the blockage.
Treatment will be directed according to your dog's condition, the severity of the symptoms, and the extent of damage to the spinal cord. Mild improvement may be seen in the first 14 days of treatment, with further improvement occurring between three to six weeks of treatment. From there on, recovery should progress until your dog is feeling energetic again. Recovery from weakness is slow but gradual and will require patient, supportive care.
While your dog is recovering from this injury, it may have some troubles with incontinence, both urinary and fecal, or it may suffer from urinary tract infections. These symptoms should improve. However, if symptoms do not improve or if there is irreversible damage to the spinal cord, your veterinarian may suggest that you consider euthanasia for your dog.
Living and Management
While your dog is in the recovery process, provide a calm and comfortable space for it to rest and heal, away from other pets and active children. If it is not practical to restrict your dog's movement, cage rest may be an option. Your dog will be feeling weak in the first several weeks of recovery. To save your dog and yourself the frustration of accidents, you may want to place a layer of newspaper near to where it is resting. Because you will need to encourage your dog to rest as much as possible, forgoing the walks for short, scheduled breaks to go outside should be the plan for several weeks.
Part of supportive care will include creating a resting area that is well padded, and making sure to turn your dog frequently to avoid bed sores. Do not underestimate the healing capacity of affection. Petting your dog so that it feels safe and hand feeding treats and small, high protein meals during this period of time will help your dog to heal. Encourage your dog to move a bit by making sure that the food is close by and easily accessible.
Your veterinarian will schedule a follow-up visit to monitor your dog's recovery and make changes to its diet or physical routine as it progresses.