Fibrocartiliginous Embolism

[cpavel]

About two months ago, my little mixed breed’s partial paralysis was diagnosed as a fibrocartiliginous embolism, after surgery ruled out any disc problems. He eventually regained feeling in his hind legs and was even starting to walk on three legs while using the fourth leg as support (without my assistance). Then, three weeks ago, his progress stopped, even with continued exercises and support. Not only has he lost the ability to walk but he also can’t stand from a sitting position, both of which he had been able to do before. Also, the weakest hind leg now seems to be the stronger of the two. Has anyone experienced a dog that is improving rapidly and then suddenly starts regressing to a worse condition?

[CarolC]

Well, this is a little complicated. Usually any gains in improved function following the FCE are considered permanent gains. However, this is the first time I have heard of a dog that had surgery but it turned out to be an FCE and not a disk. They would normally try to determine beforehand if surgery was needed by doing a CT or MRI to find out if there were any disk problems, rather than doing surgery, which turns out to have been unnecessary apparently. It's kind of unusual to be in the situation. So from what I can tell, he had surgery about 8 weeks ago, he was beginning to walk and doing therapy, and then at about 5 weeks post-surgery he quit walking. I am guessing from this he had maybe 3 weeks of crate rest after surgery before he began exercising?

In your dog's case, even though he did not have a disk problem according to the surgeon, he still had surgery, so I would look at him as a surgical patient right now. There is normally a crate rest period following spinal surgery. The number of weeks of crate rest varies, but I think 4-8 is more common. I would guess (ONLY GUESSING) that maybe your dog overdid it and was too active following surgery, and did not get enough weeks of complete rest, so perhaps there is some inflammation around the surgical site and he is showing these symptoms. I would definitely talk to the surgeon about this. He may need to be put on prednisone temporarily and crated to see if he gets back to where he was. I don't know what else you can do but rest him right now. It is true they recommend aggressive physical therapy for FCE dogs, but they are talking about dogs that had an FCE and did not have surgery. I would treat him as a surgical case now, and let him completely recover from the surgery before doing any weight bearing exercise. If you have a physical therapy clinic available, perhaps they can help you ease him back into exercise when the surgeon gives the OK. (I am not a vet.)

P.S., I asked the same question you did about one leg being stronger and then the other, a number of years ago when I was talking to my dog's physical therapist. She confirmed that this can happen, it is not so unusual.

[cpavel]

Thanks for your reply. What you say makes sense. We will talk to our vet about it tomorrow.

The reason surgery was done was the pre-surgery tests were inconclusive. Their next step was to go by the symptoms shown by the dog. It was unfortunate that surgery was done as this complicated the case. As you indicated, one requires complete rest, the other physical therapy. At this point, inflamation at the surgery site has not been considered. We will run that past the surgeon and see what he thinks.

Our many thanks to you. And may this be an answer to our problem!!!

[CarolC]

I had a feeling there was probably a good explanation about the surgery. There have been other cases here lately where they were having a hard time interpreting the imaging, I can see how that would happen. Best of luck, I am inclined to think he'll get his walking back again. Hope you will update on how he does.

[Jacko's Mum]

Welcome -

I did have the same experience with Jackson my FCE pooch. He was doing remarkably well and improving, so I bought him some boots to help protect his feet when we went to the park. While I was waiting for them, he lapsed and then all of a sudden could not walk at all. His hind legs would go all stiff and he would sit on his rear end without being able to get up. I had started to lose hope.

I then took him to a different physiotherapist and she told me it was due to sensory overload and was part of the healing process. He did loads of physio, did the underwater treadmill and accupuncture. But the best thing I did was test out the boots and they worked wonders. According to the physio, they reminded him that he had legs and feet and to move them. This means I could get him out and about and keep him active (and in good spirits).

A few weeks later he didn't need the boots for the sensory overload thing just to protect his feet which was the original reason I bought them!

Best of luck. Please let me know if I can be of more assistance.

Lee

[CarolC]

I never heard this before, it's interesting. If that is what it is, then my idea does not apply. Very interesting!

[Jacko's Mum]

I thought it was strange too! In this case, Jackson didn't stop walking but couldn't and you could see how he could not bend his legs which may be different to this case - and, he would be ok in home surroundings but if you said the word 'park' or 'walk' then he would instantly lose all mobility!

Best of luck.

Lee

[cpavel]

Hi Carol and Lee,
It's kind of good to hear others have had "strange" cases and that we're not the only one! FCE is kind of a waiting game as it is. We are going to try the boots and see if it has any results first and then proceed to the prednisone. In the meantime, he's getting lots of rest.

At this point, Darcy has one hind leg that is stiff and one that is almost totally limp. When we put him in his Walkin' Wheels cart, it's as if he forgets he has hind legs at all as they both become limp and he makes no attempt to move them. It is strange though, that when he cleans his groin area, both back legs jump and quiver while he's licking himself and he does have pain sensation in both legs. Also in the evening, as he's resting on our laps, his whole body jumps almost like he has the hiccups. We were told that could likely be the result of nerves healing.

Our vet didn't use the prednisone earlier because it causes more urine production and Darcy had lost all bladder function. He had to be catheterized for over a month. We are now able to get him to urinate with stimulation to his hind leg area and once he starts going, we use pressure on his bladder. This is the best it has gotten and has not changed with the regression. We have tried one type of medicine and are now on a second with no real results in making that area better. At least there is no need for a catheter any more.

We have limited canine physiotherapists in this area. We and our vet have sent e-mails to the only one that is certified and have not recieved any reply - maybe due to the holidays, at least we hope. With the absence of that route, it has been very helpful to hear from you both to give us some other avenues to try. We are doing everything under the supervision of our vet. We are very lucky to have him as he is board certified. The next closest clinic with that kind of expertise is hundreds of miles away.

Our many thanks to the both of you. We will keep you posted as to the results.

[critters]

Also in the evening, as he's resting on our laps, his whole body jumps almost like he has the hiccups. We were told that could likely be the result of nerves healing.

lts.

You mean more active during sleep? 2 of my 3 spinal cord injured boys do/did that; I think the muscle shut-off during sleep gets wonked. Ace, who's a VERY high-functioning fella, who only shows his SCI on stairs, kicks and thrashes so much in his sleep that he's been known to kick himself, and siblings, out of the bed. Buddy did it too, but Koi, who's a pretty severe fella, doesn't, I'm glad to say. 2 of them would be too much!!!