A fibrocartilaginous embolus is a stroke-like event in the spinal cord, caused by a clot of foreign material.

Signs include pain, initially, and the loss of use of one or multiple limbs, ranging from lameness to complete paralysis and loss of pain sensation.

Diagnosis is made through history, physical examination, neurological examination, and exclusion of other diseases producing similar signs with imaging and tests on blood and cerebrospinal fluid.

For all but the most severely affected, recovery requires supportive therapy and time.

What is a fibrocartilaginous embolism?

• A fibrocartilaginous embolism (FCE) is the functional equivalent of a stroke in the spinal cord rather than the brain. 
• It is a sudden blocking of an artery or vein of the spinal cord by a clot of foreign material. 
• FCE is often associated with strenuous exercise and/or trauma.  It can appear rapidly without any warning.  After the initial pain of trauma an FCE is not painful but can cause weakness and paralysis (inability to move).

Causes

• The cause of FCE is thought to be a small fragment of intervertebral disc material that enters the spinal cords blood supply. 
• This causes a varying degree of damage that is dependent on what part of the spinal cord is affected.

Clinical Signs

• Signs could affect one or several limbs of the body.  These signs can range from gait abnormalities to complete paralysis with fecal and urinary incontinence. 
  
• FCE signs develop over minutes to hours, and typically stabilize within the first twenty-four hours.
  
• Pain may be present immediately following the embolic event but subsides in the first twenty-four hours.

Diagnostics

• The Veterinary Neurologist will evaluate physical, behavioral, and neurological abnormalities to make a preliminary diagnosis. 
• A diagnosis of an FCE is confirmed by performing a few tests.
  
• Myelogram- a dye is injected around the spinal cord, and a series of x-rays are taken to rule out any other abnormalities like disc disease or tumors.
  
• Cerebrospinal fluid analysis- a small amount of cerebrospinal fluid is collected and evaluated for signs of trauma, infection, and/or inflammation.
  
• Magnetic resonance imaging (MRI) or Computed tomography (CT)- may be needed for a definitive diagnosis.

Treatment

• Surgery is not indicated for FCE.  
• Corticosteroids may be given initially to decrease the swelling of the spinal cord.
• Intensive nursing care to prevent bedsores and urine scald as well as monitoring of food and water intake is extremely important. 
• The patient needs to maintain muscle tone and joint mobility while the spinal cord heals, so physical therapy is also important.

Prognosis

• Prognosis for a pet with FCE is mostly based on whether they can still feel deep pain in the affected limbs. 
• If they can feel deep pain, even in paralyzed limbs, chances are good that the pet will recover to the point of being able to walk unassisted.  The healing process may take a few weeks to months.
• If they cannot feel deep pain, then prognosis for recovery is poor.