Vet Speak: When playful exercise can lead to sudden spinal cord injury – and what can be done about it
Register for free to read more of the latest local news. It's easy and will only take a moment.
Bruiser was a friendly four-year-old bullmastiff who was always forgetting his sheer size and was constantly crashing into things.
He was so happy when he was able to run around free in an open field but during one day of exuberant exercise his owner noted a sharp yelp, with Bruiser unable to stand firm on one of his back legs since.
At the surgery he was given a neurological examination and X-rays. His X-rays were normal but further investigation indicated he had had a suspected acute fibrocartilaginous embolism (FCE) and an MRI scan confirmed our suspicions.
FCE is a sudden onset spinal cord injury caused by a sudden blockage of blood supply to an area of the spinal cord. It is suspected that fibrocartilage from the soft gel-like centre of an intervertebral disc enters a vertebral blood vessel and blocks it, and this blockage causes damage to the spinal cord.
It typically occurs during times of activity such as running or jumping. Most dogs will yelp once, or seem in pain for a short time, but later there is typically no pain associated with this disease. The usual signs are a very abrupt loss of function to one limb, both hind limbs, one side of the body or all four limbs, depending on what part of the spinal cord has been affected. Young to middle-aged large and giant breed dogs are often affected, though it can impact dogs of any breed or age.
A presumptive diagnosis is made based on the history and a thorough neurological examination. Spinal radiographs are helpful to rule out a fracture or other traumatic cause, though the best way to definitively diagnose an FCE is to perform an MRI of the part of the spinal cord affected and with any loss of function due to a nervous system abnormality, a referral to a neurologist is always advised.
There is no direct therapy for an FCE as we do not have a way to remove the fibrocartilage from the blood vessels in the spinal cord and can only rely on time to allow the spinal cord to make new blood vessels to the affected area. Often other blood vessels open to facilitate the collateral circulation to the spinal cord and the swelling surrounding the damaged area slowly resolves.
The immediate aftercare depends on how severely affected the patient is. Animals are typically hospitalised until they show signs of improvement. Some need hospitalised for critical care if they cannot stand or move their limbs, keeping them rested on a soft, well-padded bed, rotating them regularly to prevent bed sores. And an indwelling urinary catheter may have to be placed to help manage the bladder.
To improve strength and coordination physiotherapy and supportive therapy are the most important considerations.
The prognosis for recovery is based on the severity and extent of the spinal cord injury. The long-term prognosis is good in most cases. The rate and extent of recovery is variable and difficult to predict but can take days – but also months. Most dogs tend to show a slow but steady improvement over the first two to six weeks, though full recovery may take much longer. Not every dog will improve though, and that is partly due to the severity of the initial injury.
Thankfully, the chances of having a second FCE in the future are slim.
Alison Laurie-Chalmers is a senior consultant at Crown Vets in Inverness.
