Integrative Veterinary Medicine and Rehabilitation

Fibrocartilaginous Embolism (FCE)
Acute Non-progressive Nucleus Pulposus Extrusion (ANNPE)

Two spinal disorders that primarily affect dogs are FCE and ANNPE. Both have similar clinical signs, test results, and are usually treated identically. These conditions are mainly seen in large breed dogs (of any age), Miniature Schnauzers, and Shelties.

When an FCE occurs, a blood vessel that feeds the spinal cord becomes blocked by piece of cartilage that originates from the intervertebral disc. Similar to a stroke, this results in a lack of blood flow to the spinal cord, causing it to malfunction.

During an ANNPE, a portion of healthy intervertebral disc suddenly shoots though its encasement and collides with the spinal cord at a high velocity. This causes bruising and sometimes bleeding within the spinal cord.

Dogs that suffer from an FCE or ANNPE often have been exercising, playing or have had some mild trauma such as a fall. They may initially yelp and cry out in pain when the incident occurs, but shortly afterward become non painful. The onset of signs is very sudden and many are not able to walk immediately after the incident. In some cases only one hind leg may be affected or one hind leg may seem worse than the other. Since FCE, ANNPE, intervertebral disc disease, and other spinal cord diseases may all show similar signs, a thorough examination by a neurologist as well as advanced diagnostics such as MRI and spinal tap are often needed to distinguish between conditions. Treatment for spinal cord disorders varies depending on the cause and the severity so it is important to determine the underlying cause of the neurologic symptoms.

The primary treatment for FCE or ANNPE is physical rehabilitation. Since the primary cause of the neurologic dysfunction is due to lack of blood flow or bruising, surgery does not improve the condition. Additionally, no medications have been shown to improve or speed recovery. Most dogs with an FCE or ANNPE will start to show improvement with a few days if the incident and most regain the ability to walk within 2 weeks. Rarely, severely affected patients may not recover, but the vast majority do well given time. Physical rehabilitation can improve the chances of a full and timely recovery.

Washington State University