Fibrocartilaginous Embolism (fce)

[aureliaaa]

Hi there.

I need some advice or any information that I can get to help my friend's dog recover.

It happened last night when my friend took his dog outside the house before bed (so that he can do his business) when suddenly I can hear him growling and yelping in pain, then all of sudden the dog is paralysed, he can't move the hind legs. My friend rushed and brought the dog to the vet and they said it might be ruptured disk and the nerve might be damaged, it will cost abt $5000 to get MRI and surgery and the dog is 8 years old so even if he's getting a surgery he may be getting a complication and it will make him suffer even more and if the dog is not getting any treatment at all he will still be living in pain. So they think that the dog might need to be put to sleep. We left the dog at the hospital last night. Then this afternoon the doctor suddenly came up with a second opinion about the dog's condition. He thinks that it might be FCE instead of the ruptured disk. So we're waiting for a couple of days to see if he's getting better. Does anyone has any experience regarding FCE? Did your dog have any problem with his defecating process? How long did it take for your furry friend to recover? We don't want to make the dog suffer by holding on to him for too long. :'((

Any information is greatly appreciated. xx

aurelia

[*kirty*]

Do the MRI and then make a decision. Or at least do xrays. Guessing won't help anyone.

[cavNrott]

Hi there.

I need some advice or any information that I can get to help my friend's dog recover.

It happened last night when my friend took his dog outside the house before bed (so that he can do his business) when suddenly I can hear him growling and yelping in pain, then all of sudden the dog is paralysed, he can't move the hind legs. My friend rushed and brought the dog to the vet and they said it might be ruptured disk and the nerve might be damaged, it will cost abt $5000 to get MRI and surgery and the dog is 8 years old so even if he's getting a surgery he may be getting a complication and it will make him suffer even more and if the dog is not getting any treatment at all he will still be living in pain. So they think that the dog might need to be put to sleep. We left the dog at the hospital last night. Then this afternoon the doctor suddenly came up with a second opinion about the dog's condition. He thinks that it might be FCE instead of the ruptured disk. So we're waiting for a couple of days to see if he's getting better. Does anyone has any experience regarding FCE? Did your dog have any problem with his defecating process? How long did it take for your furry friend to recover? We don't want to make the dog suffer by holding on to him for too long. :'((

aurelia

I don't know anything about FCE but my perfectly healthy dog ran into the yard and fell in a screaming heap. He was paralysed from the shoulders down. I rushed him to the vet immediately who sent us to a specialist surgeon. The surgeon said surgery was the only solution. Because I took immediate action and not much time had elapsed he said the dog had a very good chance of a full recovery.

My dog had a myelogram which showed a ruptured disk. He had the surgery and it certainly was very expensive. It was more than $5000 and worth every cent. The surgery was successful and my dog is now living a normal life, running, playing and doing everything a normal dog does. His surgery was performed 4 years ago and he is now almost 10yo.

There is a time limit on a possible successful outcome of the surgery. I made the decision as soon as the surgeon suggested surgery and the dog was taken in right away for the myelogram. The surgeon called me while my dog was still under the general anaesthetic for the myelogram, to give me the firm diagnosis and surgery was performed while he was still under anaesthetic.

I don't wish to sound abrupt but this is not the time for your friend to sit around for a couple of days pondering the dog's situation. She needs to make a decision now and take action. Maybe she could research IVDD (Intervertebral disk disease).

I hope it all works out ok.

[cavNrott]

Do the MRI and then make a decision. Or at least do xrays. Guessing won't help anyone.

Unfortunately Kirty, xrays are not helpful. They will show only bone and what needs to be shown in the spinal cord and the disks between the vertebrae.

A Myelogram is probably less expensive than an MRI and will show the condition of the spine and discs.

[~Anne~]

Obviously money is a big concern. Owning a dog isn't always cheap. There is insurance now to help with these unexpected costs but it is too late for this problem.

I understand that many dog owners do not value dogs the same as others and that there is an undefined financial limit in their thoughts. I get that. I don't agree with it, but I get it.

If you manage to find a way to pay for the treatment the dog needs then look into insurance immediately after for future illnesses and or injury.

Don't let future dogs become a perceived financial burden in the same way. Take out insurance.

Edited March 5, 2014 by ~Anne~

[Erny]

Sorry to hear of your friend's grave concern and what's happened with her dog.

I can't help other than to say "hasten slowly". Sounds to me she's doing what she can. Just tell her to "breath" and whilst there does sound to be some urgency around this, take the time necessary to check out what she can have checked out, don't knee-jerk panic.

[Xyz]

FCE is not a a painful condition, and this is often how it is differentiated from a disc. If she cannot afford to do a Myelogram, and the dog is not painful, I would wait and see. Dogs with FCE do recover, with most leading absolutely normal lives, though it can take weeks to months, so nursing considerations are important. Good luck and let us know how he gets on.

[cavNrott]

Unfortunately there is a window of 48 hours in which there is the chance of surgery being successful. I was informed of this by the specialist who performed my dog's surgery. Unfortunately, this negates any hastening slowly and a fairly quick decision needs to be made, if it is indeed IVDD. Of course a Myelogram or MRI needs to be done to confirm.

I'm not sure why a vet would suggest FCE without even seeing evidence of same via myelogram or MRI. It sounds like clutching at straws. Neither FCE or IVDD be accurately diagnosed without evidence.

[cavNrott]

FCE is not a a painful condition, and this is often how it is differentiated from a disc. If she cannot afford to do a Myelogram, and the dog is not painful, I would wait and see. Dogs with FCE do recover, with most leading absolutely normal lives, though it can take weeks to months, so nursing considerations are important. Good luck and let us know how he gets on.

This is not the case at all. With IVDD, the area of rupture is pressing on the spinal cord so clearly no messages from the brain can get past the area of compression, therefore there is no pain. There is of course the initial pain caused by the rupture and the dog in question appears to have had pain because the OP said growling and yelping was heard.

My dog screamed in pain when the disk ruptured. We saw the vet within 15 minutes and we were sent on our way to the specialist surgeon. This took another 10-15 minutes by which time there was no pain because there was no feeling beyond the area of rupture.

IVDD is acute. I know nothing about FCE but if it the conditon develops slowly then this was not the case with the dog in question.

[Xyz]

Sorry cavnrott, I meant dogs with FCE show no ongoing pain past the initial 'episode'. Dogs with IVVD will have ongoing pain, due to the compression, but will sometimes loose 'deep pain' past the affected disc. They will stil be painful.

[Erny]

Unfortunately there is a window of 48 hours in which there is the chance of surgery being successful. I was informed of this by the specialist who performed my dog's surgery. Unfortunately, this negates any hastening slowly and a fairly quick decision needs to be made, if it is indeed IVDD. Of course a Myelogram or MRI needs to be done to confirm.

I'm not sure why a vet would suggest FCE without even seeing evidence of same via myelogram or MRI. It sounds like clutching at straws. Neither FCE or IVDD be accurately diagnosed without evidence.

I didn't mean to counter the information you've given, cavNrott - it's only that I got the impression that there may be a financial hitch with the surgery component (yep - a lot of money) and then followed some well-meaning comments pertaining to pain and potential pts sooner rather than later (all true). By "hasten slowly" I mean urgency needs to be considered and observed, but at the same time, take a moment to breath and think before anything final in terms of consideration to (especially) termination is addressed and/or course of action (taking into account your advice regards 'small window of opportunity' if that initial diagnosis is in fact correct.

Yes, act fast, but don't panic. And I say that through experience because there are some things I've done in the past as a knee-jerk panic to do the best thing for the dog (i.e. euth) that I now regret and wished I'd said to the Vet at the time "wait" (at least to give me time to get my head around things; figure out possible alternatives and whether there were any; etc - and I'm not talking days).

I hope for the owner that her dog's condition is something that with time may improve.

[cavNrott]

I didn't mean to counter the information you've given, cavNrott - it's only that I got the impression that there may be a financial hitch with the surgery component (yep - a lot of money) and then followed some well-meaning comments pertaining to pain and potential pts sooner rather than later (all true). By "hasten slowly" I mean urgency needs to be considered and observed, but at the same time, take a moment to breath and think before anything final in terms of consideration to (especially) termination is addressed and/or course of action (taking into account your advice regards 'small window of opportunity' if that initial diagnosis is in fact correct.

Yes, act fast, but don't panic. And I say that through experience because there are some things I've done in the past as a knee-jerk panic to do the best thing for the dog (i.e. euth) that I now regret and wished I'd said to the Vet at the time "wait" (at least to give me time to get my head around things; figure out possible alternatives and whether there were any; etc - and I'm not talking days).

I hope for the owner that her dog's condition is something that with time may improve.

Thanks Erny. An excellent explanation.

I agree that euthanasia should be given very careful consideration with all alternatives being investigated. Unfortunately with IVDD the time for consideration is limited to about 48 hours if what the surgeon told me was correct and I have no reason to believe otherwise.

Hopefully this dog in question is not suffering from IVDD and that that he will improve.

[cavNrott]

Sorry cavnrott, I meant dogs with FCE show no ongoing pain past the initial 'episode'. Dogs with IVVD will have ongoing pain, due to the compression, but will sometimes loose 'deep pain' past the affected disc. They will stil be painful.

I'm certainly not in a position to argue the pain aspect. I saw the surgeon fairly quickly and had the surgery done immediately the Myelogram proved it was indeed a ruptured disk. I don't know if IVDD has ongoing pain. My dog didn't show signs of pain upon the surgeons initial examination. But knowing all that he does, he was probably very gentle and did nothing to cause pain.

If FCE dogs have no ongoing pain, is any movement restored after a period of time?

[Xyz]

.

Edited March 6, 2014 by Xyz

[Wundahoo]

IVDD can have very many ways of presenting. It can range from a slow onset, niggling pain with no neurological deficit to acute, complete paralysis without any deep pain below the area of the spine where the disc has ruptured. Discs can rupture at any point along the spine and so each place has a slightly different way of presentation. All of the presentation types are graded according to level of pain sensation, degree of neurological deficits, whether the dog is ambulatory (able to walk) and the rate of onset of signs.

Certainly where there has been an acute onset rupture with paralysis and no deep pain present, there is a narrow window of opportunity of around 48 hours to get the best outcome via surgery, but other types and grades can allow a longer time frame. In fact, not all IVDD cases need immediate surgery and some can be managed quite well to full recovery without going to theatre at all. Much depends on the grading.

This really needs to be assessed by a specialist and most spinal cases (where the dog is non-ambulatory) are referred to a practice where the facilities are present which allow staff to make the diagnosis and prognosis with some accuracy.

Sometimes FCE is diagnosed via exclusion. ie xrays, myelogram and CT do not show a disc rupture or tumour, therefore FCE is likely. However, the only high percentage diagnostic tool for FCE is MRI.

Recovery from FCE is usually pretty good but it can take a very long time and the nursing care can be quite challenging at times, particularly if the patient is large or has tendencies that make some aspects of the care difficult.... eg some aggression regarding handling when being moved or when passive physio is being done, or when bladder expression is attempted. Some dogs need indwelling urinary catheters with the ongoing care that is needed to prevent infection. Often with large dogs, two people are needed to safely turn the dog and then once some improvement commences to get the dog up and involved in physio. One of the most important aspects to dogs in this situation is that of bladder care. Most animals can cope without defecating for a few days but it's really important that their bladder is emptied several times each day,. If a dog is paralysed often the nerves which allow the bladder to empty are also affected. If the bladder becomes over stretched the nerves and muscles can be permanently damaged by the stretching and will never work properly again. It's really important that it is established whether or not your friend's dog can urinate properly without assistance. If not then it either needs to be expressed manually or needs an indwelling urinary catheter placed, This is something that CANNOT wait. It must be attended to immediately.

Simply waiting a few days is unlikely to show any improvement for either an IVDD or FCE so if you friend has decided to go down that road they must be willing to wait sometime before they make any other decision for the dog.

[cavNrott]

IVDD can have very many ways of presenting. It can range from a slow onset, niggling pain with no neurological deficit to acute, complete paralysis without any deep pain below the area of the spine where the disc has ruptured. Discs can rupture at any point along the spine and so each place has a slightly different way of presentation. All of the presentation types are graded according to level of pain sensation, degree of neurological deficits, whether the dog is ambulatory (able to walk) and the rate of onset of signs.

Certainly where there has been an acute onset rupture with paralysis and no deep pain present, there is a narrow window of opportunity of around 48 hours to get the best outcome via surgery, but other types and grades can allow a longer time frame. In fact, not all IVDD cases need immediate surgery and some can be managed quite well to full recovery without going to theatre at all. Much depends on the grading.

This really needs to be assessed by a specialist and most spinal cases (where the dog is non-ambulatory) are referred to a practice where the facilities are present which allow staff to make the diagnosis and prognosis with some accuracy.

Sometimes FCE is diagnosed via exclusion. ie xrays, myelogram and CT do not show a disc rupture or tumour, therefore FCE is likely. However, the only high percentage diagnostic tool for FCE is MRI.

Recovery from FCE is usually pretty good but it can take a very long time and the nursing care can be quite challenging at times, particularly if the patient is large or has tendencies that make some aspects of the care difficult.... eg some aggression regarding handling when being moved or when passive physio is being done, or when bladder expression is attempted. Some dogs need indwelling urinary catheters with the ongoing care that is needed to prevent infection. Often with large dogs, two people are needed to safely turn the dog and then once some improvement commences to get the dog up and involved in physio. One of the most important aspects to dogs in this situation is that of bladder care. Most animals can cope without defecating for a few days but it's really important that their bladder is emptied several times each day,. If a dog is paralysed often the nerves which allow the bladder to empty are also affected. If the bladder becomes over stretched the nerves and muscles can be permanently damaged by the stretching and will never work properly again. It's really important that it is established whether or not your friend's dog can urinate properly without assistance. If not then it either needs to be expressed manually or needs an indwelling urinary catheter placed, This is something that CANNOT wait. It must be attended to immediately.

Simply waiting a few days is unlikely to show any improvement for either an IVDD or FCE so if you friend has decided to go down that road they must be willing to wait sometime before they make any other decision for the dog.

Brilliant post Wunda Thank you so much for taking the time to post this very detailed information.

[persephone]

Aurellia ..thinking of you, and wondering how things are ?

[aureliaaa]

Hey everyone,

Thanking each one of you for the time and thoughts and all the information. I am deeply grateful that you are being very helpful to a stranger like me on the internet :)

The dog is doing fine :) He got an MRI eventually and it is not the ruptured disc. There seems to be a swollen spot on the spine hence the paralysis. The downside is that the doctor is not promising a full recovery . But now we are waiting and hoping that he will be running again in no time. :)

Thanking everyone once again and hoping that this post will be useful for anyone needing any information related to this topic. xx

Aurelia

[persephone]

Thank you for updating :) I hope that there is some improvement with time and care ...

[Erny]

That's good news, Aurelia, if not perfect news. But all the same, recovery sounds more likely.

Don't want to send you down the garden path, but I know if it were me, I'd be investigating what natural supplements might well assist in conjunction with Veterinary treatment/s. To do this, I'd be sending a hair sample to Ross Wilson for dna testing. The hair can be a wonderful tell-tale for what's going on in the body (e.g. inflammation) and what it is needing. The good part about this is that it is non-invasive and you don't have to take your dog anywhere to be poked or probed. Just post in.