It seems we never run out of opportunities around here to get acquainted with new and interesting diseases. This year we’ve learned about HGE, or hemorrhagic gastroenteritis, which struck blind Widget and blind Penny. Just last week we learned about corneal dystrophies because of blind Carmel. And last night we encountered FCE, or … ready? … fibrocartilaginous embolism. It’s basically a spinal stroke — not a brain stroke. More on that in a minute.
Yesterday afternoon (Sunday) Alayne and I were taking a group of visitors over to see the dogs at Widget’s House, and in the distance I saw blind Dusty struggle to get up and out of a hole in the gravel he had been dozing in. He had dug this shallow hole next to the Widget’s House porch, and he seemed to have trouble rising to his feet. (Dusty is very shy around people and will move out into the yard when groups show up.) Although he did manage to get up and start walking, it was clear he had some kind of problem, so I made a mental note to check him out when our visitors left.
Alayne told me later that while we were over there with our visitors, she had noticed Dusty slinking down on his hindquarters a bit, definitely not looking normal. Yet he was walking, if stiffly.
Our visitors had just left and I was heading back over to see Dusty when my phone rang. It was our employee Cindy, who had just arrived over at Widget’s House to feed the dogs. She said, "There’s something really wrong with Dusty. He’s scooting around on his back legs and can’t get up." I told her we knew something was going on with him and I would be there in a second.
Dusty was on the porch, sitting on his hind legs and unable to rise. I lifted him up and he walked into the building, which gave us hope. Once inside, Cindy held Dusty up so I could palpate his legs and spine, but he didn’t seem painful at all. With enough coaxing, he could get up on his own, but it was clearly difficult. And as soon as he was upright, he wanted to sit down again.
I started him on some prednisone, fed him dinner, and left him in his crate instead of putting him back outside. We’ve been around the track enough times now that I knew prednisone would be the first thing our vets would put Dusty on, and I figured I’d see a response soon enough if it was a steroid-responsive issue.
But a few hours later, Dusty was no better, and he dragged his feet coming out of his crate. Hmm. At that point I called the emergency number for our vet clinic in Helena, Montana Veterinary Specialists. A few minutes later Dr. Britt Culver, Brenda’s husband and a board-certified internal medicine specialist, was calling. I described Dusty’s symptoms, told Britt the pred dose I had already given him, and asked what he thought.
Britt told me it was most likely one of two things — either Type 2 intervertebral disk disease or FCE, which he then rattled off as fibrocartilaginous embolism. I said, "Fibro what?"
Essentially, it’s when a tiny piece of disk material somehow gets into the blood vessels in the spinal cord and causes an obstruction, or clot, that chokes off the blood supply to that part of the spinal cord. In effect, it’s a spinal stroke. It only effects that particular part of the spinal cord, so where it occurs will determine how many limbs are affected and the degree of severity. For a great write-up on this condition, see this PDF.
Britt thought it likely, based on how I described Dusty’s symptoms, that it was FCE. This was a good thing, he said, because FCE is typically not progressive and the animals can often regain use of their limbs. What you see in the first 24 hours is all you’re going to see. It just takes time for the spinal cord to learn how to re-route the blood supply and nerves.
Britt wanted me to increase the dose of prednisone for Dusty overnight and then see how he was in the morning. Well, this morning Dusty was about like he was last night, which I was actually happy to see. Our biggest fear was that he would get worse, because that was a bad sign and would mean it wasn’t FCE.
So I gave Dusty another dose of prednisone with his breakfast and then Alayne helped me load him in the truck for the trip to Helena. I took the photo above of Britt doing a neuro exam on Dusty at the clinic this morning, and then he took X-rays of his spine:
The X-rays confirmed Britt’s view that it was FCE, because Dusty’s spine was healthy and showed no disk disease. Britt was confident that Dusty would recover from this spinal stroke, but that it would take some time. Dusty will continue to get prednisone on a tapering dose over the course of the next couple of weeks, and then we’ll see how he’s doing.
Dusty was very relieved after all the poking and prodding to get back in the truck and head home to the ranch!
So there you have it — fibrocartilaginous embolism. I had no idea the spinal cord could have a stroke.
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