Fibrocartilaginous Embolism
Fibrocartilaginous embolism is a cause of spinal cord infarction resulting from occlusion of spinal cord arteries or veins (or both) with fragments of fibrocartilage, believed to arise from intervertebral disks.
Fibrocartilaginous embolism occurs primarily in adult dogs, especially large and giant breeds. Miniature Schnauzers and Shetland Sheepdogs also might be predisposed. It is rare in cats, horses, and pigs.
Affected dogs have an abrupt onset of gait dysfunction, often occurring during activities such as running or jumping. Other neurological deficits may be present, depending on the location and severity of the spinal cord lesion. Deficits are referable to a focal, often asymmetrical, lesion in the spinal cord and rarely progress past 12 hours. Spinal pain is typically absent.
Diagnosis of fibrocartilaginous embolism is based on clinical findings and MRI, which shows focal T2 hyperintensity within the spinal cord without evidence of a compressive lesion (see ). In the acute stage, the CSF might have a mild increase in neutrophils and protein concentration.
Mildly affected dogs often improve substantially within 1–2 weeks. Physical therapy, such as assisted walking, swimming, and underwater treadmill, can be helpful. The prognosis is poor if deep pain perception is absent or if there is no improvement within several weeks.
Sagittal plane T2-weighted MRI of a dog with a fibrocartilaginous embolism, showing T2 hyperintensity within the spinal cord at the level of the C5 and C6 vertebrae.
Courtesy of Dr. William Thomas.
Postanesthetic Hemorrhagic Myelopathy in Horses
Postanesthetic hemorrhagic myelopathy is a rare complication that occurs in horses positioned in dorsal recumbency under general anesthesia. The cause might be related to impaired venous drainage of the spinal cord due to compression of the caudal vena cava or azygous vein because of the weight of abdominal viscera.
The characteristic clinical finding in affected horses is paraplegia immediately following recovery from anesthesia. Pathological findings consist of hemorrhagic necrosis of the thoracolumbar spinal cord segments.
The prognosis is poor. Positioning the horse slightly tilted off the perpendicular and maintaining adequate blood pressure might help prevent this complication.
For More Information
Bartholomew KA, Stover KE, Olby NJ, Moore SA. Clinical characteristics of canine fibrocartilaginous embolic myelopathy (FCE): a systematic review of 393 cases (1973-2013). Vet Rec. 2016;179(25):650.
