Condition: FCE (fibrocartilaginous embolism)
Rehab categories: Laser,Therapeutic Exercises,UWTM
On the night before I flew out to NYC to spend a week with my family for Passover, I received an urgent Facebook message from my cousin Edna. Suddenly, out of the blue, her boy Sammy was in crisis and she desperately needed some help!
From Edna: “It seems my sweet Sam had a spinal cord stroke last night. He is at the vet right now being observed and evaluated. Seems they can’t do an MRI til Monday. I am hoping he will recover some strength in the next 48 hours. Do you have any suggestions?”
I was shocked and knew that Edna was panicking: Sammy is the light of her life and she needed some reassurance. I sent her as much information as I could, links to materials she could read online, and calmed her until I could get to her side. The plane trip seemed to take an eternity!
Once I landed in New York, I called Edna immediately. She was doing better, had already brought Sammy home from the Emergency Clinic and was getting set to work with him until they could see his neurologist. Edna reported that Sammy was getting depressed and refused to urinate or defecate while lying down but that he could not bear to place any weight on his right front leg or rear legs.
I advised Edna to order a 'Help Em' Up' harness right away, to keep him on soft and supportive bedding, and to turn him regularly to relieve pressure on his tissues and joints. Once I'd dropped off my bags, I drew up a plan for his Physical Rehabilitation at home. Luckily Edna is a dancer and a yoga instructor, so she had a lot of helpful items around the house such as a yoga mat, physioball, and some yoga straps. Plus we were able to re-purpose a snow sled as a temporary stretcher to help get him in and out of the car for his appointment with the neurologist!
Sammy weighs nearly 80 lbs so it was a team effort to get him to upright using a towel as a sling and the physioball to support his weight. Fortunately, while he was supported by the ball, he found it easier to eliminate and, for different reasons, that was huge relief to everyone!
After that, the hard work began! The first thing we needed to do was to stimulate his weakened front and rear legs by bouncing him gently on the physioball. The action of shifting his weight simulated weight bearing and encouraged nerve input to the brain, re-establishing communication between the spinal cord and his legs. I prescribed a series of exercise techniques that were to be performed three times per day. I knew that Edna and her family were devoted to Sammy and that they'd be able to follow the schedule, but I was thrilled when they even went as far as to draw up a chart to document when he had completed his therapy sessions!
Of course, the question persisted: What had happened to Sammy? Why had he suddenly been so devastatingly incapacitated? Although I was sure I knew what was happening, it was a relief to have it confirmed by his neurologist: the diagnosis was Fibrocartilaginous Embolism (FCE), also known as 'spinal stroke'.
Edna was fortunate to live close to the Long Island Veterinary Specialty Center where they have a certified canine rehabilitation practitioner who began treatment with the Therapeutic Laser, Pulsed Electromagnetic Field bed and Assissi Loop, as well as supported walking in water! Sammy especially loved his sessions on the underwater treadmill! The water temperature was just perfect and felt great on his body, and the natural buoyancy gave his legs relief from bearing all of his weight. His progress was amazing and we were all incredibly proud of him. But the best part of it for Sammy? Hearing the encouragement and seeing the smiles on his family's faces as he strode along the treadmill, stronger and more confident with each step!
As a veterinarian, I am thrilled to offer my own clients a treatment regime using all of these techniques so, when I saw Sammy's care-plan, I knew he was in good hands. After just a few days, he was managing to pull himself up onto the couch when he thought no-one was looking! And within 2 weeks he was getting up and walking on his own again! His story continues, and he's a true inspiration to any family facing FCE.
No one fully knows how and why spinal strokes happen. Although they can afflict any dog, victims are frequently giant breed dogs, aged between 3 and 6 years old. Smaller breeds - those which show 'dwarf-like characteristics' and so are termed 'chondrodystrophic' - tend to experience calcification of their spinal disks which actually prevents them from becoming subject to an embolism. Oddly, one small breed, the Miniature Schnauzer, is an exception to the rule because they circulate excess blood fats and cholesterol that may predispose them to an embolism. In a study, it was shown that 61% of spinal strokes occurred after some kind exercise injury or trauma although, in general, the injury is not painful. In terms of the overall effect for the dog, there is a 50% chance that only the rear legs will be involved. And it is important to remember that, because an embolism does not affect the body equally on both sides, there may be a difference in strength on either side of the dog's body.
Do all dogs recover as quickly as Sammy did? In essence, it all depends on how much loss of function there is, the severity of the embolism and the exact place in which it occurred in the spine. The good news is that the loss of function will not get worse; after the first 24 hours, the maximum damage has already occurred and a dog may start the path to recovery. What's more, in one study, 74% of dogs showed some improvement in their condition. And that's why it is so crucial that we develop a strong treatment plan for the 3 weeks following the injury. This is the period of maximum improvement and we use the Therapeutic Laser, the underwater treadmill, hydrotherapy, the Assisi Loop and the Pulsed Electromagnetic Field bed to maximize our patient's chances of radical improvement. And when we can achieve significant progress, as in Sammy's case, everyone involved feels encouraged and motivated to continue with treatments that ultimately lead to additional slow and steady improvement over the next few months.
If you're wondering how Sammy is doing now, prepare to smile. Edna recently sent us an update in which she mentioned that she'd used essential oils such as frankincense and lavender to help calm him during therapy and a video of Sammy showing off his all-new standing and walking skills. He is a real winner and has overcome the odds thanks to perseverance, patience, and support.