Fibrocartilaginous embolism – mar vista animal medical center dolor lumbar causas

Imagine your dog is happily playing in the yard, jumps up to catch a ball, lands badly, and comes up not just lame but weak or even dolor lumbar causas paralyzed in a back leg. The toes knuckle under, perhaps. Maybe his back tilts downward, his rear legs too weak to rise all the way dolor lumbar causas up. You check him over, trying to find where it hurts and it simply does dolor lumbar causas not seem to hurt at all.

To understand FCE, one has to understand some anatomy of the vertebral column. The vertebral column consists of numerous small bones called “vertebrae” which are linked together by special joints called “ intervertebral disks.” the disks are similar to the joints that connect arm dolor lumbar causas or leg bones together in many ways. They allow flexibility between vertebrae so that one can arch dolor lumbar causas or twist one’s back voluntarily just as one can flex and extend dolor lumbar causas a knee or elbow.

But the disks are unique as well. A joint of the appendicular skeleton, say a knee or elbow, has a capsule which secretes a lubricating fluid. The bones are capped with smooth cartilage to facilitate frictionless dolor lumbar causas gliding as the surfaces move during flexion and extension. The disk is nothing like this. It is more like a cushion between the end plates dolor lumbar causas of the vertebrae. It is round (hence the name “ disk”) and fibrous on the outside with a soft gelatinous inside dolor lumbar causas to absorb the forces to which the bones are exposed. This jelly-like inside material inside is called the “ nucleus pulposus” and it is this material that makes up the fibrocartilaginous dolor lumbar causas embolus.

The vertebral column provides a bony protective case around the dolor lumbar causas vulnerable spinal cord. The spinal cord is the cable of nerve connections that dolor lumbar causas transmits messages to and from the brain and controls the dolor lumbar causas reflexes of the body. The spinal cord is fed by a network of spinal dolor lumbar causas arteries. In FCE, somehow the material from the nucleus pulposus enters the arterial dolor lumbar causas system and is carried to the spinal cord where it dolor lumbar causas causes a blood vessel obstruction: an “ embolism.” this area of the spinal cord actually dies. The process is not painful but complete recovery is far dolor lumbar causas from guaranteed. The good news is that after the first 24 hours, the condition is not going to get worse.

Any dog can be a victim of FCE though about dolor lumbar causas half of the victims are giant breed dogs. Breeds that are called “chondrodystophic” (meaning they have as part of their normal breed conformation dolor lumbar causas dwarf-like characteristics) tend to calcify their disk material, making it too hard to participate in an FCE and dolor lumbar causas they are thus at lower risk. Such lower risk breeds include basset hounds, and dachshunds. Instead, these breeds tend to get type I disk herniation, a different spinal problem but one at least amenable to dolor lumbar causas surgery. Some feel the miniature schnauzer has higher risk for FCE dolor lumbar causas as this breed tends to circulate excess blood fats and dolor lumbar causas cholesterol which may predispose to embolism.

Most FCE dogs are young adults, between the ages of 3 and 6 years. In one study, 61% were presented for evaluation after some kind exercise injury or dolor lumbar causas trauma. There may be a yelp at the time of the dolor lumbar causas trauma but the injury is generally not painful. There is about a 50:50 chance that the lumbar area of the spinal cord dolor lumbar causas will be affected which means only the rear legs will dolor lumbar causas be involved. Because the embolism is not generally a symmetrical event, both left and right may not be equally affected.

This depends on how much loss of function there is. The good news, as mentioned, is that the loss of function will not progress; after the first 24 hours, the maximum function loss has occurred. Your dog may or may not be able to improve dolor lumbar causas (about 74% of dogs in one study showed some improvement ultimately) but be prepared for no improvement and ask yourself what dolor lumbar causas kind of care will be needed and can your dog dolor lumbar causas get around. Maximum improvement has generally occurred by 3 weeks after the dolor lumbar causas time of the injury with some dogs showing some additional dolor lumbar causas very slow improvement over months.

Acute neurologic weakness after trauma could also be caused by dolor lumbar causas type I disk herniation or by spinal cord trauma. In type I disk herniation, a mineralized intervertebral disk “slips” upward and is pressing on the spinal cord. The pressure may be relieved with medication (if it is not severe) or surgery may be needed. In either case, the spot where the disk is pressing is very painful dolor lumbar causas and the pain is an important distinguishing feature. Beyond this, with disk disease radiographic abnormalities may be seen when the dolor lumbar causas patient’s back is radiographed whereas in FCE the radiographs will dolor lumbar causas appear normal.

In some cases, the collapsed disk spaces are not obvious and more advanced dolor lumbar causas spinal cord imaging is needed. A myelogram involves general anesthesia and injecting special dye in dolor lumbar causas the space around the spinal cord. If there is an area of compression, it will be visible and the patient can then proceed dolor lumbar causas to surgery. In FCE, there is no such compression.

Magnetic resonance imaging (MRI) is not yet readily available to most veterinary practices but dolor lumbar causas is likely to become the imaging modality of choice for dolor lumbar causas the diagnosis of FCE. MRI is able to distinguish embolized areas of spinal cord dolor lumbar causas from those with swelling or compression. Still, absolute confirmation of the FCE diagnosis requires a piece of dolor lumbar causas spinal cord tissue for analysis and this is not something dolor lumbar causas that would be done in a living patient. For the time being, diagnosis of FCE is made based on the clinical picture dolor lumbar causas of a patient in the appropriate age group with an dolor lumbar causas acute spinal deficit, no other abnormalities on imaging and no painful areas.

Physical therapy for pets is an emerging field with limited dolor lumbar causas availability but it can be very helpful in maximizing mobility. This holds true for many orthopedic and spinal conditions including dolor lumbar causas FCE. Some of the exercises used to assist in rehabilitation are dolor lumbar causas depicted in the pictures below (pictures courtesy of california animal rehabilitation).