Fibrocartilaginous Embolism (FCE):Altus' big scare

On Mar 12, 2004, Altus lost control of his hind quarters while at the vet for regular immunizations; it was a lucky fluke that we were at the vet when he suffered the circulatory problem. He is now back home, and is recovering/rehabing thanks to the dog's strength, stubbornness, and the skills and knowledge of his vet, Dr. Ellis of the Preston Park Animal Hospital in Plano, Tx.

Timeline and progress

• Friday, March 12th:
  • 2pm: Altus and I arrive early for our 2:30pm vaccination and heartworm meds refill.
  • 2:15pm: a cat in a crate is brought in; the cat cries continuously. Altus gets anxious around cats (I think he wants to eat them), and gets very anxious when he hears other animals cry, so this was a Double Dip of Badness.
  • 2:30pm: the cat is still crying and Altus is exhibiting anxiety behaviors I have not seen from him before: hiding his head in my jacket, climbing up in my lap, heavy shedding, etc. He was vibrating and his heart rate was elevated. I would have taken him outside to get away from the cat but you can't hear your name called from out there, and it was raining lightly.
  • 2:45: we get called into the exam room. Altus is still agitated. He is led out to have blood drawn and a fecal smear done. When he comes back in he starts dragging a rear paw. The tech says "hey, does he usually do that?" Within 60 seconds he'd lost all function of his rear legs; there was no muscle tone at all, like touching a piece of beef at the store. The vet walked in during that minute and got to see the sudden falling off of function. The vet suspected either a circulatory problem or a mechanical/spinal problem like a slipped disc.
  • Later that evening: got a call from the vet. Altus still had no pain sensation on his back half and no sphincter tone at all. Zip. Vet's consult with the neurologist confirms his suspicion of a circulatory problem: Fibrocartilaginous Embolism (FCE, see links below). Basically, an embolism shuts off blood flow to the spinal cord, so a section of it dies off. The fact that the dog was in front of the vet when it happened, and the quick thinking by the vet allowed for immediate response. Basically pump'em full of anti-inflammatories to help some blood squeak through to the spinal cord. Surgery is not indicated or efficacious for FCE.
    I started googling for info on FCE, greyhound paralysis, wheelchairs, etc. A very depressing night.
• Saturday, March 13th: this morning the vet was pleasantly surprised to find Altus standing in his crate, although his backend is wobbly. Recommends keeping him for observation until Monday the 15th, when Altus would come home and start rehab with us.
• Monday, March 15th:
  • 8:00am: this morning Altus was "walking". Vet explains it this way: someone who did not know the dog would say "Hey, that dog walks funny!" Someone who knew Altus would say "Hey! That dog is walking!" So we're very pleased about that.
    Altus will come home with us today to start rehab. He will stay on the anti-inflammatories and meds for his stomach (anti-nausea)for a week, then start to taper off.
  • 9pm: Altus is at home with us now, resting in his favorite places (pics). He is quieter than normal, feels a little warmer, and has a concerned expression (not sure how else to put it).
    When we picked him up from the clinic we were pleased at how well he was walking. He can stand pretty well, although a little low and splayed out in the rear, like a German Shepherd.
    He can walk amazingly well. The rear legs are definitely still weak, with about 50% of the muscle tone he used to have. He lurches when he walks (vid, ~350k); he seems to place the feet too close to his center line which makes him lose balance and overcorrect. He does not appear to be favoring one leg over the other. He drags a foot about 20% of the time but is placing the feet down correctly and not folded over. The vid does not show his side-to-side lurching well, as it's shot mainly from the side. I'll try to follow him with the video tomorrow to show how his new gait is working. You can see, however, that the tail still works! He's a regular helicopter with that thing!
    He fell into a bush trying to lift a leg to pee. He fell onto his back "knees" while squatting to pee (he does both methods). I am not sure how the pooping stance will go, because GHs seem to work hard at it even with the most cooperative of backsides.
    He has definitely lost weight, I'd say 6-8lbs. Maybe a little more.
    He is currently on dexamethasone for the inflammation and famotidine for the upset stomach from the dex.
• Tuesday, March 16th: Altus' back leg muscle tone seemed firmer this morning, but I could have been imagining it. His walking speed is improving, although balance and accuracy are improving at a somewhat slower rate. His body temp feels more normal.
  He's had no accidents in the house, so it looks like his bowel/bladder control will still be good. I'm coming home at lunch to carry him down so he can pee. The steroids do seem to make him pee more.
  Looks like he's getting a bit more of his personality back. He pawed at me for attention today and also tried to do his traditional after-pee victory dance (kicking up grass, front legs only so far).
  When we walk him we take him both on perfectly flat and on gently undulating surfaces to give him more opportunity to balance. Seems to be tired from the effort after the walk, and goes straight to his bed.
  It is wonderful to having him sleep in the room with us again. I missed him a great deal.
• Wednesday, March 17th:
  • Morning: Threw up 3x this morning. We moved his bed into the kitchen where the mess will be easier to clean up. Seemed a bit unsure on his walk this morning, perhaps as a side effect of the nausea.
  • Lunchtime: He's kept the remainder of his food down since morning, and seems a good deal happier than this morning. Walked up a small hill after peeing.
  • Evening: threw up 2x. Will call vet in the morning to see if it's normal with those meds.
• Thursday, March 18th:
  • Morning: Made a batch of white rice this morning for b-fast and the dog and I shared it. I figured it would be bland enough for him to hold down. Altus was pulling at the leash at the top of the stairs so I let him try to walk down. He did great! His rear foot placement isn't perfect but very much improved. Vet advises going to every other day with the Dex.
  • Didn't get the Dex today and he didn't vomit. We'll see about tomorrow.
• Friday, March 18th: Did well today, then gave him the Dex about 1/2 hr after he ate. Kept it down.
• Friday, March 19th: Some signs of progress:
  • kicked his back feet after elimination last night. Pretty vigorous kicking action!
  • stood to pee but lifted one foot slightly off the ground (one of his normal poses). This means that he has both the strength and the balance to stand on one back leg.
  • Chewed a squeaky toy briefly.
• Saturday, March 20: Fell a couple of times when getting too frisky (getting up fast, trying to play), but otherwise strong and balanced. The nail-dragging when walking seems a bit better. I'll trim his rear nails a bit closer to give additional clearance.
• Sunday, March 21: Tolerated the Dex again. Fell a couple of times when trying some of the more extreme peeing stances (lost balance). Overall quite strong. Played with squeaky toys a bit and interacted with visitors. More vigorous leg kicking.
• Monday, April 12: If you didn't know him you'd probably think he just walks a bit funny. He trips sometimes, particularly when stepping over obstacles. The strength of his thighs seems to be about 80% what they were before. He runs funny, his back end bouncing up and down like a pogo stick. I'll try to get video of it.

One year update

By spring 2005 (one year later) Altus is basically normal and is a joy to have around. I can tell the difference but most people would not. Here are his long-term repercussions:

• about 90% strength in his rear end
• somewhat less coordinated on the back end; trips or stumbles sometimes
• runs funny

I hope that his recovery story gives some hope to those whose furkids are diagnosed with FCE. Thanks for reading.

related information

• CG Article: FCE - Fibrocartilaginous Emboli
• CG Article: Pretty Boy's Triumph Over FCE
• PetPlace article on FCE

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