FCE and ANNPE

Fibrocartilagenous Embolism (FCE) & Acute Nonprogressive NucleusPulposus Extrusion (ANNPE)

FCEs and ANNPEs are two spinal disorders which primarily affect dogs.  While separate disorders, they are often considered together because the clinical signs, test results, and treatment of the two disorders are nearly identical.  Large breed dogs of any age are most commonly affected, with the exception of the Sheltie and Miniature Schnauzer, who also commonly develop FCEs.

An FCE can be thought of as a spinal cord stroke.  In this disorder, a blood vessel feeding the spinal cord becomes blocked by a piece of cartilage originating from the intervertebral disc.  This results in a lack of blood and nutrient flow to the spinal cord, causing the neurons to malfunction.

ANNPEs come about through a different pathophysiology.  In this disorder, a portion of healthy intervertebral disc suddenly shoots out through its encasement and collides with the spinal cord at a high velocity.  This causes bruising of, and sometimes significant bleeding within, the spinal cord.
Dogs often have an FCE or ANNPE incident when exercising or with mild trauma such as a fall.  While some yelp at the moment the incident occurs, most are nonpainful soon thereafter.  The onset of neurologic signs is very sudden, with some dogs jumping for a ball and being unable to walk moments after they land.  In many cases, the neurologic signs may seem to affect only one hind limb, and the dog is able to walk using the other three limbs.

As an intervertebral disc extrusion and other spinal disorders may cause signs similar to an FCE or ANNPE, an MRI and spinal tap are needed to distinguish these disorders.

Physical therapy is the treatment for an FCE or ANNPE.  As the underlying cause of neurologic dysfunction is lack of blood flow or bruising, surgery will not improve the condition, and no medications have been shown to hasten recovery.  With time, the spinal cord will regain blood flow and bruising will subside.  Most dogs with an FCE or ANNPE will start to show improvement in limb function within a few days of the initial incident, with most regaining the ability to walk on the affected limb(s) within 2 weeks.  While some severely affected dogs do not recover from an FCE or ANNPE, the vast majority do well given enough time to recuperate.

If you pet is suddenly unable to walk, you should see a veterinarian immediately.  While an FCE or ANNPE has a good prognosis without surgery, if your dog has instead suffered an intervertebral disc extrusion, the prognosis without immediate surgery may be poor.

You may schedule a consultation with our Neurologist by calling us at our Manchester or Newington location today.