Rehabilitation therapy helps dogs with “spinal-cord stroke”
recuperate faster, better

 By Sarah Carey

Rory, a 5-year-old Australian shepherd, suffered from what is believed to have been a fibrocartilaginous embolism, or FCE. After a month of rehabilitation therapy at UF's Small Animal Hospital, she is back to her normal self.

When Rory, a 5-year-old female Australian shepherd, came inside after playing outdoors last fall, sophomore UF veterinary student Noelle Speilman’s mother, Jennifer Crock of Ormond Beach, noticed the family dog was limping. At first, Crock suspected a sprain, but then noticed Rory was dragging her right-front paw rather than holding it up. Rory was still able to use her other three legs, so Crock wrapped the front leg and the dog lay down in its bed to rest.

Crock contacted Spielman in Gainesville, and described Rory’s symptoms. At the same time, she videotaped Rory’s movements while calling the dog to her from a distance. Limping, Rory struggled to approach Crock. Within 20 minutes, Rory was unable to stand or walk.

Crock’s local veterinarian, Dr. Mark Salzburg, agreed to see Rory immediately. After examining Rory, he told Crock he suspected a type of “spinal-cord stroke” known as fibrocartilaginous embolism, or FCE. Saltzurg contacted the UF Small Animal Hospital’s neurology service, which recommended Rory be seen at UF for an MRI and further evaluation.

“Although I had gone to the vet’s office still believing that Rory had suffered some kind of minor injury from which she would recover in a couple of days, by the time I left, it was beginning to sink in that this was an extremely serious problem and that there could be grim prospects for meaningful recovery, or no recovery at all,” Crock said.

Rory arrived at UF as an emergency case on the evening of Oct. 4. Veterinary neurology resident Dr. Sarita Miles came in to conduct a thorough neurologic examination immediately, rather than have Rory wait until morning to be examined by a specialist. Miles looked for signs of deep pain and spinal reflexes in order to pinpoint the type of injury that had occurred. Based on their findings, Miles and the UF team agreed with the referring veterinarian’s assessment of suspected FCE and further pinpointed the likely location of the embolism within the spinal cord. An MRI the following morning confirmed the presence of a highly suspicious area within the spinal cord that was most likely an embolism.

Although Miles offered a tentative prognosis for a good recovery, Crock had mixed emotions. 

“There was a strange comingling of hope and dread,” she said. “We accommodated the hopefulness because we were certain of the expertise of the staff at UF, but the very small possibility for less positive outcomes that they also acknowledged, combined with having seen our lively and energetic Rory in this state of helplessness for hours by then, really undermined our optimism.”

Rory received underwater treadmill therapy as part of her rehabilitation regimen.

She said UF staff told her about several specific cases similar to Rory’s in which dogs had experienced significant to complete recovery.

“We were told that FCE patients don’t usually get any worse, and usually make significant improvement in walking ability within days or weeks,” she said.

Miles, the neurology resident who saw Rory first, said that the vast majority of patients with the type of problem Rory had, do recover.

“It is quite rare that they do not,” Miles said.

Dr. Carolina Medina, chief of UF’s acupuncture and rehabilitation service, said UF sees a few FCE cases a month, primarily in large breed dogs.

“FCE is a common neurological dysfunctions when a dog becomes paralyzed,” she said. “Our neurology service refers many of these cases to us, because with physical therapy, you can greatly improve the results.”

What happened to Rory was fairly typical of dogs with FCE, Medina added.

“Usually what happens is that a dog will be running fine, but then collapses, usually in obvious pain. Between 12-24 hours later, the dog is no longer painful, but it is still paralyzed, similar to a person having a stroke,” she said. “It’s very traumatic, since you can’t prepare for it. Veterinarians will often tell clients to do range-of-motion exercises and massage, which helps, but to get full recovery, you need more aggressive therapy than that.”

Dr. Carolina Medina, right, chief of the UF Veterinary Hospitals' acupuncture and rehabilitation service, positions Rory on an exercise ball to aid in muscle strengthening and balance.

After a month-long regimen of rehabilitation therapy at UF, which included acupuncture, laser therapy, neuromuscular electrical stimulation, range of motion exercises, massage and a Chinese herbal medicine, Rory quickly began to improve. 

After the first week, she improved rapidly. Soon, Rory could hop and hobble without falling.
     “Once she reached the point at which she could walk on her own, somewhat awkwardly but reliably, we felt as though she was out of the woods in many ways and would enjoy a quality of life we had not thought possible two weeks prior,” Crock said.

“Rory now plays and enjoys life as if she had never had a spinal cord injury. She can keep up with the other two dogs racing around the yard, and you could never tell that her front leg was leg was ever injured,” Crock said. “Her front leg still drags occasionally, leaving her with a goofy limp that makes us love her all the more.”

UF’s acupuncture and rehabilitation service is one of the most comprehensive in the state, and is in the process of expanding to add a therapy pool. Referrals are preferred but not required. For more information about the UF acupuncture and rehabilitation service, call 352-392-2235.

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March 2011

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