Many orthopedic or neurologic conditions affecting dogs may worsen over time. Spinal stroke in dogs, also known as fibrocartilaginous embolism (FCE), is just the opposite. Often a side effect of strenuous play, this type of stroke requires an astute dog parent and prompt medical attention, but has the potential for a happy ending. Integrative veterinarian Dr. Julie Buzby shares what you need to know about spinal stroke in dogs: its symptoms, treatment, and prognosis.
“I just don’t get it, doc. Jasper was fine this morning. Ate his breakfast like normal, went outside to play fetch, and now this.” Jasper’s distraught owner relayed his account of that morning’s events to me. Jasper, a five-year-old Bernese Mountain Dog, had been the picture of health.
But then—when he’d jumped to catch a tennis ball—he yelped and fell. He needed help getting up, and his dad knew immediately something was wrong and rushed him to the vet clinic.
Looking at Jasper sitting in my exam room, I wouldn’t have thought at first anything was wrong. He still had the same goofy, slightly drooly grin he always greeted me with. His eyes were bright, and he wasn’t whining or acting painful. But my initial neurologic examination made me very concerned. Jasper had a hard time rising in his hind end, and when he walked, his right hind leg knuckled and dragged behind.
“This looks serious,” I told his owner. “I’m glad you got him in so quickly. Let’s start with some tests.” Jasper’s bloodwork and X-rays were completely normal. He didn’t give me any signs of pain anywhere. This wasn’t an orthopedic injury; there was definitely something wrong with his nervous system. I advised his owner to take him to the local veterinary neurologist for an MRI. He did so right away.
Unfortunately, Jasper’s MRI confirmed my suspicion. Jasper had a fibrocartilaginous embolism (FCE), sometimes referred to as a spinal stroke.
Spinal anatomy in dogs
To get a better idea of what happens in a spinal stroke, first we need to review some anatomy. Dogs’ spinal cords are protected by a series of bones called vertebrae. Between each vertebra is a cartilaginous intervertebral disc. These discs are there to cushion the vertebrae and to allow the spine some flexibility and movement.
What is a spinal stroke or FCE?
Like other types of strokes, FCEs occur due to an obstruction in a blood vessel. But a spinal stroke in dogs is unique because material from an intervertebral disc—not a blood clot—clogs the blood vessel.
A spinal stroke in dogs occurs when a piece of a disc breaks off, enters the bloodstream, and blocks blood flow to a portion of the spinal cord. The location of the blood vessel that is obstructed determines which portion of the spinal cord is affected and therefore what clinical signs are noted.
Which dogs are most commonly affected?
Most dogs with this condition are relatively young (three to six years old) and healthy. FCE occurs more commonly in giant and large breed dogs and is typically associated with some sort of mild trauma or physical activity like playing fetch.
What are the signs of an FCE?
A spinal stroke results in a rapid onset of clinical signs—usually weakness or paralysis in one or both hind legs, although front legs also can be affected. Depending on where the FCE occurs, one side of the body may be affected more than the other. Although the initial injury causes discomfort, FCE does not result in long-term pain.
The following signs may be seen in dogs who have experienced a spinal stroke:
- Loss of coordination (ataxia).
- Characteristic knuckling gait where they are unable to right the paws. (See how to test for knuckling in dogs by watching this video: Knuckling in Dogs: How to Test A Dog for Conscious Proprioception.)
- Weakness in one or more limbs.
- Complete paralysis in one or more limbs.
- Signs that are more profound on one side of the body than the other.
Keep in mind that the signs may vary depending on the severity and location of the spinal stroke.
Is there hope for dogs who suffer a spinal stroke?
If your dog has suffered a spinal stroke, I want to offer you two pieces of good news that may give you some peace of mind.
- After the first 24 hours, the clinical signs associated with FCE typically won’t continue to progress. Things may look bad on day one, but remind yourself that you are seeing the worst of the worst. From here, your dog’s weakness or paralysis will either stay static or improve.
- Unlike some other conditions, a dog who had a spinal stroke is not at an increased risk for it happening again. Once you and your dog make it through this episode, you shouldn’t have to lose sleep over the potential of it reoccurring.
What is the treatment for a spinal stroke?
Unfortunately, there is no specific medical treatment that can reverse the effects of an FCE. However, that doesn’t mean that there isn’t hope. Supportive care and rehabilitation go a long way in helping these dogs regain strength.
If your dog has a spinal stroke, ask your veterinarian about rehabilitation options. Many general veterinary practitioners offer some degree of rehab services, or they may refer you to a veterinarian who specializes in physical therapy and rehabilitation. Also, the American Association of Rehabilitation Veterinarians maintains a searchable database to help you find a rehabilitation professional.
Underwater treadmills assist with walking and build strength
An underwater treadmill is a wonderful tool for dogs who have suffered a spinal stroke. The buoyancy of the water allows the patient to go through the full range of motion required for normal walking without the added stress of full weight bearing. Moving through the water also gives the muscles some resistance to improve strength.
Think about the last time you tried to walk in the swimming pool. The water made you feel lighter but it was harder to walk. The same goes for dogs on an underwater treadmill.
Laser therapy reduces inflammation
Laser therapy for dogs can also be very helpful in reducing inflammation and improving blood flow. This is beneficial as the body heals from the spinal stroke.
Ultimately, every case is different, so work with your veterinarian to find the recovery plan best suited for your dog.
What is the prognosis for FCE?
An individual dog’s prognosis after a spinal stroke varies depending on where the FCE occurs, which parts of the body are affected, the severity of the initial signs, and how quickly treatment is initiated.
The goal of rehabilitation and supportive care is to regain as much function as possible. In many patients, improvement occurs in as little as three to four months. Some dogs make almost a complete recovery. You’d never know anything ever happened, except for a shuffling gait now and then. Many dogs go on to live otherwise normal lives.
Challenges of caring for a paralyzed dog
Other dogs, unfortunately, must deal with long-term issues related to their paralysis. They may need ongoing therapy to assist with movement and strength. Because they may not be able to reposition themselves well, they are also prone to secondary issues such as skin infections or bedsores.
Paralyzed dogs could have difficulty urinating and defecating, and may rely on their owners to express their bladders. This can lead to other issues such as frequent urinary tract infections in dogs. Dogs with more severe paralysis will need frequent follow-up visits with their veterinarian as well as diligent at home care to stay on top of their recovery.
Additional ways to assist your dog’s recovery
Depending on your dog’s specific needs, your veterinarian may discuss slings or harnesses to help with support and movement.
Traction is also key in getting around on hard flooring, so Dr. Buzby’s ToeGrips® dog nail grips can be immensely helpful for dogs recovering from FCE.
In addition, ToeGrips may also enhance conscious proprioception—the body’s ability to sense the position of the limbs and placement of the paws. Dogs who are recovering from a spinal stroke need to have their ToeGrips glued on because dragging/scuffing the paws will tug the grips off the nails. Here is a short video to explain how, when, and why I recommend this…
Back to Jasper
I am happy to report that Jasper is doing well. After working with the neurologist to diagnose his FCE, we collaborated with a veterinary rehabilitation facility to tailor a treatment plan to Jasper’s needs.
Compared to some, his condition was relatively mild, affecting only his right hind limb. We used a combination of medication, an underwater treadmill, laser therapy, and range of motion exercises at home.
Now Jasper gets around without much help and still chases his tennis ball after breakfast every morning. He hasn’t let FCE slow him down one bit, or put a damper on his love of life!
If your dog has suffered a spinal stroke, don’t lose hope—even if the prognosis seems bleak at first. Work with your veterinarian or rehabilitation professional to develop a plan, and take it one day at a time.
Has your dog had a spinal stroke?
Please share your story below. We can all support each other.
On Monday, we took our dogs to the dog park. My 8 year old Boxer was his lovable self. He went hopping towards another dog when we first arrived, gave a yelp I’ve never heard and collapsed to the ground. We thought he might have hurt his leg and immediately took him to the vet. Nothing was broken but they said his X-ray looked like he had a compressed neck and treated him to reduce pain and inflammation etc. the next morning, he could not stand, both front and hind legs could not move, he could not pick up his head. Immediately took him to the vet for a full day of tests etc and he was diagnosed with a spinal incident or FCE and he may have something else going on with one of his vertebrae, I’m not sure. We brought him home, carried him outside every four hours to pee, which he did, but after 48 hours still cannot stand, move his body or raise his head, even with round the clock care. He is back at the vet today and no signs of improvement and they say we may not see any. So, it has become a quality of life issue. Boxers are a very special breed, high energy, fun loving, lovable, almost human. He is the sweetest baby I’ve ever had. I want to continue to hope that he could be a success story if given time, but not sure about prognosis with this severe of injury, and age. I need help but not sure what to do next.
Hi Kristin,
I am so sorry your Boxer has suffered a spinal injury. I highly recommend you get a referral to a veterinary neurologist as soon as possible. They can let you know if additional testing needs to be done and offer you the best treatment and/or surgical options. How is your boy doing today? I am hoping he has improved and is resting comfortably at home. Feel free to leave an update as new information comes available. Praying for a positive outcome.
Hi
So sorry to hear the sad news, I’m in the very same position with my Boston Terrier who is only 3 years old, the only difference being is he never yelped or made a noise just seemed to have fallen over on his front left leg. Within hours he was fully paralysed, this happened on 20th October. He lost all feeling in this leg and wasn’t withdrawing his front right leg when being prodded. He seems to have some feeling back now and showing slight signs of improvement. He still cannot stand or even balance himself yet but I’m hoping this is something that will come with time. Please update me on your case and give me some hope that my boy will get better!! and for that matter, hoping yours will too🤞
Hi Ebony,
I am so sorry your young pup is struggling with these neurological complications. How is he doing today? If you still aren’t seeing the improvement your vet was hoping for, it might be time to schedule a consult with a specialist. Praying there is still a chance for your sweet boy to make a full recovery. Wishing you both the best.
Last Saturday my healthy 6 year old papillon, Brockley, who is a talented agility dog, started chasing a chipmunk and yelped. After this she seemed very quiet but was walking okay. I fed her her dinner and noticed she wasn’t her usual bouncy self, although she devoured dinner as usual. Afterwards took her on a leash walk and she seemed to walk okay, but was quiet, and at home I noticed she had difficulty going up stairs. I picked her up and she did no more stairs.
The next morning she was having trouble standing on her back rear left leg . Since it was the weekend I took her to vet emerg. I though maybe she had torn a cruciate. The emerg vet could find nothing wrong with knees, joints etc. so we were sent home with gabapentin and told short leash walks only. Her X-ray also showed nothing abnormal.
Brockley seems to be improving every day. She now has no problem squatting to pee or poop and is walking well on leash for short distances but her back leg still slides on slippery floors.
Went to our vet today to get Brockley re-checked. Our vet thinks it may be FCE, and is referring us to a veterinary neurologist and has prescribed Metacam.. I was shocked as I had never heard of this condition and was hoping to get Brockley back into agility soon. It may take a few weeks to see the neurologist . In the meantime should we see about starting physiotherapy? What is the prognosis for getting back into agility.?
Hi Diane,
I understand your concern for Brockley and this new neurological issue. I am glad your vet has started the referral process and hope you will be able to see the neurologist soon. Without a definitive diagnosis, it is hard to make specific conclusions about prognosis and recovery time. Because your pup has very mild symptoms, I am hopeful that she will make a full recovery and be able to return to agility. Rehabilitation/physical therapy is a great idea! Unfortunately, without knowing the cause of the rear limb issues, therapy may have to consist of mostly treatments to decrease pain and inflammation. Exercises to strengthen muscles and retrain neuro pathways may have to wait until an exact cause is known in order to prevent causing additional trauma and unwanted side effects. I hope you able to find the answers you need to get your sweet girl back living her best life. Praying for a positive outcome and a complete recovery.
Hi there. Our 6 year old female Great Dane, Wrigley, was totally fine as of Wednesday night (4 days ago). In the early hours of Thursday morning, she woke me and I assumed she wanted to get up on the bed, as she sometimes does. She tried to jump on the bed and I could tell she was struggling with her hind legs. Couldn’t get comfortable, and a couple hours later, we could tell something was really wrong – knuckling (as we soon came to know the term) on her paws and dragging all 4.
Took her to the vet and her blood work all came back normal. Had a CT scan done and the results came back with basically a compression of multiple vertebrae in her cervical spine – basically diagnosed her with Wobblers, which came as a surprise to me, since she is 6 (almost 7), and I know that Wobblers presents much earlier. . The vet allowed us to take her home and put her on prednisone, which seems to be helping. Still dragging her left paws – front and back – but not as bad as before.
After doing some research online, I’m wondering if she may have suffered a spinal stroke, as the symptoms I’m reading on your site seem so similar to our girl’s? Wondering if it’s worth going back to our vet and asking. They basically told us to keep her on the steroid regimen for a couple of weeks and see how she does.
Any advice for us? Thank you for a wonderful article (and for providing us with hope for our sweet girl!) We just want to make sure she is not in pain!!!
Hi Kellie,
I understand how worried you must be about Wrigley. I am glad to hear that she has made some improvements over the last few days while taking the prednisone. You are right to be concerned about her pain level. Even with the prednisone on board she may need an additional medication to help control pain. It would be a good idea to talk to your vet and give them an update on Wrigley’s pain levels. Be sure to ask if there is an additional medication they could prescribe that would be appropriate for your dog’s specific situation. Also, while the symptoms you are describing could be related to a spinal stroke, I don’t think that is the case with Wrigley. Since compression of multiple vertebrae were noted in her cervical spine, you have a definitive diagnosis. With spinal stroke (FCE) you do not see compression of the spinal cord or vertebral instability. It might be a good idea to have her evaluated by a veterinary neurologist to see if she is a good candidate for other treatments or surgery to correct the issue. I hope your big girl continues to heal and makes a full recovery. Best wishes to you both!
My 3 year old pup recently suffered from losing mobility in his hind legs. I was at work and came home to find him in a sitting position, legs straight out. I rushed him to the emergency VCA who told me he would need surgery after not running a single test. I decided to take him home and provide care until I could take him to see a neurologist. Now I’m finding out about spinal stroke by searching the web for answers. Everything that is mentioned about FCE makes me believe that is what happened to my boy. We will see the neurologist on Tuesday and will hopefully be given a definitive answer. It’s been a week since it happened and he has gained mobility but still has trouble fully walking on his own. I’ve been expressing his bladder but the more mobility he gains it seems that his bladder is becoming harder to express. Could expressing his bladder become more difficult once he starts gaining more mobility because he wants to go on his own?
Hi Jennifer,
I am sorry your pup is having these issues, especially at such a young age. I am glad you have seen some improvement over the last week. You are correct that as the neurological function starts to return, it can make the bladder more difficult to express due to your dog having more sphincter control. Ultimately, the neurologist will evaluate everything and let you know what to expect and how to proceed. I hope your appointment today went well and was productive. Praying your sweet boy makes a full recovery and gets back to living his best life very soon.
My 8 year old English Mastiff had what our vet suspects is an FCE a couple of weeks ago. First couple of days after the stroke it was looking pretty bleak, no movement in both of her back legs. On the third day she was actually up and trying to walk, then the 4th day she was walking but was staggering quite a bit and was really tired. Now a little over two weeks in and she is walking and trying to run. Our vet told me to keep her confined for a few more weeks and try and take her for some short walks just to try and build up her strength. Crazy how they can go from fine one minute to being paralyzed within a span of a few hours. Looks like my big girl is on the mend, fingers crossed!
Hi Rod,
I am happy to hear your Mastiff girl has recovered so quickly! What a blessing to have her back wanting to run and play. Thank you for sharing your story with our readers. This may be the encouragement someone else needs who is in a similar situation. Best wishes to you and your sweet girl.
Dr. Buzby,our German Shepard was diagnosed with fce 2 1/2 weeks ago.. She has stayed at the vet hospital all this time . During this time she has had a uti and had nose bleeds and that’s why we’ve kept her there. Just a few days into her stay she’s moved her back legs,they removed her catheter,she urinates on her own. My question to you is…she has the toe knuckle in her front paws and hasn’t shown any improvement there,she doesn’t react with me putting my fingers in between her toes either. She sits up on her sternum by herself now,she eats and drinks on her own now(she was getting syringe fed) she’s very alert and definitely wants to get up but can’t. Out of all the cases I’ve read about fce,never was there one where front paws were paralyzed. Our vet believes her fce(injury is clear up to almost her neck. What are her chances of getting use of her front paws? I know you haven’t examined her but is the 3-4 month recovery go for her case too? I guess my question is have you seen a case where a dog has become paralyzed in the front(from fce) and recovered? We bring her home today and I will be trying to do therapy (physical) with her but it’s so hard to see a very active dog just laying there,that’s not the life we want for her. Just so you know,we’re not in a position for a neurologist or a physical therapist. We reached a dollar amount we never thought of reaching and we have kids we’re raising,that’s why I’m asking your advice. Thank you, Michelle Marney (Kentucky)
Hi Michelle,
I commend you for taking on all the difficulty that comes with being a caregiver to a dog with FCE. I am glad that your girl has made some progress and was able to come home yesterday. I know that without higher imaging such as MRI or CT it may not be possible to get a definite diagnosis of FCE but is usually diagnosed based on symptoms and ruling out other issues. As long as your girl had an FCE and not some other spinal cord issue, the probability of recovery should be the same no matter the location of the FCE. I hope your shepherd girl continues to improve and has many happy days ahead. Praying you will have the strength to endure and that you can hold on to hope even when the days seem long. Wishing you both the best. ♥
Hi Julie, In the early hours of this morning my 3 year old Australia Kelpie Rocco was lying at the foot of my stairs. When I called him he initially he wasn’t able to move himself, but after few minutes he stood up and attempted to walk towards me. His hind legs were weak. I rushed him to an emergency vets and after assessment have suspected Rocco’s had an FCE. I have him at home now and the vets have prescribed pain medicine and loxicom which I think is an anti inflammatory. Rocco was absolutely fine the previous day.. I’m so worried about him, He’s been my best friend and has helped to get me through the loss of my beautiful wife to cancer only in July last year. I’d be totally lost without him. I did get him to stand since being home and he can support his own weight without my help. So I’m hoping that’s positive. He’s walked briefly at the vets. I place a towel under him to provide support. It’s seems that it’s predominantly his left side rear leg. Im reaching out to you for your advice. Thank you
Hi Nigel,
I am sorry you had such a scary experience with Rocco the other day. I am glad the vet is suspecting an FCE instead of other more worrisome issues. It sounds like you have some good medications, and he is doing pretty well so far at home. My biggest recommendation would be to talk to a rehabilitation veterinarian in your area. They can assess Rocco’s specific needs and formulate an at home exercise plan to help his healing progress. They also have access to other treatments that may be a great benefit such as laser therapy and underwater treadmill. Praying you will see Rocco make a complete recovery and enjoy many more happy years together. ♥
Hi so very sorry to read your story. I hope rocco is doing much better now.
I have a similar story,I adopted Charlie a 4yr old Dalmatian 9 years ago almost.my husband passed away and I decided to get a dog to make me see the outside still exists. So Charlie arrived and has been my life source ever since,he is covered in arthritis and has nerve damage from injuries he had prior to myself adopting him but none the less it very painful for him at times,he has various medicines for his spinal problems & arthritis but 8 weeks ago I walked in the house and he was just sat looking at me apposed to the normal stuffing his head in my bag to find something that must be in there for him! Haha,anyway he couldn’t get up and I called out the emergency vet who diagnosed he had indeed had a stroke, amazingly he was back walking again within 48hrs and a week later you wouldn’t know anything had happened. He is 13 very soon and those last week has been a real struggle again for him,his back legs are going and is starting to take short cuts to avoid standing etc ?..he has 3 lots of pain relief per 24hrs but feel he is going down hill fast this week.
I will do what I have to for his sake when the time comes but wanted to let you know the recovery & longer term for your younger dog is going to be just fine plenty of swimming & shorter walks for a while,never to early to get bigger dogs taking yumove for joints it’s excellent and I would definitely recommend it and I’m convinced that is why Charlie has gotten to his age as Dalmatians normally don’t live passed 10 especially large males like Charlie is.
Good luck and enjoy many more years with your little soul mate.
Dr. Buzby, my almost 9 year old labradoodle suffered sudden right sided paralysis 2 days ago. The vet stated that it is most likely FCE. He has since got some of his mobility back quickly, still using a harness on him, but he continues to have a head bobble off and on. This effect hasn’t been mentioned regarding FCE. Is the head bobble possibly a sign of a more severe stroke?
Hi Dawna,
I am glad you have already seen some improvement in your sweet boy. It sounds like he may make a full recovery given more time. Since I haven’t examined your dog myself, it is hard to know for sure what his head bobble means. I recommend you let you vet know about this persisting symptom so they can monitor it closely as your pup continues to heal. If it does not resolve, it might be a good idea to get a referral to a veterinary neurologist. I hope the healing process is going well and that your senior guy will be back to his normal happy self in no time. Good luck and best wishes!
In the Prognosis section of this article, you state that prognosis includes how quickly treatment is initiated. Is 6-7 hours after the first signs considered quick?
My pup, who was staying with me ex, suffered a spinal stroke. It’s been over a week, and he still has almost complete paralysis. What are the odds of physical therapy NOT working on him?
Thank you
Hi Colleen,
I understand your concern with your pup and the lack of progress in his recovery at this point. Each dog is different, and it is very hard to know what will and won’t work, especially since I haven’t examined him myself. I recommend you talk to the veterinary rehabilitation specialist that would be treating your dog and get their opinion. You may need to have your dog examined by a veterinary neurologist or have some higher imaging done to get all the answers. But yes, having treatment initiated within 6-7 hours of the incident is very fast. I hope there are options that can restore your sweet boy’s quality of life. Wishing you both the best as you walk this difficult path.
Last night I was walking Luke ( 14 year old healthy Shih Tzu) home from the beach. As usual I picked him up to cross a very busy street. When we got to the other side I was bending over to put him down on the grass. He wiggled out of my arms and dropped probably 10 inches, landing on his feet and yelped.
He tried to start walking but both back legs were paralyzed.and we’re dragging. I picked him up and carried him about 100 ft and put him down. He was able to stand on his hind left leg but not the right. He did not appear to be in any pain.
I carried him about 1/4 mile home intending to grab my car keys and take him to the 24 hour emergency hospital.
When I got home and put him down, he started walking like nothing happened.
I took Luke to his regular vet this morning and the doctor preformed an exam along with Xrays. The X-rays don’t give a lot of info on herniated/ruptured discs, but do show the spacing between the vertebra.
The doctor did see the usual degeneration of discs common in older
Dogs, and felt comfortable with a FCE diagnosis. We came home with anti inflammatory & ( pain if needed )meds and will monitor him to make sure there is no regression.
It was the scariest moment I’ve had with Luke in his 14 years but comforted by the fact his prognosis is very good.
Hi Kevin,
I can only imagine how scary it must have been to see Luke go through such a traumatic event. I am glad you were able to get him to the vet so quickly the next day to have everything evaluated. It makes my heart happy to know he received a positive prognosis! I hope he continues to recover uneventfully and is restored to his usual joyful self. Thank you for sharing your experience with us and I wish you both the best.