Rehabilitation of Fibrocartilaginous Embolism (FCE)

As a non-surgical disease of the spinal cord, rehabilitation has a huge role to play in managing dogs diagnosed with FCE. Following diagnosis one of our chartered physiotherapists will assess your dog and design a treatment plan unique for them. Maintenance of physical function and prevention of secondary compensatory changes is vital to your dog making good progress throughout the rehabilitation process. The level to which a patient is affected by the FCE will vary from dog to dog. Furthermore, the rate at which a patient progresses will dictate the necessary adjustments to the rehabilitation plan. Ongoing re evaluation is essential to allow an effective and appropriate treatment course.

 

Physiotherapy Aims:

In the initial stage following diagnosis, the aims are as follow:

  • Maintain soft tissue flexibility
  • Prevent muscle spasm
  • Provide sensory stimulation
  • Provide supported means of mobility

Depending on your dogs progress, the aims might then progress to:

  • Improving core stability
  • Improving body awareness and coordination
  • Providing home care management advice

6 weeks on from diagnosis your chartered physiotherapist would aim to:

  • Strengthen core stability
  • Improve gait pattern
  • Increase cardiovascular fitness
  • Return to normal functional activities

Physiotherapy Options

Correct positioning, massage and stretches can be implemented in the early days. Laser, heat therapy and sensory stimulation techniques complement the healing at this stage. Muscle stimulation is invaluable to maintain “at risk” muscle groups whilst your dog might be recumbent. As your dog improves, an appropriate exercise plan can be used to assist in gait re-education, strengthening and promote balance. In the latter stages once your dog is recovering well, core stability exercises need advancing as does general cardiovascular fitness. Advice regarding assisting with every day activities will be given as can injury prevention.

The following table gives an example of a rehabilitation plan for a dog recovering from a FCE:

 

Time Scale Physiotherapy Aims Physiotherapy Treatment options
0-2 weeks Reduce potential risk of soft tissue trauma
  • Correct positioning
  • Soft tissue massage and stretches.
Reduce muscular guarding
  • Electrotherapy – laser
  • Soft tissue massage
  • Heat therapy

Increase sensory input and motor activity

Possibly gait re-education according to deficits

  • Neuromuscular stimulation
  • Sensory techniques eg brushing, tapping
  • Hydrotherapy
  • Under water treadmill
2-4 weeks Improve Core stability
  • Home exercise program
  • Neuromuscular electrical stimulation
  • Hydrotherapy
  • Under water treadmill
Increase sensation and awareness of body position Proprioceptive based home exercise program
Maintain soft tissue length and flexibility
  • Home exercise program
  • Passive movements and stretches
Management at home
  • Exercise restriction
  • Advice regarding flooring
  • Advice regarding assisted walking with harness and sling if required
  • Advice regarding cavaletti pole work, gradients, steps and different surfaces
4-6 weeks Continue as above Progression of home exercise program to challenge balance, body awareness and strength
Advice on maintaining controlled exercise when dog feeling better
6 – 12 weeks Increase exercise tolerance Increase exercise level, considering land and water based options.
Continue to increase core stability Home exercise program considering land and water based exercises
12 weeks + Return to full function or establish deficits and advise regarding long term management. Progress to off lead exercise and previous exercise level if appropriate.

 

Hydrotherapy Options

Our underwater treadmill is a useful tool for assisting with gait re-education. The warm water provides support to the patient and allows effective gait training. For generalised strength and cardiovascular fitness, the pool itself might also be employed.

Fitzpatrick Referrals