Neurobites – April 10, 2019 ANNPE and FCE – An Outcome Comparison.

Every week, the BVNS neurologists, residents and interns convene to discuss a human or veterinary neurology/neurosurgery article.

NeuroBites is a digestible synopsis written by Dr. Bush of the article covered in journal club.

Welcome to NeuroBites.


Lorenzo M, et al. Outcome comparison in dogs with a presumptive diagnosis of thoracolumbar fibrocartilaginous embolic myelopathy and acute non-compressive nucleus pulposus extrusion.

Veterinary Record 2017 181: 293 originally published online August 7, 2017. doi: 10.1136/vr.104090

Click HERE for the full article.

The best part about today’s journal club was everyone talking about their experiences and thoughts about these diseases – the article was pretty good too – but not as good as the discussion it sparked. Thank You, Dr. Akin.

What is ANNPE?
Acute non-compressive nucleus pulposus extrusion. Basically a small amount of jello-like material from the center of the intervertebral disk gets shot at the spinal cord at a very high velocity – the impact causes damage and often paralysis on just one side.

What is FCE?
Fibrocartilaginous emboli is when material from the inside of the intervertebral disk enters the blood supply to the spinal cord causing a spinal cord stroke – the result causes damage and often paralysis on just one side.

Are these diseases similar?
Yes very similar – in each disease the dog is suddenly paralyzed on one side and a MRI is required to make the diagnosis and establish prognosis.  Interestingly today’s journal club focused on a study whose goal was to detect significant differences between the 2 diseases.

How did this study detect significant differences?
157 ANNPE dogs and 44 FCE dogs were compared for many different characteristics and when statistically there was less than 5% chance the difference was from chance alone – then the characteristic was considered significantly different.

What were some of the significant differences?

Characteristic ANNPE FCE
Age 6.5 years 5.5 years
Weight 23 KG 18.5 KG
Active at onset 96% 44%
Vocalizing at onset 91 % 23%
Painful 63% 19%
NSAID therapy 54% 18%
Underwater treadmill therapy 31% 51%
Successful Outcome 73% 90 %
Fecal Incontinence 23% 7%

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