Sonne is a 3-year-old miniature schnauzer that suffered an FCE on 11 April 2022. She lives in London, England and her owners reached out to me in Australia after reading my article on Patrick’s FCE. This is now the third almost identical FCE I’ve seen in a miniature schnauzer in the last 18 months. This article looks at FCE rehabilitation in a miniature schnauzer, Sonne.
Background:
Sonne was an otherwise healthy young miniature schnauzer until April 11 2022 when she suffered an FCE. She went on her morning walk as usual but when she got home her owners noticed a limp in her right leg. Over the day the limp deteriorated with Sonne struggling to walk due to lameness in both the right front and right rear legs (she was falling over / dragging her legs).
Sonne was taken to the local vet that day. She was kept overnight with the consideration of an MRI to help determine the cause – at that stage spinal, neurological, and vascular seemed likely and they had ruled out poison. Sonne was unable to walk with absent/delayed proprioception. Most importantly however was that deep pain was maintained (this means that there are still some nerve impulses getting down to the feet). Check out this article if you want more general information on FCE in dogs.
As you can see from the video above, Sonne couldn’t use her right front and rear legs very well. She was booked in with a neurologist at a local specialist vet center at the first available appointment – this was just before Easter.
The neurologist ruled out a surgical cause (e.g. IVDD) and FCE remained a possible diagnosis. Whether fortunate or not, the MRI couldn’t be completed until after easter so Sonne went home for the weekend. If FCE were a strong diagnosis then you’d expect some improvement over the weekend as they typically regress quickly over the first 24hrs, stabilize, and then start improving as the body re-establishes collateral circulation. In Sonne’s case, the clinical presentation suggested a neurological event on the right side of her lower neck.
Sonne had a follow-up appointment with the neurologist prior to the MRI. She had improved a little over the weekend, not necessarily enough to definitely diagnose an FCE, but enough to delay the MRI. MRI’s are >$3K so if they don’t change the treatment plan delaying is a financially prudent option.
The goal with Sonne and any other dog that suffers from an FCE is to start rehabilitation as soon as possible. You want to normalize movement as much as possible, as quickly and safely as possible. For Sonne, she was also overweight, so part of her rehabilitation was to lose weight. The owners also needed to consider that her daily exercise had dropped dramatically and reduce her calories accordingly. Sonne started at 11.3kg.
FCE Rehabilitation:
Rehabilitation starts as soon as possible following FCE. For Sonne, exercises were to be performed ~4X a day and included:
- Tickling the toes / using an electric toothbrush on the bottom of their feet – the goal of this exercise is to get the dog withdrawing away from the tickle / toothbrush. The result is to re-establish neural pathways, improve sensation, and get the legs and muscles working through a ROM
- Joint range of motion (ROM) – the goal is to keep all of the joints moving through a full ROM – shoulders / elbows / wrists, hip / knee / ankle and feet /toes.
- Massage – the goal is to keep the muscles from getting too tight. Sonne should enjoy this and consent to more.
- Standing with all four feet placed on the ground. It may need to be assisted to start but the goal is to have the dog standing and holding their own body weight for ~30sec.
- Walking, if possible for ~ 5 minutes to start. For Sonne, this was her toilet walks around the backyard. We included some food encouragement and scatter feeding too. If Sonne couldn’t support her own body weight we would have used a towel or similar under her tummy to help.
Exercise Progression 1:
As Sonne improved in week 1/2 we added the following exercises:
- Transitions e.g. down to stand – 3-5 reps
- Weight shifts in standing – focus on shifting weight to right side, hold for 5secs and repeat 3-5x
- Cookie stretches in down and standing – 2-3 reps each side
- Front feet up – Sonne’s back right leg was the worst so this exercise encouraged more weight bearing on the rear legs (see video below)
Exercise Progression 2:
Week 3/4 saw the addition of more new exercises. These were in addition to the current exercises:
- Cavaletti – the goal of cavaletti is to get the legs lifting over a set of low secure poles – 5-10 reps
- Sit to stand – 2-3 reps to begin with – build rear leg strength
- Puppy Press Ups – 5 reps building to 10 (eating food between her legs) – build front leg strength
- The toothbrush/tickling and joint ROM was no longer needed at this time as they had achieved their goals.
Exercise Progression 3:
Sonne continued to progress well. She was now back doing short walks outside and we were progressing with the exercises she had. We increased the number of reps/sets and some of the exercises progressed to be slightly harder versions of the same exercise (e.g. slightly taller platform). Sonne’s weight also continued to drop slowly over the weeks.
Exercise Progression 4:
Sonne was getting back to pre-FCE life. She was now walking 3-4km a day and her weight continued to come down. She continued her exercises most days. We didn’t make the exercises too much harder as the goal had always been to get Sonne back to having a good quality of life. We weren’t striving for agility or sport of any kind. Check out the video below to see Sonne in January 2023.
Conclusion:
Miniature Schnauzers are one of the most common breeds to suffer from FCE. FCE presents with a rapid decline in neurological function of the limbs, followed by stabilization at ~24hrs, before starting to improve again. Rehabilitation is the treatment for FCE and while MRI is diagnostic, the clinical presentation is often sufficient to form the diagnosis.
Prognostically, if a dog maintains deep pain sensation there is a good chance of getting them walking again and improving their quality of life to a point they can toilet themselves and potter around the house.
In Sonne’s case, one of her big goals was to allow her to safely play with her doggie friends. By the two-three-month mark, she was out living her best life again doing zoomies with her friends in the local dog park. Supermodel Sonne also weighed in at 8.9kg. Wow, her parents did such a fantastic job with her recovery. Go Team!