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Fibrosarcoma 337

and restricted joint mobility. Physical ○ Ensure proper physical rehabilitation is the administration of glucocorticoids. For
rehabilitation can also help maximize a provided. cases in which there is clinical suspicion of
VetBooks.ir ○ If a presumptive diagnosis of FCEM is Recommended Monitoring be pursued, valuable information can be Diseases and Disorders
functional recovery.
FCEM but advanced diagnostics cannot
made on clinical suspicion alone, restricted
Serial neurologic exams (q 1-2 weeks) to
obtained by monitoring for clinical improve-
activity for 4-6 weeks with controlled
exercise is recommended. If other dif- monitor for recovery of function ment without initiating glucocorticoid
therapy. Improvement of neurologic status
ferentials have not been excluded, care PROGNOSIS & OUTCOME with glucocorticoids is very nonspecific
must be taken to minimize the risk of and does not help to eliminate potential
further spinal cord injury (e.g., further disc • The prognosis for FCEM varies based on the differential diagnoses.
extrusion in an animal with intervertebral neurologic status at presentation and extent
disc disease). of the spinal cord injury. Technician Tips
○ Physical rehabilitation should be performed • Prognosis for dogs and cats with intact Nursing care is the mainstay of therapy for
at home by the owners and augmented by nociception (deep pain perception) at patients with FCEM. Patients with FCEM
sessions at a certified veterinary physical presentation is generally good to excellent. can take weeks to recover, and day-to-day
rehabilitation facility. These animals often return to an ambulatory improvement can be minimal in the hospital.
neurologic status within 2-3 weeks but can These cases require a great deal of work but
Behavior/Exercise have persistent neurologic deficits such as can be very rewarding.
Physical rehabilitation is important. urinary incontinence, fecal incontinence,
pelvic limb ataxia, and/or toe scuffing. Client Education
Possible Complications • As with any type of spinal cord injury, Clients should be informed of the commitment
• Decubital ulcers animals that lack nociception have a poor necessary to care for non-ambulatory patients at
○ Ensure adequate recumbency care. prognosis. home. Realistic expectations about the recovery
○ Initiate wound management if skin • Animals with lower motor neuron signs of a patient with FCEM should be discussed
ulceration is noted. (involvement of an intumescence) can have a with clients so that owners do not give up
• Pneumonia more guarded prognosis or more prolonged prematurely. Animals with FCEM can return
○ Ensure proper recumbency care. recovery. to a great quality of life as a functional pet but
○ Monitor appetite, respiratory rate, and • MRI and CSF analysis findings can provide may not return to normal.
body temperature. information regarding prognosis.
○ Perform thoracic radiograph if there is SUGGESTED READING
clinical suspicion of pneumonia. PEARLS & CONSIDERATIONS Bartholomew K, et al: Clinical characteristics of
• Urinary tract infection (p. 232) canine fibrocartilaginous embolic myelopathy
○ Monitor for hematuria, pollakiuria, Comments (FCE): a systemic review of 393 cases (1973-2013).
stranguria. • There should be strong clinical suspicion of Vet Rec 179:650, 2016.
○ Perform urinalysis and urine culture. FCEM when a dog presents with a peracute
○ Treat based on culture and sensitivity onset of nonprogressive signs of myelopathy AUTHOR: Hillary Greatting, DVM, MS, DACVIM, CCRT
EDITOR: Karen R. Muñana, DVM, MS, DACVIM
results. and is not painful on vertebral palpation.
• Muscle atrophy and loss of joint range of • An animal with FCEM will show evidence of
motion improvement, often over a few days, without

Fibrosarcoma Client Education
Sheet

BASIC INFORMATION • Sarcomas that are histologically low grade but • Regional lymphadenopathy may be present
biologically high grade (malignant behavior) secondary to inflammation or (rarely) lymph
Definition are an uncommon variant of fibrosarcoma node metastasis.
A common, primary, malignant neoplasm of found in the maxilla and mandible in large- • Dogs with a splenic fibrosarcoma may
fibrous tissue. Fibrosarcoma is most common breed dogs. present with an abdominal mass, pain, or
in the skin, subcutis, and oral cavity but can enlargement.
occur anywhere, including the spleen. HISTORY, CHIEF COMPLAINT
Most animals present with a progressive mass Etiology and Pathophysiology
Epidemiology noticed by the owner or clinical signs related to • Fibrosarcomas are spontaneously occurring
SPECIES, AGE, SEX the location of the tumor (e.g., oral or splenic tumors in most cases in dogs.
Fibrosarcomas are more common in middle- tumor). • Prior irradiation and metal implants have
aged to older dogs and cats. Injection-site been implicated as causes of fibrosarcoma.
sarcomas are discussed separately (p. 550). PHYSICAL EXAM FINDINGS There are cases of fibrosarcoma in cats
• Fibrosarcoma often appears as a firm, pal- developing at sites of microchips and surgical
Clinical Presentation pable mass in the subcutis or deep tissues; sponges.
DISEASE FORMS/SUBTYPES it is occasionally hairless or ulcerated. Oral • Specific dysfunction caused by fibrosarcomas
• The most common form of fibrosarcoma in fibrosarcomas often appear as smooth, round depends on the location of the primary
dogs is a solitary mass, typically found on masses. On the hard palate, fibrosarcomas tumor.
the head, limbs, or oral cavity. are frequently flat and ulcerated.

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