An update on meningoencephalomyelitis of unknown aetiology in dogs

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Published: Dec 19, 2017
DOI: https://doi.org/10.12681/jhvms.15486
Keywords:
dog inflammatory diseases meningoecephalomyelitis nervous system
M. CHARALAMBOUS (Μ. ΧΑΡΑΛΑΜΠΟΥΣ)
Queen’s Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge
T. DANOURDIS (Τ. ΔΑΝΟΥΡΔΗΣ)
A. HATZIS (Α. ΧΑΤΖΗΣ)
Z. S. POLIZOPOULOU (Ζ. ΠΟΛΥΖΟΠΟΥΛΟΥ)
Diagnostic Laboratory, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki
Abstract

Inflammatory diseases of the central nervous system are common causes of neurological dysfunction in the dog and can be grouped into two broad categories; those of infectious and those of unknown aetiology. Μeningoencephalomyelitis of unknown aetiology include non-infectious inflammatory central nervous system diseases in which abnormal findings on magnetic resonance imaging and cerebrospinal fluid analysis indicate inflammatory central nervous system disease, but for which histopathological confirmation has not been reached. Meningoencephalomyelitis of unknown aetiology describes a group of non-infectious inflammatory diseases of the central nervous system. These include the granulomatous meningoencephalomyelitis and the necrotising encephalitis, the latter can be further distinguished into two subtypes: necrotising meningoencephalitis and necrotising leucoencephalitis. Steroid-responsive meningitis-arteritis may be also included to this category and, usually, does not present signs of encephalitis or/and myelitis (except in the chronic form) and is easier diagnosed even without histopathological examination. In most cases of meningoencephalomyelitis of unknown aetiology, a presumptive diagnosis can be achieved by the assessment of case presentation, theneurologic signs, cerebrospinal fluid testing, cross-sectional imaging of the central nervous system and appropriate microbiological tests.

Definite diagnosis is achieved with histopathological examination. The underlying cause for these diseases is unknown. The clinical signs in meningoencephalomyelitis of unknown aetiology is variable and depends on which area of the central nervous sytem is affected. Meningoencephalomyelitis is acute in onset, progressive in nature and associated with multifocal to diffuse neuroanatomic localization. Extraneural signs are less common and these usually include pyrexia and peripheral neutrophilia. The differential diagnosis for dogs presented for an acute onset of multifocal central nervous system signs includes genetic abnormalities, metabolic disorders, infectious meningoencephalitis, toxin exposure, stroke and neoplasia.
The diagnostic approach includes a complete blood count, a comprehensive chemistry panel, urinalysis, survey radiographs of the thorax plus abdominal ultrasound to rule out systematic disease and metastatic neoplasia, computed-tomography or magnetic reso meningitisnance imaging, cerebrospinal fluid analysis and microbiological tests.

When neoplasia is suspected, computed-tomography-guided brain biopsy may be required for the differentiation. Meningoencephalomyelitis of unknown aetiology responds more or less to immunosuppressive therapies, but the prognosis should be guarded to poor with the exception of steroid-responsive meningitisarteritis, for which it is good. Treatment protocols are based on prednisolone, but new immunosuppressive agents have now been added in those to control the diseases and they seem to be effective. However, gold standard protocols have yet to be established.

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References
Alley MR, Jones BR, Johnstone AC (1983) Granulomatous meningoencephalomyelitis of dogs in New Zealand. NZ Vet J 31:117-119.
Bateman SW, Parent JM (1999) Clinical findings, treatment, and outcome of dogs with status epilepticus or cluster seizures: 156 cases (1990-1995). J Am Vet Med Assoc 215:1463-1468.
Bathen-Noethen AR, Carlson D, Menzel R, Mischke, Tipold A (2008) Concentrations of acute-phase proteins in dogs with steroid responsive meningitis-arteritis J Vet Intern Med 22:1149-1156.
Berthelin CF, Legendre AM, Bailey CS, Kass PH, Wolf AM (1994). Cryptococcosis of the nervous system in dogs, part 2: diagnosis, treatment, monitoring, and prognosis. Prog Vet Neurol 5:136- 146.
Bjorkman C, Uggla A (1999) Serological diagnosis of Neospora caninum infection. Int J Parasitol 29:1497-1507.
Braund KG (1980) Encephalitis and meningitis. Vet Clin North Am Small Anim Pract 10:31-56.
Braund KG (1985) Granulomatous meningoencephalomyelitis. J Am Vet Med Assoc 186:138-141.
Braund KG, Vandevelde M, Walker, TL, Redding RW (1978) Granulomatous meningoencephalomyelitis in six dogs. J Am Vet Med Assoc 172:1195-1200.
Cerón JJ, Eckersall PD, Martínez-Subiela S (2005) Acute phase proteins in dogs and cats: current knowledge and future perspectives Vet Clin Pathol 34:85–99.
Cherubini G, Platt S, Anderson T, Rusbrige C, Lorenzo V, Manis P, Cappello R (2006) Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs. Vet Rec 159:110-5.
Cizinauskas S, Jaggy A, Tipold A (2000) Long-term treatment of dogs with steroid-responsive meningitis–arteritis: clinical, laboratory and therapeutic results J Small Anim Pract 41:295-301.
Coates JR (2011) An update on immune-mediated brain disease in dogs. Proceedings of the BSAVA Congress, (Birmingham, United Kingdom), pp. 1-3.
Coates JR, Barone G, Dewey CW, Vitale CL, Holloway-Azene NM, Sessions JK (2007) Procarcazine as adjunctive therapy for treatment of dogs with presumptive antemortem diagnosis of granulomatous meningoencephalomyelitis: 21 cases (1998-2004). J Vet Intern Med 21:100-106.
Cordy DR (1979) Canine granulomatous meningoencephalomyelitis. Vet Pathol 16:325-333.
Cordy DR, Holliday TA (1989) A necrotizing meningoencephalitis of pug dogs. Vet Pathol 26:191-194.
De Lahunta A, Glass E (2009) Veterinary Neuroanatomy and Clinical Neurology, 3rd edn. Saunders, St. Louis.
Demierre S, Tipold A, Griot-Wenk ME, Welle W, Vandevelde M, Jaggy A (2001) Correlation between the clinical course of granulomatous meningoencephalomyelitis in dogs and the extent of mast cell infiltration. Vet Rec 148:467-472.
Di Terlizzi R, Platt S (2006) The function, composition and analysis of cerebrospinal fluid in companion animals: Part I – Function and composition. Vet J 172:422-431.
Friedland IR and Mccracken GH (1994) Drug-therapy - management of infections caused by antibiotic-resistant streptococcuspneumoniae. N Engl J Med 331:377-382.
Glastonbury JR, Frauenfelder AR (1981) Granulomatous meningoencephalomyelitis in a dog. Aust Vet J 57:186-189.
Granger N, Smith PM, Jeffery ND (2010) Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008. Vet J 184 290-297.
Greer KA, Schatzberg SJ, Porter BF, Jones KA, Famula TR, Murphy KE (2008) Heritability and transmission analysis of necrotizing meningoencephalitis in the Pug. Res Vet Sci 86:438-442.
Harcourt RA (1978) Polyarteritis in a colony of Beagles. Vet Rec 102:519–522.
Harris CW, Didier PJ, Parker AJ (1988) Simultaneous central nervous system reticulosis in two related Afghan hounds. Comp Contin Educ Pract Vet 10:304-310.
Hayes TJ, Roberts GKS, Halliwell WH (1989) An idiopathic febrile necrotizing arteritis syndrome in the dog: beagle pain syndrome Toxicol. Pathol 17:129-137.
Kipar A, Baumgartner W, Vogl C, Gaedke K, Wellman M (1998) Immunohistochemical characterization of inflammatory cells in brains of dogs with granulomatous meningoencephalitis. Vet Pathol 35:43-52.
Kitagawa M, Okada M, Watari T, Sato T, Kanayama K, Sakai T (2009) Ocular granulomatous meningoencephalomyelitis in a dog: magnetic resonance images and clinical findings. J Vet Med Sci 71:233-237.
Klein BU, Muller E (2001) Seroprevalence of antibodies to Neospora caninum in dogs with and without clinical suspicion for neosporosis in Germany. Praktische Tierarzt 82:437-440.
Kuwamura M, Adachi T, Yamate J, Kotani T, Ohashi F, Summers BA (2002) Necrotising encephalitis in the Yorkshire terrier: a case report and literature review. J Small Anim Pract 43:459-463.
LeCouteur R. (2009) Inflammatory brain disorders of dogs: GME, NME, NE and SRMA. Proceedings of the CVC conference (Baltimore, Maryland, USA), p. 4-6.
Lowrie M (2011) Steroid Responsive Meningitis-Arteritis: a Prospective Study of Potential Disease Markers, Prednisolone Treatment and Long-Term Outcome in 20 Dogs (2006-2008). Master of Veterinary Medicine Thesis, University of Glasgow.
Lowrie M, Anderson TJ, Penderis J (2008). Steroid responsive meningitis-arteritis in dogs. Comp Anim 13:41-47
Lowrie M, Penderis J, Eckersall PD, McLaughlin M, Mellor D, Anderson TJ (2009) The role of acute phase proteins in diagnosis and management of steroid-responsive meningitis arteritis in dogs. Vet J 182:125-130.
Matsuki N, Takahashi M, Yaegashi M; Tamahara S, Ono K (2009) Serial examinations of anti-GFAP autoantibodies in cerebrospinal fluids in canine necrotizing meningoencephalitis. J Vet Med Sci 71:99-100.
Meric S, Perman V, Hardy RM (1985) Corticosteroid-responsive meningitis in ten dogs. J Am Anim Hosp Assoc 21:677–684.
Munana KR (1996) Encephalitis and meningitis. Vet Clin North Am Small Anim Pract 26:857-874.
Munana KR, Luttgen PJ (1998) Prognostic factors for dogs with granulomatous meningoencephalomyelitis: 42 cases (1982- 1996). J Am Vet Med Assoc 212:1902-1906.
Olby N (2010) Meningoencephalitis of unknown origin - the rationale for treatment. Proceedings of the 65th SCIVAC international congress (Rimini, Italy), pp. 403-404.
Penderis J (2008) Common non-surgical diseases of the canine spine. Proceedings of the 33rd World Small Animal Veterinary Congress (Dublin, Ireland), pp. 476-479.
Percy DH, Munnel JF, Olander HJ, Carmichaeî LE (1970) Pathogenesis of canine herpesvirus encephalitis. Am J Vet Res 31:145-56.
Plummer SB, Wheeler SJ, Thrall DE, Kornegay JN (1992) Computed tomography of primary inflammatory brain disorders in dogs and cats. Vet Radiol Ultrasound 33:307-312.
Poncelet L, Balligand M (1993) Steroid responsive meningitis in three boxer dogs. Vet Rec 132:361-362.
Radaelli ST, Platt SR (2002) Bacterial meningoencephalomyelitis in dogs: a retrospective study of 23 cases (1990-1999). J Vet Intern Med 16:159-163.
Robin D, Delverdier M, Raymond I, Asimus E, Mathon D, Autefage A (1993) Granulomatous meningoencephalomyelitis in a dog: case report. Rev Med Vet 144:879-884.
Russo ME (1979) Primary reticulosis of the central nervous system in dogs. J Am Vet Med Assoc 174:492-500.
Schatzberg SJ (2010) Idiopathic granulomatous and necrotizing inflammatory disorders of the canine central nervous system. Vet Clin Small Anim 40:101-120
Schatzberg SJ, Haley NJ, De Lahunda A, Sharp NJ (2005) Polymerase chain reaction screening for DNA viruses in paraffin embedded brains from dogs with necrotizing meningoencephalitis, necrotizing leukoencephalitis, and granulomatous meningoencephalitis. J Vet Intern Med 19:553-559.
Schwartz M, Puff C, Stein VM, Baumgärtner W, Tipold A (2011) Pathogenetic factors for excessive IgA production: Th2-
dominated immune response in canine steroid-responsive meningitis-arteritis. Vet J 187:260-266.
Scott-Moncrieff JC, Snyder PW, Glickman LT, Davis EL, Felsbüro PJ (1992) Systemic necrotizing vasculitis in nine young Beagles. J Am Vet Med Ass 201:1553–1558.
Shibuya M, Matsuki N, Fujiwara K, Imajoh-Ohmi S, Fukuda H, Pham NT, Tamahara S, Ono K (2007) Autoantibodies against glial fibrillary acidic protein (GFAP) in cerebrospinal fluids from Pug with necrotizing meningoencephalitis. J Vet Med Sci 69:241-5.
Sorjonen DC (1990) Clinical and histopathological features of granulomatous meningoencephalomyelitis in dogs. J Am Anim Hosp Assoc 26:141-147.
Speciale J, Van Winkle TJ, Steinberg SA, Wortman JA (1992) Computed tomography in the diagnosis of focal granulomatous meningoencephalitis: retrospective evaluation of three cases. J Am Anim Hosp Assoc 28:327-32.
Spencer JA, Witherow AK, Blagburn BL (2000) A random amplified polymorphic DNA polymerase chain reaction technique that differentiates between Neospora species. J Parasitol 86:1366-1368.
Summers B, Cummings J, de Lahunta A (1995).Veterinary Neuropathology. Mosby, St Louis.
Sutton RH, Atwell RB (1982) Nervous disorders in dogs associated with levamisole therapy. J Small Anim Pract 23:391-397.
Thomas WB (1998) Inflammatory diseases of the central nervous system in dogs. Clin Tech Small Anim Pract 13:167-78.
Tipold A (1995) Diagnosis of inflammatory and infectious diseases of the central nervous system in dogs: a retrospective study. J Vet Intern Med 9:304-314.
Tipold A (2000) Steroid-responsive meningitis-arteritis in dogs: computed tomographic findings. Proceedings of the 14th annual symposium of the European Society of Veterinary Neurology (London, United Kingdom), p. 52.
Tipold A (2000) Steroid-responsive meningitis-arteritis in dogs. In:(ed.: Bonagura JD) Kirk’s Current Veterinary Therapy XIII: Small Animal Practice, 3rd edn. Saunders, Philadelphia, pp. 978-981.
Tipold A, Jaggy A (1994) Steroid responsive meningitis-arteritis in dogs: long-term study of 32 cases. J Small Anim Pract 35:311- 316.
Tipold A, Schatzberg SJ (2010) An update on steroid responsive meningitis-arteritis. J Small Anim Pract 51:150-154.
Tipold A, Vandevelde M, Zurbriggen A (1995) Neuroimmunological studies in steroid-responsive meningitis-arteritis in dogs. Res Vet Sci 58:103-108.
Vandevelde M, Fatzer R, Fankhauser R (1981) Immunohistological studies on primary reticulosis of the canine brain. Vet Pathol 18:577-588.
Von Praun F, Matiasek K, Grevel V, Alef M, Flegel T (2006) Magnetic resonance imaging and pathologic findings associated with necrotizing encephalitis in two Yorkshire terriers. Vet Radiol Ultrasound 47:260-264
Webb AA , Taylor SM, Muir GD (2002) Steroid-responsive meningitisarteritis in dogs with noninfectious, nonerosive, idiopathic, immune-mediated polyarthritis. J Vet Intern Med 16:269-273.
Whitley RJ, Gnann JW (2002) Viral encephalitis: familiar infections and emerging pathogens. Lancet 359:507-13.
Wrzosek M, Konar M, Vandevelde M, Oevermann A (2009) Cerebral extension of steroid responsive meningitis-arteritis in a boxer. J Small Anim Pract 50:35–37
Young B, Levine JL, Fosgate A, De Lahunda A, Flegel T, Matiasel K, Miller A, Silver G, Sharp N, Greer K, Schatzberg SJ (2009) Magnetic resonance imaging characteristics of Necrotizing meningoencephalitis in Pug dogs. J Vet Intern Med 23:527-535.
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