Steroid-responsive meningitis

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr Paul Cuddon BVSc DipACVIM
Synonyms Aseptic meningitis

Introduction

  • Common(est) meningitis, usually <2 year old animals of larger breeds.
  • Signs : mimic cervical disk extrusion.
  • Breed: specific syndromes in Bernese Mountain Dog, Beagle.
  • Diagnosis : signs, CSF.
  • Treatment : corticosteroids.
  • Prognosis : may be acute or have relapsing pattern.

Diagnosis

Clinical signs

  • Cervical pain and rigidity.
  • Hyperesthesia.
  • Pyrexia.
  • Varying severity of neurologic dysfunction, including paresis, ataxia, siezures and/or cranial/nerve signs.

Diagnosis

Differential diagnosis

  • Granulomatous meningoencephalomyelitis Granulomatous meningoencephalomyelitis.
  • Acute cervical disk extrusion.
  • Idiopathic polyarthritis Arthritis: polyarthritis - idiopathic.
  • Polymyositis Polyarthritis polymyositis syndrome.
  • Brain trauma Brain: trauma.
  • Viral meningitis Meningitis.
  • Vertebral fracture/spinal trauma.
  • Spinal cord or vertebral neoplasia.
  • Brain neoplasia Brain: neoplasia.
  • Bacterial meningitis Meningitis.
  • Rickettsial meningitis Meningitis.
  • Spirochaete meningitis Meningitis.
  • Fungal meningitis Meningitis.
  • Protozoal meningitis Meningitis.

Sequelae

Prognosis

  • Decreases with increasing severity and duration of neurologic signs
  • Good: although some animals relapse.
  • Prognosis is poorer in dogs with strong breed-associated aseptic meningitis, eg Beagle, Bernese Mountain Dog.

Expected response to treatment

  • Dog should respond to drug therapy within 48 hours.
  • CSF and blood profile values should begin to normalize within 1-2 months after initial therapy.

Reasons for treatment failure

  • Recurrent signs due to inadequate steroid therapy (dosage or length of treatment) resulting in chronic disease.
  • Secondary spinal cord compression due to enlarged vessels or tissue ischemia

Sources

Publications

Refereed papers

  • Burgener I et al(1998) Chemotactic activity and IL-8 levels in the cerebrospinal fluid in canine steroid responsive meningitis-arteritis. J Neuroimmunol 89 (1-2), 182-190.
  • Haburjak J J et al(1997) Flavobacterium breve meningitis in a dog. JAHAA 33 (6), 509-512.
  • Hess P R et al(1997) Steroid-responsive, cervical, pyogranulomatous pachymeningitis in a dog. JAHAA 33 (5), 461-468.
  • Tipold A (1995) Diagnosis of inflammatory and infectious diseases of the central nervous system in dogs - a retrospective study. JVIM 9 (5), 304-314.
  • Tipold A et al(1995) Neuroimmunological studies in steroid-responsive meningitis-arteritis in dogs. Res Vet Sci 58 (2), 103-108.
  • Tipold A (1994) Steroid-responsive meningitis - arteritis in dogs; long term study of 32 cases. JSAP(35), 311-316.
  • Maretzki C H et al(1994) Granulocytic ehrlichiosis and meningitis in a dog. JAVMA 205 (11), 1554-1556.
  • Poncelet L et al(1993) Steroid-responsive meningitis in three boxer dogs. Vet Rec 132 (10), 361-362.
  • Sorjenen D C (1992) Myelitis and meningitis. Vet Clin North Am Sm Anim Pract 22 (4), 951-964.
  • Meric S M (1988) Canine meningitis - a changing emphasis. JVIM 2 (1), 26-35.
  • Meric S M (1985) Corticosteroid responsive meningitis in ten dogs. JAAHA 21 (5), 677-684.
  • Easley J R (1979) Necrotizing vasculitis - an overview. JAAHA 15 (2), 207-211.

Other sources of information

  • Merck Veterinary Manual. (1998) 8th edn. Merck and Co Inc, p. 581.
  • Taylor S M (1997) Bernese Mountain Dog steroid-responsive meningitis - polyarteritis. In: The 5 minute veterinary consult - canine and feline.p. 390.

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