ISSN 2398-2969      

Granulomatous meningoencephalomyelitis

icanis
Contributor(s):

Paul Cuddon

Simon Platt

Synonym(s): Reticulosis, GME


Introduction

  • Small and toy breeds most commonly affected, although any breed can develop the disease.
  • Highest incidence occurs in dogs between 3-7 years age although any age dog can be affected.
  • Signs: generally multifocal presentation but can mimic many syndromes.
  • Diagnosis: cerebrospinal fluid analysis, and CT/MRI scans.
  • Treatment: corticosteroids at immunosuppresive doses, and/or other immunosuppressive drugs, and/or radiation therapy.
  • Prognosis: fair but relapses may occur. Dogs with multifocal signs have a poorer prognosis.

Pathogenesis

Pathophysiology

  • Histiocytes, or monocytes, which are derived from circulating monocytes → invade white matter following breakdown of blood-brain barrier → immune-mediated damage and general loss of structural detail and can develop into → discrete masses, especially cerebral white matter, thalamus, brain stem, cerebellum, spinal cord → increased production of intrathecal immunoglobulin.

Timecourse

  • With focal form of the disease signs progress slowly over several months.
  • Weeks to months.
  • With multifocal form of the disease signs are acute initially and then progress over 1-8 weeks.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Cherubini G B, Platt S R, Anderson T J et al (2006) Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs. Vet Rec 159, 110-115 PubMed.
  • Gnirs K (2006) Ciclosporin treatment of suspected granulomatous meningoencephalomyelitits in three dogs. JSAP 47, 201-206 PubMed.
  • Benigni L & Lamb C R (2005) Comparison of fluid-attenuated inversion recovery and T2-weighted magnetic resonance images in dogs and cats with suspected brain disease. Vet Radiol Ultrasound 46, 287-292 PubMed.
  • Adamo F P, O'Brien R T (2004) Use of cyclosporine to treat granulomatous meningoencephalitis in three dogs. JAVMA 225, 1211-1216 PubMed.
  • Kitagawa M, Kanayama K, Satoh T et al (2004) Cerebellar focal granulomatous meningoencephalitis in a dog: clinical findings anf MR imaging. J Vet Med A Physiol Pathol Clin Med 51, 277-279 PubMed.
  • Radaelli S T & Platt S R (2002) Bacterial meningoencephalomyelitis in dogs: a retrospective study of 23 cases (1990-1999). JVIM 16 (2), 159-163 PubMed.
  • Burtch M (1998) Granulomatous meningitis caused by Coccidiodes immitis in a dog. JAVMA 212 (6), 827-829 PubMed.
  • Kipar A et al (1998) Immunohistochemical characterization of inflammatory cells in the brains of dogs with granulomatous meningoencephalitis. Vet Pathol 35 (1), 43-52 PubMed.
  • Muñana K R et al (1998) Prognostic factors for dogs with granulomatous meningoencephalomyelitis - 42 cases (1982-1996). JAVMA 212 (12), 1902-1906 PubMed.
  • Sorjonen D C (1990) Clinical and histopathological features of granulomatous meningoencephalitis in dogs. JAAHA 26, 141-147 CAB Direct.
  • Sisson A F (1989) Radiation therapy for granulomatous meningoencephalitis of dogs. J Vet Int Med (2), 119.
  • Bailey C S (1986) Characteristics of CSF associated with canine granulomatous meningoecephalitis - a retrospective study. JAVMA 188 (4), 418-421 PubMed.
  • Braund K G (1985) Granulomatous meningoencephalomyelitisJAVMA 186 (2), 138-141 PubMed.

Other sources of information

  • Merck Veterinary Manual (1998) 8th edn. p 927.
  • Sisson A (1997) Encephalitis. In:The 5 minute Veterinary Consult - Canine and Feline. pp 544-545.
  • Oliver J E (1997) Handbook of Veterinary Neurology. 3rd edn. pp 361.
  • DeLahunta A (1983) Veterinary Neuroanatomy and Clinical Neurology. 2nd edn. pp 382.

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