ISSN 2398-2969      

Steroid-responsive meningitis-arteritis (SRMA)

icanis
Contributor(s):

Paul Cuddon

Laurent Garosi

Synonym(s): Necrotizing vasculitis, Beagle pain syndrome, aseptic suppurative meningitis, canine pain syndrome, canine juvenile polyarteritis syndrome.


Introduction

  • Common(est) meningitis, usually <2 year old animals of larger breeds.
  • Also known as necrotizing vasculitis, Beagle pain syndrome, aseptic suppurative meningitis, canine pain syndrome, canine juvenile polyarteritis syndrome.
  • Signs: mimic cervical disk extrusion.
  • Breed: specific syndromes in Bernese Mountain Dog, Beagle, Boxers, Weimeraners, and Nova Scotia duck tolling retreivers.
  • Diagnosis: signs, CSF.
  • Treatment: corticosteroids.
  • Prognosis: may be acute or have relapsing pattern.

Pathogenesis

Etiology

  • Immunopathologic basis suspected.
  • Idiopathic.
  • Disease is believed to be heritable.
  • Activated T cells have been demonstrated in dogs with SRMA indicating potential contact with an antigenic stimulus.
  • A Th2-mediated immune response is most likely based on the presence of high CD4:CD8a ratios and a high proportion of B cells in peripheral blood and CSF.

Predisposing factors

General

  • Frequent exposure to monovalent attenuated live virus vaccines may sensitize patient to viral antigen and increase the risk of developing an immune-mediated reaction.

Pathophysiology

  • Cerebral vessel injury due to immunologic disease → deposition of immune complexes in vessel walls → activation of Hageman Factor → activation of complement, kinin, and plasma systems → chemotaxis of neutrophils → enhanced vessel wall permeability → fibrin deposition, thrombosis and necrosis.
  • Clinical signs result from a combined meninigitis and arteritis of leptomeningeal vessels.
  • The arteritis also may involve the vessels of the heart, mediastinum and thyroid glands.

Timecourse

  • Slowly progressive course over several months
  • Animals may experience cyclic bouts of the disease with each bout lasting 5-10 days with intervening periods of complete or partial normalcy lasting at least one week.

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.
  • Eminaga S, Cherubin G B et al (2013) STIR muscle hyperintensity in the cervical muscles associated with inflammatory spinal cord disease of unknown origin. JSAP 54 (3), 137-142 PubMed.
  • Rose J H, Harcourt-Brown T R (2013) Screening diagnostics to identify triggers in 21 cass of steroid-responsive meningitis-arteritis. JSAP 54 (11), 575-578 PubMed.
  • Tipold A, Schatzberg S J (2010) An update on steroid responsive meninigitis-arteritis. JSAP 51 (3), 150-154 PubMed.
  • Lowrie M, Penderis J et al (2009) The role of acute phase proteins in diagnosis and management of steroid-responsive meningitis arteritis in dog. Vet J 182 (1), 125-130 PubMed.
  • Wrzosek M, Konar M et al (2009) Cerebral extension of steroid-responsive meningitis arteritis in a Boxer. JSAP 50 (1), 35-37 PubMed.
  • Behr S, Cauzinille L (2006) Aseptic suppurative meningitis in juvenile Boxer dogs: retrospective study of 12 cases. JAAHA 42 (4), 277-282 PubMed.
  • 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 KUNDOC.
  • Haburjak J J, Schubert T A  (1997) Flavobacterium breve meningitis in a dog. JAAHA 33 (6), 509-512 PubMed.
  • Hess P R, Sellon R K (1997) Steroid-responsive, cervical, pyogranulomatous pachymeningitis in a dog. JAAHA 33 (5), 461-468 PubMed.
  • Tipold A (1995) Diagnosis of inflammatory and infectious diseases of the central nervous system in dogs - a retrospective study. JVIM (5), 304-314 PubMed.
  • Tipold A, Vandevelde M, Zurbriggen A (1995) Neuroimmunological studies in steroid-responsive meningitis-arteritis in dogs. Res Vet Sci 58 (2), 103-108 PubMed.
  • Maretzki C H, Fisher D J, Greene C E (1994) Granulocytic ehrlichiosis and meningitis in a dog. JAVMA 205 (11), 1554-1556 PubMed.
  • Tipold A, Jaggy A (1994) Steroid responsive meningitis-arteritis in dogs: long term study of 32 cases. JSAP 35 (6), 311-316 VetMedResource.
  • Poncelet L, Balligand M (1993) Steroid-responsive meningitis in three boxer dogs. Vet Rec 132 (14), 361-362 PubMed.
  • Sorjonen D C (1992) Myelitis and meningitis. Vet Clin North Am Sm Anim Pract 22 (4), 951-964 PubMed.
  • Meric S M (1988) Canine meningitis - a changing emphasis. JVIM (1), 26-35 PubMed.
  • Meric S M, Perman V, Hardy R M (1985) Corticosteroid responsive meningitis in ten dogs. JAAHA 21 (5), 677-684 VetMedResource.
  • Easley J R (1979) Necrotizing vasculitis - an overview. JAAHA 15 (2), 207-211 VetMedResource.

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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