Ciclosporin use in multi‐drug therapy for meningoencephalomyelitis of unknown aetiology in dogs

Adamo, P. Filippo; Rylander, Harald; Adams, William Milton

doi:10.1111/j.1748-5827.2006.00303.x

Cited by 54 publications

(85 citation statements)

References 34 publications

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confidence: 78%

“…Thus, NME is suggested to be an idiopathic autoimmune CNS disease like granulomatous meningoencephalitis (GME). Beneficial but limited effects of various immunosuppressive drugs in autoimmune CNS inflammatory diseases have been reported previously [1,2,4,6,7,16].This report describes the clinical findings, serial magnetic resonance imaging (MRI) characteristics, histopathologic changes, and long-term management with cyclosporine in an NME case.A 4-year-old intact female Pekingese dog with a body weight of 3.9 kg was presented with a 1-week history of ataxia and seizure episodes. Neurological signs were observed suddenly and worsened gradually.…”

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confidence: 83%

“…Sci. 74(6): 765-769, 2012 Necrotizing meningoencephalitis (NME) is an idiopathic noninfectious inflammatory disorder of the brain in dogs and has been reported in various breeds, including the Pekingese, Yorkshire terrier, Maltese, Chihuahua, Pug and Shih tzu [2,5,7,8,[12][13][14]. While there is little information about the pathogenesis of NME, several previous reports [9,10,12] have described the presence of autoantibodies against glial fibrillary acidic protein in the cerebrospinal fluid (CSF) of affected dogs, indicating an autoimmune pathophysiology of NME.…”

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confidence: 99%

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Long-Term Immunosuppressive Therapy with Cyclosporine plus Prednisolone for Necrotizing Meningoencephalitis in a Pekingese Dog

Jung

Kim

Park

2012

The Journal of Veterinary Medical Science

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ABSTRACT. A 4-year-old intact female Pekingese dog was presented with ataxia and seizure episodes. Based on magnetic resonance imaging and cerebrospinal fluid analysis results, meningoencephalitis of unknown etiology was suspected. The present case survived for 1,096 days under cyclosporine plus prednisolone therapy and was definitively diagnosed with necrotizing meningoencephalitis. This report describes the clinical findings, serial magnetic resonance imaging characteristics and pathologic features of a necrotizing meningoencephalitis and long-term survival after cyclosporine with prednisolone therapy. KEY WORDS: canine, cyclosporine, necrotizing meningoencephalitis (NME).doi: 10.1292/jvms.11-0468; J. Vet. Med. Sci. 74(6): 765-769, 2012 Necrotizing meningoencephalitis (NME) is an idiopathic noninfectious inflammatory disorder of the brain in dogs and has been reported in various breeds, including the Pekingese, Yorkshire terrier, Maltese, Chihuahua, Pug and Shih tzu [2,5,7,8,[12][13][14]. While there is little information about the pathogenesis of NME, several previous reports [9,10,12] have described the presence of autoantibodies against glial fibrillary acidic protein in the cerebrospinal fluid (CSF) of affected dogs, indicating an autoimmune pathophysiology of NME. Thus, NME is suggested to be an idiopathic autoimmune CNS disease like granulomatous meningoencephalitis (GME). Beneficial but limited effects of various immunosuppressive drugs in autoimmune CNS inflammatory diseases have been reported previously [1,2,4,6,7,16].This report describes the clinical findings, serial magnetic resonance imaging (MRI) characteristics, histopathologic changes, and long-term management with cyclosporine in an NME case.A 4-year-old intact female Pekingese dog with a body weight of 3.9 kg was presented with a 1-week history of ataxia and seizure episodes. Neurological signs were observed suddenly and worsened gradually. On neurological examination, postural reactions of 4 limbs were reduced, and other reflexes, including cranial nerve and spinal reflexes, revealed no remarkable findings. The results of a fundus examination and other ophthalmologic examinations were normal. The results of complete blood count, serum chemistry profiling, and radiography were not remarkable. On the basis of a neurological examination, the clinical signs were deemed to be likely due to an intracranial lesion.We then performed a brain MRI scan using a 0.2-T scanner (E-scan ® , ESAOTE, Genova, Italy). T1-and T2-weighted images, and postcontrast T1-weighted images were obtained. Analysis of the images revealed multifocal lesions in the cerebrum (Fig. 1). Multiple, ill-defined hyperintense lesions were noted in the white matter area on both sides (left and right) of the frontal, parietal and temporal lobes including the cortical portion on T2-weighted images (Fig. 1B, 1D and 1F). These lesions appeared isointense or hypointense on T1-weighted images (Fig. 1A, 1C and 1E) and were not enhanced after a contrast study. Results of CSF analysis indi...

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confidence: 83%

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confidence: 99%

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Long-Term Immunosuppressive Therapy with Cyclosporine plus Prednisolone for Necrotizing Meningoencephalitis in a Pekingese Dog

Jung

Kim

Park

2012

The Journal of Veterinary Medical Science

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“…Radiation therapy has also been reported for the treatment of GME [15]. The approximate survival time of patients with GME with each therapy is: 930 days with cyclosporin, 420 days with procarbazine, 531 days with cytosine arabinosid and 404 days with radiation therapy [1,4,23]. The survival time of cases with focal lesions that were given corticosteroids alone was 41 days (3 to >1215 days) [15].…”

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confidence: 99%

“…Several therapies for GME have been reported. Previously reported therapies include immunosuppressive therapy such as cyclosporin, cytosine arabinosid and procarbazine [1,4,23]. These drugs are given either together with a corticosteroid or other drug, or alone.…”

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Ocular Granulomatous Meningoencephalomyelitis in a Dog: Magnetic Resonance Images and Clinical Findings

Kitagawa

Okada

Watari

et al. 2009

The Journal of Veterinary Medical Science

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ABSTRACT. A 4-year-old female miniature dachshund presented with a history of progressive decrease in vision, neck pain, and ataxia for which an MRI was performed 21 days after the initial consultation. The optic nerves showed isointensities on T1-(T1W) and T2-weighted (T2W) images that were enhanced by the contrast medium. The optic chiasm was swollen. Other parts of the cerebral parenchyma, not only the visual pathway, showed symmetrical hyperintensities on T2W images. Cerebrospinal fluid showed increased anti-GFAP autoantibodies. The dog received corticosteroid therapy despite which she exhibited anorexia, vomiting, and lethargy. Hence, a follow-up MRI was repeated 30 days after the initial consultation in which T2W images showed enlargement of the hyperintense area. The dog died 45 days after the initial consultation. Postmortem pathological examination confirmed a diagnosis of granulomatous meningoencephalomyelitis (GME). KEY WORDS: canine, MRI, ocular GME.J. Vet. Med. Sci. 71(2): 233-237, 2009 Granulomatous meningoencephalomyelitis (GME) is an idiopathic inflammatory disorder of the central nervous system. Depending on the mode of onset, it is classified into 3 forms: focal, disseminated, and ocular [9]. GME mainly develops in the cerebrum, brain stem, cerebellum, and spinal cord, although it can also develop in the eyes [9]. The definitive diagnosis of GME is made by histopathological examination although several studies have revealed that imaging procedures such as magnetic resonance imaging (MRI) and computed tomography (CT), and cerebrospinal fluid (CSF) antibody tests assist in the clinical diagnosis [12,13,21].Many studies have reported the MRI findings of focal and disseminated forms of GME with few studies presenting those of the ocular form. We report the clinical signs and MRI findings of ocular form GME that was pathologically diagnosed in a dog.A 4-year-old female miniature dachshund had a 2-month history of progressive decrease in vision leading to blindness. She developed neck pain and ataxia 1 month after the onset of her symptoms. When dexamethasone administration at a local clinic did not receive in alleviation of her symptoms, the dog was brought to Nihon University Animal Medical Center. On preliminary examination, bilateral pupillary dilatation was observed without ocular signs such as discharge or conjunctival hyperemia. Ocular tension was slightly increased in both eyes (L23, R24 mmHg; reference values 19.2-5.9 [8]). Fundus examination revealed an irregular left optic disc suggestive of papilledema. Ultrasonic imaging of the eyes revealed enlargement of the optic discs.Neurological examination revealed a decreased menace reaction, pupillary dilatation, and loss of the light reflex in both eyes. An MRI was planned, but it was delayed due to the owner's circumstances, and corticosteroid therapy was continued. Since the dog exhibited circling to the left, MRI and CSF collection were performed 21 days after the initial consultation. The left and right optic nerves showed isointensities...

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Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

Woolcock

Wang

Haley

et al. 2016

Veterinary Medicine & Sci

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The use of mycophenolate mofetil (MMF) for a variety of immune‐mediated diseases in veterinary medicine has been described. However, there is only a small number of cases documenting its use in dogs with meningoencephalomyelitis of unknown aetiology (MUE). We hypothesized that the use of MMF and corticosteroids in dogs with MUE results in comparable survival data to other published treatment protocols and is associated with limited adverse effects. A retrospective study of medical case records of dogs clinically diagnosed with MUE recorded signalment, neuroanatomic localization, magnetic resonance imaging findings, cerebrospinal fluid analysis results, medications administered, follow‐up neurologic examinations, survival and adverse events. Variables were compared between dogs which were treated with MMF within 30 days of diagnosis (immediate group) vs. dogs in which MMF therapy was started >30 days after diagnosis (delayed group). Twenty‐five cases of MUE were identified. The overall median survival time from diagnosis was 731 days (range 43–1672 days). After 1 month of MMF treatment, 92% of dogs showed improvement on a neurological examination. There was no significant effect of any recorded parameter on survival, including delayed vs. immediate initiation of MMF treatment. Dogs with delayed treatment had significantly lower clinical remission rates than dogs with immediate treatment at 6 months after starting MMF. Adverse events were identified in two cases (8%) and were characterized by mild gastrointestinal signs (vomiting and decreased appetite). Administration of MMF appears safe in dogs with MUE. The use of MMF results in comparable survival times to alternate immunosuppressive protocols.

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Ciclosporin use in multi‐drug therapy for meningoencephalomyelitis of unknown aetiology in dogs

Abstract: Results suggest that ciclosporin either alone or in combination with ketoconazole may be a safe and effective treatment for meningoencephalomyelitis of unknown aetiology in dogs.

Cited by 54 publications

References 34 publications

Long-Term Immunosuppressive Therapy with Cyclosporine plus Prednisolone for Necrotizing Meningoencephalitis in a Pekingese Dog

Long-Term Immunosuppressive Therapy with Cyclosporine plus Prednisolone for Necrotizing Meningoencephalitis in a Pekingese Dog

Ocular Granulomatous Meningoencephalomyelitis in a Dog: Magnetic Resonance Images and Clinical Findings

Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

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