Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long‐term disability

Gonçalves, Rita; De Decker, Steven; Walmsley, Gemma; Maddox, Thomas W.

doi:10.1111/jvim.17037

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…A worth-mentioning nding is the difference in optimal cut-off values on the NDS2 scale. Regarding the 6-month survival, a threshold of 7 points has been proposed [11].…”

Section: Discussionmentioning

confidence: 99%

“…Brie y, the modi ed MGCS is a 14-point scale (minimum 3 points, maximum 16 points), positively linked with the neurological status, which assess 3 functional areas of the nervous system: motor activity, brainstem re exes, and consciousness. The categorization of MGCS into scores indicating good (15)(16)(17)(18), guarded (9)(10)(11)(12)(13)(14), and poor (≤8) prognosis has been proposed [19]. NDS1 is a 21-point scale (minimum 0 points, maximum 20 points), negatively linked with the neurological status (i.e.…”

Section: Scoring Systemmentioning

confidence: 99%

“…It has recently been shown that the higher neurodisability score at presentation was negatively associated with survival to 6 months. [11] The current state of knowledge is even less advanced in terms of long-term prognosis. Therefore, the knowledge gained is not easily applicable for clinical use, and need for establishment of robust clinical scores for evaluation of treatment has been suggested.…”

Section: Introductionmentioning

confidence: 99%

“…Later on usefulness of NDS2 in middle term (6 months) prognostication was con rmed. [11] The present study aimed to determine (1) whether MGCS, NDS1, or NDS2 scores at admission were associated with the survival time of YST with MUO (primary endpoint), and (2) whether they play role in providing the short-term (7 days), midterm (100 days), or long-term prognosis (365 days). Moreover, we investigated which factors were associated with the resolution of neurological signs (secondary endpoint).…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of neurological assessment scales in prognosis of meningoencephalitis of unknown origin in Yorkshire Terriers

Brewińska,

Banasik,

Czopowicz

et al. 2024

Preprint

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Background – Attempts to determine the prognostic factors that affect the survival time of canine patients with meningoencephalitis of unknown origin (MUO) have provided highly variable results. Scaled complex ratings to predict general outcomes are required. This study aimed to determine whether neurological assessment scales could be useful in the prognosis of Yorkshire Terriers with MUO. The study population comprised 127 Yorkshire terriers who met the inclusion criteria for a highly probable diagnosis of MUO. This multicenter, cohort study was designed as a retrospective review of medical records. Based on documented neurological examinations, animals were scored on three scales: the Modified Glasgow Coma Scale, Neuro Disability Scale 1 (Smith et al.), and Neuro Disability Scale 2 (Gonçalves et al.). The association between the scores and survival time was investigated over three time periods. Results – All scales were significantly associated (p<0.001) with MUO-specific survival and death owing to MUO within the first 7 days and had high prognostic accuracy in terms of short-term prognosis. None of the scales was significantly associated with the probability of survival after 100 or 365 days. Dogs with unilateral lesions on magnetic resonance images (MRI) had approximately 12- and 3-fold higher odds of surviving until 100 and 365 days, respectively, than dogs with bilateral lesions on MRI. Dogs heavier than 3.2 kg at presentation had approximately 6-fold higher odds of survival until day 365. Conclusions - The study provides strong evidence for a high short-term prognostic accuracy of the three neurological assessment scales in Yorkshire Terriers with MUO – the scales seem to be very useful in predicting death within the first week of the onset of MUO. Prognostic potential of the scales disappears, however, in the longer perspective and their place is taken by the spread of pathological lesions visualized in MRI and a patient’s weight.

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“…A worth-mentioning nding is the difference in optimal cut-off values on the NDS2 scale. Regarding the 6-month survival, a threshold of 7 points has been proposed [11].…”

Section: Discussionmentioning

confidence: 99%

Section: Scoring Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Usefulness of neurological assessment scales in prognosis of meningoencephalitis of unknown origin in Yorkshire Terriers

Brewińska,

Banasik,

Czopowicz

et al. 2024

Preprint

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Clinical signs, diagnostic imaging, histopathology and outcome in a dog with meningoencephalomyelitis of unknown origin and concurrent involvement of the cauda equina and left sciatic nerve

Loncarica,

Mandara,

La Rosa

et al. 2024

Vet Record Case Reports

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A 3‐year‐old, female, neutered toy poodle dog was presented with generalised tremors, neck pain and obtundation. Neurological examination revealed a multifocal localisation (brainstem and cervical spinal cord). Magnetic resonance imaging findings and cerebrospinal fluid tap were consistent with meningoencephalomyelitis of unknown origin. After immunosuppressive treatment, the dog improved, but while tapering experienced two relapses. During the second relapse, clinical presentation revealed multifocal clinical signs affecting the brainstem, the lumbosacral spinal cord and the left sciatic nerve. Magnetic resonance imagings of the brain, lumbosacral spinal cord and the left sciatic nerve, cerebrospinal fluid analysis and histopathology of the left sciatic nerve confirmed a recurrence of a meningoencephalomyelitis of unknown origin involving the central nervous system and the peripheral nervous system. Immunosuppressive treatment was re‐instituted, with improvement of clinical signs. At 1‐year follow‐up, the dog remains clinically stable with no treatment.

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Clinical presentation, diagnostic findings and short‐term outcome in French bulldogs with presumptive spinal only meningoencephalomyelitis of unknown origin: 15 cases (2016‐2023)

Boudou,

Troupel,

Bedu

et al. 2024

J of Small Animal Practice

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ObjectivesTo describe clinical presentation, diagnostic findings and outcome of presumptive spinal only meningoencephalomyelitis of unknown origin in French bulldogs, and to compare clinical presentation between intervertebral disc herniation and spinal only meningoencephalomyelitis of unknown origin in this breed.Material and MethodsMedical records of French bulldogs diagnosed with presumptive spinal only meningoencephalomyelitis of unknown origin in seven referral centres were reviewed. Clinical presentation was compared to a group of French bulldogs with intervertebral disc herniation.ResultsFifteen French bulldogs were included. Median age at presentation was 31 months. Most dogs were presented with a chronic onset (54%), and the median duration of clinical signs before diagnosis was 21 days. The most common presentation was ambulatory paresis and proprioceptive ataxia (80%). Spinal pain was uncommon (20%). There was no preferential location between the cervical and thoracolumbar segments. In all but one case, magnetic resonance imaging revealed broad focal or multifocal, poorly defined, intramedullary lesions that typically appeared hyperintense on T2W images and isointense on T1W images with parenchymal and/or meningeal contrast enhancement in 12 dogs (80%). Median total nucleated cell count in cerebrospinal fluid was 15 cells/mm3 with predominance of mononuclear cells in all cases. Follow‐up (available for 12 dogs, ranging from 1 month to 1 year) indicated initial positive response to various immunosuppressive treatments in all but one case, with subsequent suspected relapse in three cases. Dogs with spinal only meningoencephalomyelitis of unknown origin had longer clinical sign duration compared to intervertebral disc herniation cases (60 dogs) (21 days compared to 3 days, respectively) and less frequent spinal pain during examination (20% compared to 75%, respectively).Clinical SignificanceSpinal only meningoencephalomyelitis of unknown origin is an uncommon cause of myelopathy in French bulldogs that should be particularly considered in young adults with non‐acute and non‐painful presentation.

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Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long‐term disability

Cited by 5 publications

References 41 publications

Usefulness of neurological assessment scales in prognosis of meningoencephalitis of unknown origin in Yorkshire Terriers

Usefulness of neurological assessment scales in prognosis of meningoencephalitis of unknown origin in Yorkshire Terriers

Clinical signs, diagnostic imaging, histopathology and outcome in a dog with meningoencephalomyelitis of unknown origin and concurrent involvement of the cauda equina and left sciatic nerve

Clinical presentation, diagnostic findings and short‐term outcome in French bulldogs with presumptive spinal only meningoencephalomyelitis of unknown origin: 15 cases (2016‐2023)

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