Treatment of granulomatous meningoencephalomyelitis in a dog

Abstract

The clinical work-up, diagnosis and follow-up of an 8-year-old, female-spayed Shih Tzu with diffuse, granulomatous meningoencephalomyelitis (GME)-causing visual deficits is reported. The use of cytosine arabinoside as an alternative treatment for GME is discussed.

Perspectives on Meningoencephalomyelitis of Unknown Origin

“…Reported second-line immunosuppressive drug therapies for MUO include leflunomide, 145 procarbazine, 146 cytosine arabinoside, 17,[147][148][149][150][151][152] lomustine, 144,153 mycophenolate mofetil, 154 azathioprine 155 ; COP 149 (cyclophosphamide, vincristine, prednisone), and cyclosporine ( Table 3). 118,[155][156][157][158][159] Radiation therapy has also proved to be effective for focal GME lesions.…”

“…144 Selection of a specific immunosuppressive protocol depends on the clinician's decision, the patient's clinical status, and the pet owner's financial considerations. In accordance with guidelines from other studies, 17,147,148,151 a common protocol is daily administration of prednisone at an immunosuppressive dose combined with cytosine arabinoside administered at 50 mg/m 2 every 12 hours as a subcutaneous bolus for 2 consecutive days, or by intravenous infusion at 200 mg/m 2 over 8 hours. The treatment cycle is repeated every 3 to 4 weeks for 3 cycles.…”

“…17,[144][145][146][147][148][149][150][151][152][153][154][155][156][157][158][159] MR imaging may offer a broader assessment by which to guide therapy in dogs with MUO. MR imaging abnormalities of foramen magnum herniation, loss of cerebral sulci, or mass effect attributable to MUO have been associated with reduced survival time.…”

Efficacy of the Use of a Colorimetric Pupil Light Reflex Device in the Diagnosis of Fundus Disease or Optic Pathway Disease in Dogs

“…The fundus may be normal if the condition is completely retrobulbar, but the typical appearance is congestion and a swollen optic disc with deviation of the retinal blood vessels. Central blindness resulting in progressive vision loss has been reported in association with hydrocephalus, neoplasia of the central nervous system and granulomatous meningoencephalomyelitis (GME) [5, 16]. Intracranial tumors compressing the optic chiasm result in total vision loss with complete or near-complete loss of PLR [3].…”

Encefalopatias não-infecciosas em cães: análise anatomopatológica e imunohistoquímica

“…Em casos de MEG focal, a lesão é resultante da coalescência de infiltrados perivasculares em uma grande área, acometendo vários vasos sanguíneos . A forma ocular também apresenta os mesmos manguitos perivasculares, mas localizados no nervo óptico e quiasma óptico, na região da retina ou pós-retina (NUHSBAUM, 2002).…”