Unsuccessful Cyclosporine plus Prednisolone Therapy for Autoimmune Meningoencephalitis in Three Dogs

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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“…; Jung et al . ). Therefore, an added immunosuppressive may convey a benefit in the treatment of MUE in dogs (Granger et al .…”

Section: Introductionmentioning

confidence: 99%

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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“…NLE has been diagnosed mainly in Yorkshire dogs (TIPOLD et al, 1993;KUWAMURA et al, 2002;SCHATZBERG et al, 2005;VON PRAUN et al, 2006;LEZMI et al, 2007;BEARD et al, 2011;PARK et al, 2014). Additionally, NLE was also observed in one Chihuahua and two French bulldogs (COOPER et al, 2014), and in the Shih Tzu and a Maltese breed of dogs (JUNG et al, 2013;KIM et al, 2014). Although there are 25 cases reported with NLE, the worldwide actual incidence of the disease is surely underestimated; the disease is well known in Europe and USA from over 20 years.…”

Section: Discussionmentioning

confidence: 99%

“…However, the diagnosis of NLE in a new geographical location where the disease was not previously registered may contribute to the knowledge of the NE epidemiology. NLE has been diagnosed in Asia, North America, Europe and Oceania (TIPOLD et al, 1993;KUWAMURA et al, 2002;SCHATZBERG et al, 2005;VON PRAUN et al, 2006;LEZMI et al, 2007;BEARD et al, 2011;JUNG et al, 2013;KIM et al, 2014;PARK et al, 2014); nevertheless, there is no report of this disease in South America. Consequently, the importance of this study lies in the characterization of NLE in a Yorkshire dog from Brazil, suggesting that the distribution of this neurological syndrome is worldwide.…”

Section: Discussionmentioning

confidence: 99%

“…In NME lesions affecting the cerebral gray matter is the main feature of the disease (PARK et al, 2014), while necrosis is restricted to the deep white matter of the cerebrum and/or brainstem in NLE (TIPOLD et al, 1993;LEZMI et al, 2007). Although NLE has been described in dogs from North America (SCHATZBERG et al, 2005), Europe (TIPOLD et al, 1993;LEZMI et al, 2007), and Asia (KUWAMURA et al, 2002;JUNG et al, 2013;PARK et al, 2014), cases of this syndrome in South America dogs were not located when major databases were searched. This report describes the occurrence of NLE in a Yorkshire terrier dog from Brazil, thereby confirming the worldwide distribution of this unique syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Necrotizing leukoencephalitis in a Yorkshire dog from Brazil

Amude

Arias

Headley

et al. 2019

SCA

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Necrotizing leukoencephalitis (NLE) is an uncommon inflammatory condition of brain of dogs, and was described in dogs from North America, Europe, and Asia. Cases of NLE from South America were not located when major data bases were examined. Consequently, this report describes the findings associated with NLE in a Brazilian 3.5-year-old female Yorkshire dog with neurological findings related to the myelencephalon; the dog died, besides medical treatment, and was submitted for autopsy exam and histopathological evaluation. Lesions were restricted to the encephalon and characterized as leukoencephalomalacia with severe non-suppurative inflammation with extensive perivascular cuffing; the non-suppurative inflammation was characterized by influx of lymphocytes and histiocytes, and occasionally plasma cells, and gitter cells. Infectious disease agents were not identified by molecular techniques or visualized with histochemical stains. This report represents the first definitive diagnose of NLE in Brazil, suggesting that this disease may be present in South America dogs suffering from neurological conditions. This knowledge may be useful for veterinarians in Brazil, taking into account that this disease should be considered as a differential diagnosis when infectious causes are excluded.

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“…NME and NLE in canines seem to result from autoimmune inflammation in the CNS, as several reports describe a beneficial efficacy in using immunosuppressants to treat NME and NLE (Jung et al 2007;Jung et al 2012;Jung et al 2013;Dewey 2016). Recently, mycophenolate mofetil (MMF) has been shown to exert beneficial effects on autoimmune CNS inflammatory cases (Barnoon et al 2016;Woolcock et al 2016…”

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confidence: 99%

Mycophenolate mofetil plus prednisolone combination therapy for necrotising leukoencephalitis in a dog: long-term clinical observation, serial imaging analysis and histopathological findings

An¹,

Jh²,

Yu³

et al. 2019

Vet. Med. - Czech

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An 8-year-old intact male mixed-breed dog presented with tetraparesis, right side head tilt, and cluster seizure-like episodes. Based on the magnetic resonance imaging and cerebrospinal fluid analysis results, meningoencephalitis of an unknown aetiology was strongly suspected. The patient survived for 963 days under mycophenolate mofetil plus prednisolone therapy and was ultimately diagnosed with necrotising leukoencephalitis. This report describes the clinical findings, the serial magnetic resonance imaging characteristics, and the histopathologic features of a case of necrotising leukoencephalitis and the long-term survival after mycophenolate mofetil plus prednisolone therapy.

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Unsuccessful Cyclosporine plus Prednisolone Therapy for Autoimmune Meningoencephalitis in Three Dogs

Cited by 4 publications

References 21 publications

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

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

Necrotizing leukoencephalitis in a Yorkshire dog from Brazil

Mycophenolate mofetil plus prednisolone combination therapy for necrotising leukoencephalitis in a dog: long-term clinical observation, serial imaging analysis and histopathological findings

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