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Meningoencephalitis of unknown origin: investigation of prognostic factors and outcome using a standard treatment

M Lowrie1, P M Smith, L Garosi

  • 1Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire SG5 3HR, UK. mll@vetspecialists.co.uk

The Veterinary Record
|March 7, 2013
PubMed

Insights

Prognostic markers for canine meningoencephalitis of unknown origin (MUO) were identified. Certain MRI findings and cerebrospinal fluid (CSF) analysis can predict mortality and relapse risk in dogs with this CNS disease.

Area of Science:

  • Veterinary Neurology
  • Neuroimmunology
  • Inflammatory CNS Diseases

Background:

  • Meningoencephalitis of unknown origin (MUO) is a prevalent, inflammatory central nervous system (CNS) disease in dogs.
  • MUO presents with variable and unpredictable clinical outcomes, posing challenges for treatment and prognosis.

Purpose of the Study:

  • To prospectively evaluate Magnetic Resonance Imaging (MRI) and cerebrospinal fluid (CSF) features as prognostic markers for mortality, relapse, and long-term outcomes in dogs with MUO.
  • To determine the predictive value of combined MRI and CSF analysis for MUO prognosis.

Main Methods:

  • Prospective evaluation of 39 dogs diagnosed with MUO.
  • Initial and follow-up MRI and CSF analyses during prednisolone and cytosine arabinoside treatment.
  • Longitudinal monitoring of outcomes, including mortality, relapse, and long-term survival.

Main Results:

  • Median survival time was 26 days; 56% of dogs died within 52 days of diagnosis.
  • Loss of cerebral sulci and foramen magnum herniation on MRI correlated with increased mortality risk.
  • Abnormal CSF at three months predicted relapse risk (P=0.04); combined MRI/CSF improved relapse prediction sensitivity.
  • Treatment discontinuation before MRI lesion resolution invariably led to relapse.

Conclusions:

  • Specific MRI characteristics are associated with increased mortality risk in canine MUO.
  • CSF analysis at three months is a valuable predictor of relapse.
  • The combination of MRI and CSF analysis offers enhanced prognostic accuracy for MUO, guiding treatment decisions and improving patient outcomes.
Keywords:
Central nervous system (CNS)Cerebrospinal fluidDogsInflammationMagnetic resonance imaging (MRI)Meningoencephalitis

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