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  11. Corticosteroid Monotherapy Versus Combined Cytarabine Continuous Rate Infusion And Corticosteroid Therapy In Dogs With Meningoencephalitis Of Unknown Origin: A Blinded, Randomized, Controlled Trial

Corticosteroid monotherapy versus combined cytarabine continuous rate infusion and corticosteroid therapy in dogs with meningoencephalitis of unknown origin: A blinded, randomized, controlled trial

Bethan S Jones1, Francois Xavier Liebel1, Angela Fadda1

  • 1Langford Vets Small Animal Hospital, Bristol, United Kingdom.

Journal of Veterinary Internal Medicine
|May 3, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Corticosteroids alone or combined with cytosine arabinoside (CA) continuous rate infusion (CRI) showed no significant difference in treating meningoencephalitis of unknown origin (MUO) in dogs. Outcomes at 7, 30, and 100 days were similar, with no observed adverse effects.

Area of Science:

  • Veterinary Neurology
  • Immunosuppressive Therapy
  • Canine Infectious Diseases

Background:

  • Meningoencephalitis of unknown origin (MUO) in dogs has limited effective treatment options.
  • Current therapeutic protocols for canine MUO lack a superior, established standard of care.

Purpose of the Study:

  • To compare the efficacy of corticosteroid monotherapy versus combination therapy with cytosine arabinoside (CA) continuous rate infusion (CRI) in dogs with MUO.
  • To evaluate neurological deterioration rates at 7 days and clinical outcomes, including survival, at 30 and 100 days post-treatment initiation.

Main Methods:

  • A parallel-group, blinded, randomized controlled trial was conducted involving 69 dogs diagnosed with MUO based on MRI and CSF findings.
  • Dogs were randomized to receive either prednisolone (or dexamethasone) alone or in combination with CA CRI.
Keywords:
dogmeningoencephalitis of unknown originneurologynoninfectious meningoencephalitis

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  • Treatment failure was defined by neurological deterioration or death, with outcomes analyzed using intention-to-treat principles and survival analysis.

    • Main Results:

    • No significant difference in treatment failure rates was observed between the corticosteroid-only group and the corticosteroid plus CA CRI group at 7, 30, or 100 days.
    • All-cause mortality at 100 days did not differ significantly between the two treatment groups.
    • No clinically relevant treatment-related adverse effects were reported in either group.

    Conclusions:

    • Corticosteroid monotherapy and combination therapy with CA CRI do not yield different outcomes for dogs diagnosed with MUO.
    • The findings suggest that adding CA CRI to corticosteroid treatment does not improve short-term or long-term outcomes in canine MUO.
    • Further research may be warranted to explore alternative or adjunctive therapies for this challenging condition.