Uveodermatologic syndrome presenting with concurrent aseptic meningoencephalitis in a dog

Canine uveodermatologic syndrome (UDS) resembles human Vogt-Koyanagi-Harada syndrome but typically lacks associated neurological signs. We report a 3-year-old Australian shepherd dog diagnosed with UDS following bilateral enucleation and histopathology. Twelve days postoperatively, neurological symptoms developed, including head tilt, circling, and deafness. Brain MRI and CSF analyses were consistent with meningoencephalitis of unknown etiology (MUE). Oral immunosuppressive therapy (prednisone and cyclosporine) resulted in substantial improvement. Eight months later, during gradual dose reduction, MUE relapsed, prompting an increase in dose to immunosuppressive levels. The dog's death due to an unrelated cause 4 mo later prompted postmortem evaluation. This report adds to the limited literature on MUE associated with UDS in dogs and underscores challenges in diagnosis and management. Literature review suggests this is the second reported case of Vogt-Koyanagi-Harada-like meningoencephalitis in a dog and the first reported case with a confirmed diagnosis via MRI and CSF analyses. Key clinical message: It is important to include UDS as a differential diagnosis for dogs that present with MUE with concurrent ocular and cutaneous signs. For dogs diagnosed with UDS on histology after enucleation, more aggressive immunosuppressive treatment or vigilant monitoring for neurological signs may help prevent or slow progression to neurological involvement.