granulomatous meningio-encephalitis

Canine neurological cases don’t have to die.

The male beagle stood at the reception desk waiting patiently for his owner to complete registration. His feet were planted slightly apart; his neck was rigid with his head lowered and his chin tilted in. Slowly, he shuffled into the exam room. The dog had become progressively weakened over the previous three days, but his body temperature, blood count and serum chemistry studies were all within the normal range. The poor dog gave the impression of being in pain but there was no history of trauma or injury as is so often seen when outside dogs run around at night. Nor was there evidence of cranial nerve or other brain involvement.

This is the third case I have seen in two months, with neither breed nor gender partiality. Neck symptoms and pain while walking suggested inflammation of the meninges (membranes surrounding the brain and spinal cord). There is a condition called granulomatous meningoencephalitis (GME) with similar symptoms but usually there are also signs of progressive brain involvement. GME is characterized by aggregations of cells surrounding blood vessels in white matter of brain and spinal cord and is thought to be an autoimmune condition associated with development of immunity against nervous tissues. Cerebrospinal fluid analysis is the best way to confirm the diagnosis. However, getting the fluid is a delicate and risky procedure this owner declined. Because of success I had with an earlier case, I opted for a treatment trial to determine the possible nature of the dog’s disease. The beagle was given an antivirus drug, interferon (INF), daily for one month, along with two weeks of a drug that countered pain and inflammatory responses of neurons and astrocytes (two classes of brain cells). The dog recovered incrementally without a relapse in the 30-day treatment period.

In an earlier case, I initially considered the disease to be GME so I treated it with a synthetic cortisone-like drug as is recommended in veterinary literature. And, as is mentioned in the literature, the dog’s condition improved but relapsed when treatment was stopped. To me, that was an unsatisfactory treatment response; I followed up with oral INF at a very low dosage (3U/# SID). Due to the dosage limitation, treatment continued for 30 days. This dog, too, recovered.

It appears that because of positive response to the antivirus drug by these two dogs, this disease may be caused by a virus, and the response to cortisone suggests the infection has an autoimmune legacy. Its incidence is increasing among patients I see.

Pets are important family members. Extensive testing and literature searches established effective diagnostic and treatment programs. In both cases, the owners were diligent in treatment applications and dedicated to the month-long regimen required to get their pets on the road to recovery.

(1) comment


Great information doc. I’m wondering if GME can be contracted from the pet to the human owners? And what are common signs and symptoms?

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