Steroid-responsive meningitis-arteritis in dogs in Germany: Are there epidemiological or clinical factors influencing recurrence rate?

Abstract

Objective Steroid-responsive meningitis arteritis (SRMA) is one of the most common inflammatory diseases of the central nervous system in dogs. The present study examined breed and sex predisposition factors based on the population of dogs in Germany as well as epidemiological and clinical factors regarding the relapse rate of SRMA. Material and methods Data of 153 dogs with SRMA (SRMA) were analysed retrospectively in this multicentre study. It was investigated whether some dog breeds that suffer from SRMA were disproportionately more often (n ≥ 5) represented when compared to the total population of dogs in Germany. Furthermore it was examined which sex is affected more often. Data provided by “Verband für das deutsche Hundewesen“ (VDH) and „Tasso e. V.“ was used as reference data of the total population. The following factors were investigated with regard to the occurrence of one or more relapses: signalment; body weight; age at first presentation; time period between last vaccination and onset of clinical signs; clinical signs and timepoint of the first SRMA manifestation; results of cerebrospinal fluid (CSF) analysis at first presentation (nucleated cell count and differentiation, protein concentration); immunglobulin A and C-reactive protein (CRP) concentrations in serum and CSF; immunosuppressive medication; follow-up data including response to therapy, occurrence of relapses and mortality including reasons, i. e. due to the disease, therapy or euthanasia. Results The breed had a statistically significant influence on the development of SRMA (p < 0.05). Beagles and Boxers were affected more often by SRMA than other breeds in relation to the total population in Germany. Relapses occurred in 29.4 % of the 153 dogs of this study. In contrast to the development of SRMA, in which male dogs have a significantly increased risk of developing SRMA (p < 0.05), female dogs are more likely to relapse (p = 0.02). Patients on prednisolone monotherapy had fewer relapses than those with prednisolone and azathioprine in combination (p < 0.05). Younger age (p = 0.071) und lower CRP concentrations (p = 0.081) at first presentation were tentatively associated with a higher incidence of relapses. Conclusion The determined breed and sex predispositions support the diagnosis of SRMA arteritis and confirm previous observations. This study allows a more accurate explanation to owners about the risk of relapse.

Detection of Extracellular Traps in Canine Steroid-Responsive Meningitis-Arteritis

“…Generating histological samples in the future will be very unlikely because clinical diagnosis, treatment management, and awareness of this disease reduced the mortality of SRMA in the last decades ( 44 , 46 , 88 ). Therefore, prospective clinical studies could confirm antemortem evidence of ETs in dogs measuring ET markers and correlating ET inducers in clinical accessible samples of serum and CSF such as H3Cit and cell-free DNA.…”

“…SRMA can occur in any dog breed, but is overrepresented in Bernese mountain dogs, Boxers, Beagles ( 43 , 44 ), Nova Scotia Duck Tolling Retrievers, Weimaraners, and Petit Basset Griffon Vendéens ( 45 ). A German study showed a sex predisposition for male individuals ( 46 ), but other studies do not show significant difference in sex distribution of this disease ( 47 , 48 ). The assembly of signalment, clinical signs, and laboratory findings of CSF and blood analysis associated with a quick clinical improvement after application of immunosuppressive therapy with glucocorticosteroids and an exclusion of an infectious etiology lead to the antemortem diagnosis of SRMA ( 40 , 48 – 50 ).…”

Salmonella enterica subspecies houtenae as an opportunistic pathogen in a case of meningoencephalomyelitis and bacteriuria in a dog

“…In two studies of the clinical course of SRMA, all dogs had cervical pain on presentation, with thoracolumbar being a concurrent clinical sign in 15 and 34% of dogs; isolated lumbar pain in the absence of cervical pain was not reported in these two populations [32,33]. Description of clinical signs associated with relapses commonly report "recurrence of previous signs," cervical pain, lethargy, neurological deficits (paresis, ataxia), and fever [11,[33][34][35]. Though first relapses have been reported up to 2176 days, most occur earlier [11,32].…”

Neutrophil extracellular traps in CSF and serum of dogs with steroid-responsive meningitis-arteritis

“…Despite that, SRMA is promisingly treatable with immunosuppressive agents like glucocorticosteroids [8], relapse (29.4-47.5%) and mortality rates (4.6-8.1%) are demanding an improvement of therapeutic outcome [9,[95][96][97] especially in the background of undesirable therapeutic side effects. Specific immunosuppressive treatment is lacking in veterinary medicine [98].…”