Treatment of 11 dogs with meningoencephalomyelitis of unknown origin with a combination of prednisolone and cytosine arabinoside

Abstract

The records of 11 dogs with evidence of meningoencephalomyelitis of unknown origin were reviewed. Two of them had had a focal form of the disease and the other nine a disseminated form. The forebrain was involved in five of the nine dogs with disseminated disease, the brainstem in all nine and the cerebellum in one. They had been treated with courses of cytosine arabinoside every three weeks and immunosuppressive doses of prednisolone. Their response to the treatment, in terms of quality of life, was judged by their owners and referring veterinarians to have been excellent in five, good in five and poor in one; their survival times ranged from 78 days to more than 603 days. The cumulative probability of survival at two years was 58.4 per cent. No signs of myelosuppression or other side effects associated with cytosine arabinoside were observed.

Treatment of meningoencephalitis of unknown origin in a dog

“…The above findings were compatible with the diagnosis of MUO (Schatzberg 2005, Schatzberg and others 2005, Zarfoss and others 2006, Menaut and others 2008) considering the multifocal lesions noticed on MRI and the CSF results. Immunosuppressive treatment was initiated with prednisolone (Prednicare; Animalcare) and cytosine arabinoside (Cytarabine 20 mg/ml injection; Mayne Pharma) (Scott-Moncrieff and others 1991, Cuddon and others 2002, Nuhsbaum 2002, Zarfoss and others 2006).…”

Evaluation of treatment with a combination of azathioprine and prednisone in dogs with meningoencephalomyelitis of undetermined etiology: 40 cases (2000-2007)

“…Hematologic abnormalities included thrombocytosis (n = 25 dogs), elevated liver enzyme activities (17), hypertriglyceridemia (13), elevated lipase or amylase activity (5), anemia (3), leukopenia (3), hypercalcemia (3), and hypocalcemia (2). Relevant hematologic abnormalities were infrequent.…”

Perspectives on Meningoencephalomyelitis of Unknown Origin

“…144 Selection of a specific immunosuppressive protocol depends on the clinician's decision, the patient's clinical status, and the pet owner's financial considerations. In accordance with guidelines from other studies, 17,147,148,151 a common protocol is daily administration of prednisone at an immunosuppressive dose combined with cytosine arabinoside administered at 50 mg/m 2 every 12 hours as a subcutaneous bolus for 2 consecutive days, or by intravenous infusion at 200 mg/m 2 over 8 hours. The treatment cycle is repeated every 3 to 4 weeks for 3 cycles.…”

“…Reported second-line immunosuppressive drug therapies for MUO include leflunomide, 145 procarbazine, 146 cytosine arabinoside, 17,[147][148][149][150][151][152] lomustine, 144,153 mycophenolate mofetil, 154 azathioprine 155 ; COP 149 (cyclophosphamide, vincristine, prednisone), and cyclosporine ( Table 3). 118,[155][156][157][158][159] Radiation therapy has also proved to be effective for focal GME lesions.…”

“…17,[144][145][146][147][148][149][150][151][152][153][154][155][156][157][158][159] MR imaging may offer a broader assessment by which to guide therapy in dogs with MUO. MR imaging abnormalities of foramen magnum herniation, loss of cerebral sulci, or mass effect attributable to MUO have been associated with reduced survival time.…”