Unsuccessful cyclosporine plus prednisolone therapy for autoimmune meningoencephalitis in three dogs

Necrotizing leukoencephalitis in a Yorkshire dog from Brazil

Necrotizing leukoencephalitis (NLE) is an uncommon inflammatory condition of brain of dogs, and was described in dogs from North America, Europe, and Asia. Cases of NLE from South America were not located when major data bases were examined. Consequently, this report describes the findings associated with NLE in a Brazilian 3.5-year-old female Yorkshire dog with neurological findings related to the myelencephalon; the dog died, besides medical treatment, and was submitted for autopsy exam and histopathological evaluation. Lesions were restricted to the encephalon and characterized as leukoencephalomalacia with severe non-suppurative inflammation with extensive perivascular cuffing; the non-suppurative inflammation was characterized by influx of lymphocytes and histiocytes, and occasionally plasma cells, and gitter cells. Infectious disease agents were not identified by molecular techniques or visualized with histochemical stains. This report represents the first definitive diagnose of NLE in Brazil, suggesting that this disease may be present in South America dogs suffering from neurological conditions. This knowledge may be useful for veterinarians in Brazil, taking into account that this disease should be considered as a differential diagnosis when infectious causes are excluded.

Clinical presentation, diagnostic findings, prognostic factors, treatment and outcome in dogs with meningoencephalomyelitis of unknown origin: A review

Meningoencephalomyelitis of unknown origin (MUO) encompasses a group of idiopathic, most likely immune mediated, inflammatory central nervous system diseases that cause clinical, diagnostic and treatment challenges to veterinary neurologists. Clinical criteria for obtaining this presumptive diagnosis are currently available, and multiple treatment protocols have previously been investigated in small (prospective or retrospective) case series. As this group of diseases is considered fatal if left untreated, the identification of clinically usable prognostic indices could be of great value. This review provides an overview of recent developments in the clinical presentation, diagnostic findings, possible prognostic factors, treatment and outcome in dogs diagnosed with MUO.

Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007-2012)

The use of mycophenolate mofetil (MMF) for a variety of immune‐mediated diseases in veterinary medicine has been described. However, there is only a small number of cases documenting its use in dogs with meningoencephalomyelitis of unknown aetiology (MUE). We hypothesized that the use of MMF and corticosteroids in dogs with MUE results in comparable survival data to other published treatment protocols and is associated with limited adverse effects. A retrospective study of medical case records of dogs clinically diagnosed with MUE recorded signalment, neuroanatomic localization, magnetic resonance imaging findings, cerebrospinal fluid analysis results, medications administered, follow‐up neurologic examinations, survival and adverse events. Variables were compared between dogs which were treated with MMF within 30 days of diagnosis (immediate group) vs. dogs in which MMF therapy was started >30 days after diagnosis (delayed group). Twenty‐five cases of MUE were identified. The overall median survival time from diagnosis was 731 days (range 43–1672 days). After 1 month of MMF treatment, 92% of dogs showed improvement on a neurological examination. There was no significant effect of any recorded parameter on survival, including delayed vs. immediate initiation of MMF treatment. Dogs with delayed treatment had significantly lower clinical remission rates than dogs with immediate treatment at 6 months after starting MMF. Adverse events were identified in two cases (8%) and were characterized by mild gastrointestinal signs (vomiting and decreased appetite). Administration of MMF appears safe in dogs with MUE. The use of MMF results in comparable survival times to alternate immunosuppressive protocols.