Steroid responsive meningitis-arteritis in dogs: Long-term study of 32 cases

Steroid responsive meningitis-arteritis in 32 cases was studied. Two forms were recognised: The typical form showing cervical rigidity and pain, fever and pleocytosis with polymorphonuclear cells in the cerebrospinal fluid (CSF); and the atypical form, a more protracted type characterised by additional neurological deficits and lack of typical CSF changes. Both groups responded to steroid application. Several ancillary laboratory procedures were applied in an attempt to improve the diagnosis. Electroencephalography was found to be helpful in detecting an inflammatory process. Measuring IgA levels in the serum and CSF was also another useful technique for detecting atypical cases. Long-term treatment with prednisolone was undertaken in 20 dogs. The treatment was monitored by rigorous control examinations of the blood and CSF at regular intervals. Twelve dogs were considered cured after this treatment. Thirteen dogs were euthanased; five of these in the acute stage of the disease and eight because of progressive neurological disease. In all these cases histopathological examination was performed. The data are compared to reports in the literature on meningitis and arteritis in dogs and the pathogenesis of the disease is briefly discussed.     

Selective CD11a upregulation on neutrophils in the acute phase of steroid-responsive meningitis-arteritis in dogs

Steroid-responsive meningitis-arteritis (SRMA) is a systemic inflammatory disease of juvenile to young adult dogs with a relapsing course and most prominent manifestation in the cervical meninges. The most important laboratory finding is a marked neutrophilic pleocytosis. Integrin (CD11a, b, c) expression on polymorphonuclear cells (PMNs) was quantified by immunophenotyping and subsequent flow cytometric measurements. Values were determined for peripheral blood in the acute phase of SRMA (n=14) as well as during glucocorticosteroid treatment (n=16). Results were compared to those from dogs with other neurological diseases (n=49) and healthy individuals (n=7). Integrin expression was also investigated on PMNs deriving from cerebrospinal fluid (CSF) of dogs in the acute phase of SRMA (n=14). In a second part of the study PMNs of healthy dogs were incubated with sera of dogs in the acute phase of SRMA (n=12). The influence on integrin expression was studied and results were compared to those after incubation with pooled sera of dogs suffering from idiopathic epilepsy (n=3). PMNs in peripheral blood of dogs in the acute phase of SRMA showed higher values of CD11a expression when compared to dogs under treatment and to control groups, whereas CD11b and c expression was comparable among the different groups. In the acute phase of SRMA CD11b expression on PMNs in CSF was increased in comparison to that in peripheral blood. Incubation with SRMA sera caused a stronger upregulation of CD11a than did pooled epilepsy sera in 9/12 cases whereas an upregulation of CD11b and c was observed in single cases only. High CD11a expression on PMNs in peripheral blood appears to be an important factor in the pathogenesis of SRMA. This integrin is known to be essential for adhesion of PMNs within the neutrophil recruitment cascade and therefore might mediate the enhanced invasion of neutrophils into the subarachnoidal space eventually leading to meningitis and clinical signs. Since sera of dogs suffering from SRMA selectively induce an upregulation of CD11a it can be suspected that this fluid contains one or multiple factors being responsible for this.     

Determination of immunoglobulin A concentrations in the serum and cerebrospinal fluid of dogs: an estimation of its diagnostic value in canine steroid-responsive meningitis-arteritis

Previous studies on canine steroid-responsive meningitis-arteritis (SRMA) suggested that elevation of immunoglobulin A (IgA) concentrations in both serum and cerebrospinal fluid (CSF) is specific for SRMA throughout the different disease stages. Recent studies however have raised concerns about the value of this test. The purpose of this study was to investigate the diagnostic value of IgA concentration testing in paired CSF and serum samples. IgA concentrations of 525 paired canine CSF and serum samples were evaluated. Samples were obtained from dogs with SRMA (n=311) and dogs with miscellaneous conditions (n=214) such as other central nervous system (CNS) inflammatory diseases (n=34), CNS tumours (n=46), idiopathic epilepsy (n=42), intervertebral disc disease (n=46) and non-CNS diseases (n=46). Serum IgA concentrations were significantly higher in dogs with untreated SRMA compared to those with other diseases. IgA CSF concentrations were significantly higher in dogs with SRMA compared to other disease categories, with the exception of inflammatory CNS disease. The sensitivity for IgA concentrations in serum and CSF was 91% with a specificity of 78%. Analysis of 525 paired samples confirmed that IgA concentrations were higher in dogs with SRMA. Calculation of the diagnostic value of IgA concentration confirmed that the test is highly sensitive for SRMA. Testing paired CSF and serum samples for IgA is still recommended for the diagnosis of suspected cases of SRMA.     

Steroid-responsive meningitis-arteritis in dogs with noninfectious,nonerosive, idiopathic,immune-mediated polyarthritis

Signs related to spinal pain are commonly reported in dogs with noninfectious, nonerosive, idiopathic immune-mediated polyarthritis (IMPA). This study examined the prevalence and etiology of spinal pain in these dogs through a retrospective review of 62 case records of dogs with IMPA. All dogs with IMPA and signs suggestive of spinal pain were described with regard to age, gender, breed, physical stature, location of vertebral pain, rectal temperature, and clinical laboratory findings. The prevalence of spinal pain in these dogs was 29% (18 of 62). Fourteen of the 18 dogs with spinal pain and IMPA were male. Cerebrospinal fluid (CSF) from 11 dogs with signs of spinal pain was analyzed. Five of these (46%) had concurrent steroid-responsive meningitis-arteritis (SRMA). We concluded that SRMA does occur concurrently in some dogs having IMPA. Meningeal involvement may explain the origin of spinal pain observed in some of these dogs.     

Concentrations of acute-phase proteins in dogs with steroid responsive meningitis-arteritis

Background: Measurement of concentrations of acute-phase proteins (APPs) is used as an aid in the diagnosis of a variety of diseases in animals.
Objective: To determine the concentration of APPs in dogs with steroid responsive meningitis-arteritis (SRMA) and other neurologic diseases.
Animals: One hundred and thirty-three dogs with neurologic diseases, 6 dogs with sepsis, and 8 healthy dogs were included in the study. Thirty-six dogs had SRMA (31 of which had monitoring), 14 dogs had other meningoencephalitides (ME), 32 had disk disease (IVDD/DLSS), 26 had tumors affecting the central nervous system (TCNS), and 25 had idiopathic epilepsy (IE).
Methods: Prospective, observational study: C-reactive protein (CRP), α₂-macroglobulin (AMG), and albumin concentrations were determined in the serum or plasma. CRP was also measured in the cerebrospinal fluid.
Results: Serum CRP was significantly higher in dogs with SRMA (     = 142 μg/mL ± 75) and sepsis (     = 114 μg/mL ± 67) in comparison with dogs with other neurologic diseases (     = 2.3–21 μg/mL; P < .001). There was no significant difference detected in AMG between groups. Serum albumin concentration was significantly lower ( P < .01) in dogs with SRMA (     = 3.2 g/dL ± 0.41) than in other groups (     = 3.6–3.9 g/dL). Serum CRP concentration of SRMA dogs correlated with alkaline phosphatase levels ( r = 0.515, P = .003).
Conclusions and Clinical Importance: CRP concentrations in serum are useful in diagnosis of dogs with SRMA. Serum CRP could be used as a monitoring parameter in treatment management of these dogs.     

Long-term treatment with carprofen of 805 dogs with osteoarthritis

The pain-relieving effect of carprofen and tolerance to the drug were investigated in 805 dogs that were lame as a result of osteoarthritis. The dogs were of different breeds, ages and bodyweights and of both sexes, and were selected from 51 veterinary clinics. Each dog was treated orally by its owner with 4 mg/kg carprofen for 84 consecutive days. Twenty-four dogs were removed from the study because of side effects, and 55 left the study for reasons unrelated to the treatment. The condition of the dogs and the benefit of the treatment were evaluated by the veterinary surgeons and the owners after 14 days, and at the end of the period of treatment, when 194 of the dogs (26.7 per cent) were no longer lame, and 357 (49.2 per cent) had improved. The period for which the dogs had been lame before entering the study significantly (P<0.01) affected the results and the rate of improvement. Too much exercise during the 84 days of treatment caused some dogs to relapse.     

Nasal aspergillosis and penicilliosis in dogs: results of treatment with thiabendazole

Forty-seven dogs with nasal aspergillosis or penicilliosis were treated with thiabendazole (20 mg/kg orally for 6 weeks). Nasal turbinectomy was performed on 26 of the dogs. Six months or more later, 43% of the dogs were clinically normal or considerably improved; results were better in dogs not treated surgically. It was concluded that thiabendazole at a dosage of 20 mg/kg is not an effective treatment for nasal aspergillosis or penicilliosis in dogs.     

Results of clinical examinations, laboratory tests, and ultrasonography in dogs with pituitary-dependent hyperadrenocorticism treated with trilostane

OBJECTIVE: To determine the efficacy of trilostane, a 3beta-hydroxysteroid dehydrogenase inhibitor, in dogs with pituitary-dependent hyperadrenocorticism (PDH). ANIMALS: 11 dogs with PDH. PROCEDURE: The initial dose of trilostane was 30 mg, PO, q 24 h for dogs that weighed < 5 kg and 60 mg, PO, q 24 h for dogs that weighed > or = 5 kg. A CBC count, serum biochemical analyses, urinalysis, ACTH stimulation test, and ultrasonographic evaluation of the adrenal glands were performed in each dog 1, 3 to 4, 6 to 7, 12 to 16, and 24 to 28 weeks after initiation of treatment. RESULTS: All dogs responded well to treatment. All had reductions in polyuria-polydipsia and panting and an increase in activity. Polyphagia decreased in 9 of 10 dogs, and 9 of 11 dogs had improvement of coat quality and skin condition. Concentration of cortisol after ACTH stimulation significantly decreased by 1 week after initiation of treatment. After treatment for 6 months, clinical signs resolved in 9 dogs. In the other 2 dogs, marked clinical improvement was reported for 1 dog, and moderate improvement was reported in the other dog. Ultrasonographically, there was a considerable change in the parenchyma and an increase in size of the adrenal glands. Adverse effects consisted of 1 dog with transient lethargy and 1 dog with anorexia. CONCLUSIONS AND CLINICAL RELEVANCE: Trilostane is an efficacious and safe medication for treatment of dogs with PDH. Additional studies in a larger group of dogs and characterization of progressive changes in adrenal glands are needed.     

Long-term results of upper respiratory syndrome surgery and gastrointestinal tract medical treatment in 51 brachycephalic dogs

OBJECTIVES: After a first clinical study showing a high prevalence of gastrointestinal tract diseases in brachycephalic dogs presented for upper respiratory syndrome, a prospective study was performed to determine the influence of medical treatment for gastrointestinal tract disorders associated with upper respiratory syndrome surgery. METHODS: The gastrointestinal tract and respiratory disorders of 61 brachycephalic dogs presented for upper respiratory syndrome were evaluated. Together with surgery of the upper respiratory tract, a specific gastrointestinal medical treatment was administered. A minimal follow-up of six months was required for inclusion. RESULTS: Palatoplasty with rhinoplasty was the most common surgical correction (88.5 per cent). The mortality rate in the perioperative period was 3.3 per cent. Minor complications accounted for 26.2 per cent of cases. No aspiration pneumonia was encountered. A sufficient follow-up was obtained in 51 dogs. The improvement was judged by the owners as excellent or good in 88.3 per cent of the respiratory disorders and in 91.4 per cent of the gastrointestinal disorders. Clinically, a statistically significant improvement was obtained for both respiratory and gastrointestinal disorders. CLINICAL SIGNIFICANCE: In comparison with other studies, digestive tract medical treatment combined with upper respiratory surgery seems to decrease the complication rate and improve the prognosis of dogs presented for upper respiratory syndrome.     

Retrospective study of fever in dogs: laboratory testing, diagnoses and influence of prior treatment

OBJECTIVES: To analyse the demographic information of dogs referred for investigation of fever, to determine the usefulness of various diagnostic investigations and to assess the effect of treatment before referral on the presence of fever at referral, the duration of the investigation and the ability to reach a final diagnosis. METHODS: The clinical records of 66 dogs, in which fever was part of the clinical signs documented by the referring veterinary surgeon, were reviewed. The effects of treatment 24 hours before referral on temperature at initial consultation and on time to diagnosis were evaluated. The effect of body temperature at initial consultation on cost and on time to diagnosis was also determined. The effect of insurance on costs incurred was assessed. The utility of different diagnostic investigations was recorded, and cases were classified according to the final diagnosis. RESULTS: Only 34.8 per cent of dogs were diagnosed with immune-mediated disease, with most frequent diagnoses being steroid-responsive meningitis and polyarthritis. Treatment 24 hours before referral significantly increased the time to diagnosis (P = 0.004) and affected the presence of fever at referral (P = 0.006). Insurance status did not significantly affect cost incurred by the owner. CLINICAL SIGNIFICANCE: This study documents a high incidence of immune-mediated disease in dogs referred for investigation of fever. It also documents a higher incidence of inflammatory central nervous system disease in febrile dogs than that reported previously. Of the diagnostic modalities employed in the majority of cases, radiography, cytology and bacteriological and fungal cultures (fluids/tissues) were the most useful. It is suggested that treatment is withdrawn or withheld before commencing diagnostic investigation of fever.     

Infection of dogs by experimental inoculation with human isolates of Giardia duodenalis: clinical and laboratory manifestations

The susceptibility of dogs to experimental inoculation with trophozoites and cysts of human isolates of Giardia duodenalis and the clinical and laboratory profiles of infection of these animals were studied. Two groups (A and B), each comprising three dogs, were inoculated with G. duodenalis trophozoites and cysts, respectively. A third group of two dogs was not inoculated and remained as control. After inoculation feces were collected daily to determine the pre-patent period, by flotation in 33% zinc sulfate solution. Blood samples (5mL) were collected from animals at 15-day intervals during the 165 days of the experimental period and were used to carry out the hemogram and biochemical evaluation of the levels of total protein, albumin, alanine aminotransferase, gamma glutamyltransferase, urea and creatinine. A prepatent period was observed at 5-6 days post-inoculation (p.i.) in the inoculated dogs, with cysts eliminated for approximately 3 months. No alterations were seen in the clinical parameters evaluated. Anemia was observed at 15 p.i. in the inoculated dogs. The mean eosinophil count of inoculated groups was higher than that of the control (p< or =0.05) but none of the biochemical parameters analyzed presented significant differences. The results of this study show that G. duodenalis from human isolates is able to infect dogs with minimal systemic manifestations without producing clinical signs of giardiasis.     

Long-term efficacy and safety of firocoxib in the treatment of dogs with osteoarthritis

Thirty-nine client-owned dogs with osteoarthritis were treated with 5 mg/kg firocoxib administered orally, once a day for 52 weeks. Veterinary examinations were performed on approximately days 0, 15, 90, 180, 270 and 360. Twenty-five dogs completed the study. The withdrawal rate associated with gastrointestinal side effects was low (5.1 per cent of dogs). Based on the owners' assessment, 82 per cent of the dogs had improved at day 15, 84 per cent of the 32 remaining dogs had improved at day 90, and 96 per cent of the 25 dogs that completed the trial had improved at day 360. During this trial, 12 (48 per cent) of the 25 remaining dogs showed an improvement in their lameness from day 90 to day 360 (P<0.05).     

Behavioural problems in dogs. Problems, diagnoses, therapeutic measures and results in 133 patients

The treatment of 133 dogs with behavioural problems is reviewed. The problems most frequently presented concerned aggressive behaviour and/or fear (agonistic behaviour). The combination of problems of dominance and problem behaviour stimulating conditioning (PBSC) was a diagnosis made significantly more often than others. The owner's inability to control the dog appeared to be associated primarily with aggression, but also with fear, in the dog. In aggression as well as in fear, reinstatement of the appropriate ranking order was the usual goal of therapy. In cases of aggression the results of treatment were considered good or fair in 42 percent of the cases, moderate in 11, and bad in 41 percent of the cases. In those involving fear, the results were good or fair in 52 percent of the cases, moderate in 15, and bad in 25 percent. Hence treatment was only moderately successful. This reflects the need for more reliable and valid knowledge about symptoms, diagnostic methods and therapeutic possibilities.     

Spinal arachnoid cyst in four dogs: diagnosis, surgical treatment and follow-up results

Spinal arachnoid cysts were diagnosed in four dogs; two schipperkes and two rottweilers. Myelography showed the cysts to be localised either at the second to third caudal vertebrae or between the eighth and tenth thoracic vertebrae. The cysts were drop-shaped with a dorsal midline localisation, intradural in the arachnoid space, and with a cranial opening. Surgical treatment was performed by one of two techniques; durotomy with drainage or durectomy with resection. As the pathological examination in one case revealed a lining of hyperplastic pia-arachnoid meningothelial cells in the cyst, it was assumed that the cyst originates from a developmental disturbance during formation of the arachnoid membrane. Follow-up studies were carried out from 10 months to four years postoperatively and revealed that there were no further problems in three out of four of the dogs during this period.     

Brucella canis endophthalmitis in 3 dogs: clinical features, diagnosis, and treatment

Objective  To describe historical, clinical and diagnostic features of dogs with Brucella canis endophthalmitis and the response to medical therapy.
Animals studied  Three dogs with naturally acquired B. canis endophthalmitis.
Procedure  Dogs were treated symptomatically with topical ophthalmic anti-inflammatories and a novel antimicrobial protocol that included doxycycline, enrofloxacin, rifampin and streptomycin.
Results  All dogs presented with chronic or recurrent uveitis in the absence of overt systemic disease. Clinical ophthalmologic abnormalities were unilateral in each dog and included mild-to-moderate anterior uveitis, iris hyperpigmentation, marked vitreal infiltrates, and multifocal chorioretinitis. Dogs were diagnosed with canine brucellosis serologically and by blood culture ( n  = 2 dogs) or polymerase chain reaction of aqueous humor and blood ( n  = 1 dog). Active ocular inflammation resolved in all dogs during treatment, with preservation of vision in 2 dogs. Following treatment, B. canis could not be cultured from blood samples and serological values declined with seronegativity achieved in all dogs after a median of 96 weeks (range: 36–112 weeks) of therapy.
Conclusions  Brucella canis infection should be included in the differential diagnosis for dogs with intraocular inflammation, regardless of previous history or neuter status. This is the first report of apparently successful medical therapy of canine brucellosis with ocular involvement.