Publicação
Relapsing meningoencephalomyelitis of unknown origin : neurological presentation, diagnostic clinicopathological findings, imaging characteristics and therapeutic management of dogs with and without relapse
| Resumo: | Meningoencephalomyelitis of Unknown Origin (MUO) is a challenging condition to treat and many dogs eventually relapse, die or are euthanised. Hence, to describe and compare signalment, neurological presentation, magnetic resonance imaging (MRI) findings, cerebrospinal fluid (CSF) analysis and treatment protocol, a retrospective study was conducted including 52 client-owned dogs with a presumptive diagnosis of MUO presented at one institution from May 2017 to December 2021, grouped according to their outcome: recovered (group 0), relapsed (group 1) or deceased (group 2). 24 dogs survived MUO (46%), 13 relapsed (25%) and 15 died or were euthanised because of MUO (29%). The onset and presence of seizures and/or hyperesthesia were not predictive of the outcome. Most dogs treated with corticosteroids alone were euthanised or died (67%) [p < 0.001] and the relapsing dogs were more often treated with 3 or more drugs (62%) [p < 0.001]. The most prevalent MRI abnormalities locations were in the cerebral hemispheres (63%), thalamus (40%) and spinal cord (44%). Multifocal lesions, brain herniation, presence of meningeal and parenchymal contrast enhancement, and type and cell count of CSF pleocytosis were not associated with a higher risk of relapse or death. As soon as the diagnosis is achieved, it seems advantageous to start the treatment with a second immunossupressive agent (other than corticosteroids) and often the disease is only managed using a multi-drug therapy protocol, since the rate of relapse is high. Previously reported findings, as seizures, multifocal lesions, brain herniation, presence of meningeal and parenchymal contrast enhancement, and type and cell count of CSF pleocytosis aren’t associated with a higher risk of relapse and death |
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| Autores principais: | Aragão, Ana Rita Vaz de |
| Assunto: | Dog Meningoencephalitis Relapse Immunosuppressive treatment Cão Meningoencefalite Recidiva Tratamento imunossupressor |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Meningoencephalomyelitis of Unknown Origin (MUO) is a challenging condition to treat and many dogs eventually relapse, die or are euthanised. Hence, to describe and compare signalment, neurological presentation, magnetic resonance imaging (MRI) findings, cerebrospinal fluid (CSF) analysis and treatment protocol, a retrospective study was conducted including 52 client-owned dogs with a presumptive diagnosis of MUO presented at one institution from May 2017 to December 2021, grouped according to their outcome: recovered (group 0), relapsed (group 1) or deceased (group 2). 24 dogs survived MUO (46%), 13 relapsed (25%) and 15 died or were euthanised because of MUO (29%). The onset and presence of seizures and/or hyperesthesia were not predictive of the outcome. Most dogs treated with corticosteroids alone were euthanised or died (67%) [p < 0.001] and the relapsing dogs were more often treated with 3 or more drugs (62%) [p < 0.001]. The most prevalent MRI abnormalities locations were in the cerebral hemispheres (63%), thalamus (40%) and spinal cord (44%). Multifocal lesions, brain herniation, presence of meningeal and parenchymal contrast enhancement, and type and cell count of CSF pleocytosis were not associated with a higher risk of relapse or death. As soon as the diagnosis is achieved, it seems advantageous to start the treatment with a second immunossupressive agent (other than corticosteroids) and often the disease is only managed using a multi-drug therapy protocol, since the rate of relapse is high. Previously reported findings, as seizures, multifocal lesions, brain herniation, presence of meningeal and parenchymal contrast enhancement, and type and cell count of CSF pleocytosis aren’t associated with a higher risk of relapse and death |
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