Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

Combined Cytosine Arabinoside and Prednisolone Therapy for Meningoencephalitis of Unknown Etiology in 2 Dogs

원인불명의 수막뇌염을 보인 개에서 Cytosine Arabinoside와 Prednisolone으로 치료한 2례

  • Kim, Tae-Ho (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University and BK21 Programfor Veterinary Science) ;
  • Seo, Kyoung-Won (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University and BK21 Programfor Veterinary Science) ;
  • Lee, Young-Heun (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University and BK21 Programfor Veterinary Science) ;
  • Hwang, Cheol-Yong (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University and BK21 Programfor Veterinary Science) ;
  • Lee, Young-Won (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Youn, Hwa-Young (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University and BK21 Program for Veterinary Science)
  • 김태호 (서울대학교 수의과대학 내과학교실 BK21 수의과학연구인력양성사업단) ;
  • 서경원 (서울대학교 수의과대학 내과학교실 BK21 수의과학연구인력양성사업단) ;
  • 이영흔 (서울대학교 수의과대학 내과학교실 BK21 수의과학연구인력양성사업단) ;
  • 황철용 (서울대학교 수의과대학 내과학교실 BK21 수의과학연구인력양성사업단) ;
  • 이영원 (충남대학교 수의과대학 동물의과학연구소) ;
  • 윤화영 (서울대학교 수의과대학 내과학교실 BK21 수의과학연구인력양성사업단)
  • Accepted : 2010.06.03
  • Published : 2010.08.30
Download PDF
⟨ Previous Next ⟩

Abstract

A Maltese (5-years old, castrated male) and a Yorkshire Terrier (8-years old, intact female) were referred to Seoul National University Hospital for Animals with ataxia, circling, depression and anorexia. It was suspected to meningoencephalitis of unknown etiology (MUE) based on neurological signs, magnetic resonance imaging findings, cerebrospinal fluid analysis and canine distemper virus antigen test. Immunosuppressive dose of corticosteroid was initially chosen to treat in two dogs. However, the clinical signs were relapsed and side effects had arisen including polyuria, polydipsia, calcinosis cutis, liver enzyme elevation, weight gain and abdominal distension. Combination therapy of cytosine arabinoside (CA) and prednisolone (PDS) was tried. With this combination, the clinical signs were resolved and the side effects were alleviated. The dose of PDS was tapered to 0.5 mg/kg q48h in one case and the PDS was discontinued in the other case. These cases suggested that combined CA and PDS therapy may be significantly useful for the treatment of MUE uncontrolled by PDS alone.

Keywords

References

  1. Adamo FP, O'Brien RT. Use of cyclosporine to treat granulomatous meningoencephalitis in three dogs. J Am Vet Med Assoc 2004; 225: 1211-1216. https://doi.org/10.2460/javma.2004.225.1211
  2. Adamo PF, Adams WM, Steinberg H. Granulomatous meningoencephalomyelitis in dogs. Compend Contin Educ Vet 2007; 29: 678-690.
  3. Adamo PF, Rylander H, Adams WM. Ciclosporin use in multi-drug therapy for meningoencephalomyelitis of unknown aetiology in dogs. J Small Anim Pract 2007; 48: 486-496. https://doi.org/10.1111/j.1748-5827.2006.00303.x
  4. Aresu L, D'Angelo A, Zanatta R, Valenza F, Capucchio MT. Canine necrotizing encephalitis associated with anti-glomerular basement membrane glomerulonephritis. J Comp Pathol 2007; 136: 279-282. https://doi.org/10.1016/j.jcpa.2007.02.008
  5. Cantile C, Chianini F, Arispici M, Fatzer R. Necrotizing meningoencephalitis associated with cortical hippocampal hamartia in a Pekingese dog. Vet Pathol 2001; 38: 119-122. https://doi.org/10.1354/vp.38-1-119
  6. Cherubini GB, Platt SR, Anderson TJ, Rusbridge C, Lorenzo V, Mantis P, Cappello R. Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs. Vet Rec 2006; 159: 110-115. https://doi.org/10.1136/vr.159.4.110
  7. Coates JR, Barone G, Dewey CW, Vitale CL, Holloway-Azene NM, Sessions JK. Procarbazine as adjunctive therapy for treatment of dogs with presumptive antemortem diagnosis of granulomatous meningoencephalomyelitis: 21 cases (1998-2004). J Vet Intern Med 2007; 21: 100-106.
  8. Cordy DR, Holliday TA. A Necrotizing Meningoencephalitis of Pug Dogs. Vet Pathol 1989; 26: 191-194. https://doi.org/10.1177/030098588902600301
  9. Donald CP, Plumb's Veterinary drug handbook, 6th ed. Ames: Blackwell publishing, 2008: 324-326.
  10. Gnirs K. Ciclosporin treatment of suspected granulomatous meningoencephalomyelitis in three dogs. J Small Anim Pract 2006; 47: 201-206. https://doi.org/10.1111/j.1748-5827.2006.00065.x
  11. Jung DI, Kang BT, Park C, Yoo JH, Gu SH, Jeon HW, Kim JW, Heo RY, Sung HJ, Eom KD, Lee JH, Woo EJ, Park HM. A comparison of combination therapy (cyclosporine plus prednisolone) with sole prednisolone therapy in 7 dogs with necrotizing meningoencephalitis. J Vet Med Sci 2007; 69: 1303-1306. https://doi.org/10.1292/jvms.69.1303
  12. Kipar A, Baumgartner W, Vogl C, Gaedke K, Wellman M. Immunohistochemical characterization of inflammatory cells in brains of dogs with granulomatous meningoencephalitis. Vet Pathol 1998; 35: 43-52. https://doi.org/10.1177/030098589803500104
  13. Matsuki N, Fujiwara K, Tamahara S, Uchida K, Matsunaga S, Nakayama H, Doi K, Ogawa H, Ono K. Prevalence of autoantibody in cerebrospinal fluids from dogs with various CNS diseases. J Vet Med Sci 2004; 66: 295-297. https://doi.org/10.1292/jvms.66.295
  14. Menaut P, Landart J, Behr S, Lanore D, Trumel C. Treatment of 11 dogs with meningoencephalomyelitis of unknown origin with a combination of prednisolone and cytosine arabinoside. Vet Rec 2008; 162: 241-245. https://doi.org/10.1136/vr.162.8.241
  15. Munana KR, Luttgen PJ. Prognostic factors for dogs with granulomatous meningoencephalomyelitis: 42 cases (1982-1996). J Am Vet Med Assoc 1998; 212: 1902-1906.
  16. Murtaugh RJ, Fenner WR, Johnson GC. Focal granulomatous meningoencephalomyelitis in a pup. J Am Vet Med Assoc 1985; 187: 835-836.
  17. Nuhsbaum MT, Powell CC, Gionfriddo JR, Cuddon PA. Treatment of granulomatous meningoencephalomyelitis in a dog. Vet Ophthalmol 2002; 5: 29-33. https://doi.org/10.1046/j.1463-5224.2002.00215.x
  18. Scott-moncrieff JC, Chan TC, Samuels ML, Cook JR, Coppoc GL, Denicola DB, Richardson RC. Plasma and cerebrospinal fluid pharmacokinetics of cytosine arabinoside in dogs. Cancer Chemother Pharmacol 1991; 29: 13-18. https://doi.org/10.1007/BF00686329
  19. Smith PM, Stalin CE, Shaw D, Granger N, Jeffery ND. Comparison of two regimens for the treatment of meningoencephalomyelitis of unknown etiology. J Vet Intern Med 2009; 23: 520-526. https://doi.org/10.1111/j.1939-1676.2009.0299.x
  20. Sorjonen DC. Clinical and histopathological features of granulomatous meningo encephalomyelitis in dogs. J Am Anim Hosp Assoc 1990; 26: 141-147.
  21. Stalis IH, Chadwick B, Dayrellhart B, Summers BA, Vanwinkle TJ. Necrotizing Meningoencephalitis of Maltese Dogs. Vet Pathol 1995; 32: 230-235. https://doi.org/10.1177/030098589503200303
  22. Talarico LR, Schatzberg SJ. Idiopathic granulomatous and necrotising inflammatory disorders of the canine central nervous system: a review and future perspectives. J Small Anim Pract 2010; 51 :138-149. https://doi.org/10.1111/j.1748-5827.2009.00823.x
  23. Timmann D, Konar M, Howard J, Vandevelde M. Necrotising encephalitis in a French bulldog. J Small Anim Pract 2007; 48: 339-342. https://doi.org/10.1111/j.1748-5827.2006.00239.x
  24. Tipold A. Diagnosis of inflammatory and infectious diseases of the central nervous system in dogs: a retrospective study. J Vet Intern Med 1995; 9: 304-314. https://doi.org/10.1111/j.1939-1676.1995.tb01089.x
  25. Tipold A, Fatzer R, Jaggy A, Zurbriggen A, Vandevelde M. Necrotizing Encephalitis in Yorkshire Terriers. J Small Anim Pract 1993; 34: 623-628. https://doi.org/10.1111/j.1748-5827.1993.tb02598.x
  26. Uchida K, Hasegawa T, Ikeda M, Yamaguchi R, Tateyama S. Detection of an autoantibody from Pug dogs with necrotizing encephalitis (Pug dog encephalitis). Vet Pathol 1999; 36: 301-307. https://doi.org/10.1354/vp.36-4-301
  27. Zarfoss M, Schatzberg S, Venator K, Cutter-Schatzberg K, Cuddon P, Pintar J, Weinkle T, Scarlett J, Delahunta A. Combined cytosine arabinoside and prednisone therapy for meningoencephalitis of unknown aetiology in 10 dogs. J Small Anim Pract 2006; 47: 588-595. https://doi.org/10.1111/j.1748-5827.2006.00172.x