Treat Canis Steroid-responsive meningitis-arteritis (SRMA)

Steroid-responsive meningitis-arteritis (SRMA)

i canis

Contributor(s):

Paul Cuddon

Laurent Garosi

Synonym(s): Necrotizing vasculitis, Beagle pain syndrome, aseptic suppurative meningitis, canine pain syndrome, canine juvenile polyarteritis syndrome.

Introduction

Common(est) meningitis, usually <2 year old animals of larger breeds.
Also known as necrotizing vasculitis, Beagle pain syndrome, aseptic suppurative meningitis, canine pain syndrome, canine juvenile polyarteritis syndrome.
Signs: mimic cervical disk extrusion.
Breed: specific syndromes in Bernese Mountain Dog, Beagle, Boxers, Weimeraners, and Nova Scotia duck tolling retreivers.
Diagnosis: signs, CSF.
Treatment: corticosteroids.
Prognosis: may be acute or have relapsing pattern.

Pathogenesis

Etiology

Immunopathologic basis suspected.
Idiopathic.
Disease is believed to be heritable.
Activated T cells have been demonstrated in dogs with SRMA indicating potential contact with an antigenic stimulus.
A Th2-mediated immune response is most likely based on the presence of high CD4:CD8a ratios and a high proportion of B cells in peripheral blood and CSF.

Predisposing factors

General

Frequent exposure to monovalent attenuated live virus vaccines may sensitize patient to viral antigen and increase the risk of developing an immune-mediated reaction.

Pathophysiology

Cerebral vessel injury due to immunologic disease → deposition of immune complexes in vessel walls → activation of Hageman Factor → activation of complement, kinin, and plasma systems → chemotaxis of neutrophils → enhanced vessel wall permeability → fibrin deposition, thrombosis and necrosis.
Clinical signs result from a combined meninigitis and arteritis of leptomeningeal vessels.
The arteritis also may involve the vessels of the heart, mediastinum and thyroid glands.

Timecourse

Slowly progressive course over several months
Animals may experience cyclic bouts of the disease with each bout lasting 5-10 days with intervening periods of complete or partial normalcy lasting at least one week.

Diagnosis

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Treatment

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Outcomes

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Steroid-responsive meningitis-arteritis (SRMA)

Introduction