Steroid Responsive Meningitis-Arteritis in North American Dogs

Steroid responsive meningitis-arteritis (SRMA) is a common inflammatory disease of the central nervous system in young dogs. A recently published study¹  examining records from a British veterinary referral hospital found that 48% of juvenile dogs that presented with a fever were diagnosed with SRMA. Most of the published literature on this disease describes cases from Europe, but a dedicated group of dog owners and researchers are collaborating with the AKC Canine Health Foundation (CHF) to learn more about the disease in North American dogs.

SRMA is characterized by immune-mediated inflammation of the meninges (the membranes that envelope the brain and spinal cord) and associated blood vessels. The acute form is most common in dogs less than 18-24 months old. Clinical signs such as severe neck pain, high fever, and lethargy are experienced intermittently. MRI may be normal and infectious disease testing will be negative in affected dogs, but cerebrospinal fluid analysis reveals severe neutrophilic inflammation (neutrophils are a type of white blood cell). C-reactive protein (a substance produced by the liver in response to inflammation) is elevated in the serum of affected dogs and mirrors the level of neutrophils in the cerebrospinal fluid, providing a non-invasive way to monitor a dog’s response to treatment. Immuno-suppressive doses of steroids such as prednisone have been the standard treatment, with additional immuno-suppressive medications added as needed. Patients are slowly weaned off medications, but inadequate treatment may lead to a more chronic form of the disease.

Jeanie Lau, BVSc received a 2017 CHF Clinician-Scientist Fellowship and was awarded funding to study SRMA under the mentorship of Dr. Karen Muñana at North Carolina State University. The objectives of CHF Grant 02324-E were to describe the clinical course of SRMA in a population of North American dogs, determine if there were breed differences in the clinical course of disease, and evaluate owner perception of the quality of life for affected dogs. The study examined records from 61 dogs: 32 cases seen at the North Carolina State University Veterinary Teaching Hospital from 2003 to 2017 and 29 cases identified through an owner survey distributed by CHF.

Results of this study were presented at the Annual Forum of the American College of Veterinary Internal Medicine in June 2018² and a manuscript is being prepared for publication. Blood or saliva samples were banked on a portion of dogs in the study, providing a valuable resource for future research on the genetics and environmental triggers for SRMA. Dog owners and veterinarians can also learn more about this disease and study through the CHF-sponsored webinar “Understanding Steroid Responsive Meningitis-Arteritis and Other Inflammatory Neurological Disorders In Dogs” recorded in November 2018 and available on-demand here.

Steroid responsive meningitis-arteritis significantly impacts the quality of life of affected dogs and their owners. The AKC Canine Health Foundation and its donors remain committed to improving the health of all dogs through scientific research and dissemination of health information to prevent, treat and cure canine disease. A better understanding of SRMA in North American dogs is a necessary first step to tackle this challenging disease. Support CHF-funded research at akcchf.org/donate so that all dogs can live longer, healthier lives.

1. Black VL, Whitworth FJ, and Adamantos, S. (2018) Pyrexia in juvenile dogs: a review of 140 referred cases. J Small Anim Pract.
doi:10.1111/jsap.12938
2. Lau J (2018) Clinical Characteristics of Steroid Responsive Meningitis‐Arteritis in a Population of Dogs in North America. In: 2018 ACVIM Forum Research Abstract Program. J Vet Intern Med.
doi.org/10.1111/jvim.15319

Update:

The results of this research have been published in the Journal of Veterinary Internal Medicine. The conclusion notes that “Golden Retrievers and Wirehaired Pointing Griffons should be considered among the breeds recognized to develop SRMA. Treatment with higher corticosteroid dosages is correlated with more severe adverse effects and worse quality of life (QoL), but it may not improve clinical outcome.”
For the full article, see: 
Lau J, Nettifee JA, Early PJ, Mariani CL, Olby NJ, Muñana KR. Clinical characteristics, breed differences, and quality of life in North American dogs with acute steroid-responsive meningitis-arteritis. J Vet Intern Med. 2019;1–9.
https://doi.org/10.1111/jvim.15543