Myelitis and meningitis

Retrobulbar steatitis and meningitis/empyema secondary to right otitis media, right otitis interna and an inflammatory polyp in a cat

The purpose was to describe a case of retrobulbar steatitis and meningitis in a cat caused by otitis media, otitis interna and an inflammatory polyp in the middle ear. Investigations included ophthalmic and neurological examinations, haematology and biochemistry, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis and aerobic, anaerobic bacterial and fungal culture of material from the middle ear. A 6-year-old female neutered domestic-short-haired cat presented with right-sided exophthalmos and resistance to retropulsion. Anisocoria, reduced corneal sensation and oculocephalic movements and low Schirmer tear test (STT1) were found. An MRI revealed the right external ear canal and tympanic bulla to be fluid filled with presence of a thickened contrast-enhancing mucosa. Contrast enhancement extended into the calvarium, as marked thickening and contrast enhancement of the pachymeninges, and further rostrally through the right orbital fissure into the orbit. The retrobulbar tissues were swollen, resulting in mild exophthalmos. Enrichment culture of material from the middle ear revealed Klebsiella pneumonia susceptible to marbofloxacin. The cat underwent a total ear canal ablation with removal of the cartilaginous cuff at the external auditory meatus and local debridement and curettage. A polypoid structure was removed from the middle ear. No bulla osteotomy was performed. Horner’s syndrome was present immediately following surgery. The cat received a course of systemic dexamethasone (1mg/cat SID/3 weeks) tapered off and marbofloxacin (2mg/kg SID/2 weeks). Follow up at 120 days showed no recurrence of the symptoms. The Horner’s syndrome and low STT1 had resolved and returned to normal values respectively. This case highlights the importance of MRI in the investigation of retrobulbar diseases. MRI is a useful tool for the evaluation of the extent of the lesion and the appearance of adjacent structures in which additional potentially life-threatening abnormalities, such as meningitis, can be seen.

Arrhythmias and elevated troponin I in a dog with steroid-responsive meningitis-arteritis

A 10-month-old dog was presented with clinical signs of fever, lethargy, inappetence, and cardiac arrhythmias. Computed tomography scan and cerebrospinal fluid analysis supported the diagnosis of steroid-responsive meningitis-arteritis. Echocardiography, electrocardiogram, and elevated serum troponin I supported a diagnosis of myocarditis. The arrhythmias resolved during treatment of the primary neurological disease, and they were considered as secondary to the meningitis.

Non-suppurative meningoencephalitis of unknown origin in cats and dogs: an immunohistochemical study

Non-suppurative meningoencephalitis of unknown cause is a frequent finding in dogs and cats. Fifty-three dogs and 33 cats with non-suppurative meningoencephalitis of unknown aetiology were examined immunohistochemically for 18 different infectious agents, including viruses, bacteria and prion protein^Sc. In 14 (26%) of the dogs and 13 (39%) of the cats a causative agent was identified in the central nervous system (CNS), two dogs and one cat giving positive results for two infectious agents simultaneously. The study revealed infections with known causative agents (porcine herpes virus 1, feline infectious peritonitis virus, Escherichia coli) and a new disease pattern of parvovirus infection in the CNS of dogs and cats. Infection of the CNS with feline leukaemia virus was found in a cat. Five dogs and four cats gave positive results for West Nile virus (WNV) antigen. In one dog, canine parainfluenza virus antigen was detected in the brain. Four dogs and four cats gave positive results for encephalomyocarditis virus (EMCV). The significance of the detection of WNV and EMCV antigen requires further study. The aetiology remained undetermined in 39 dogs (74%) and 20 cats (61%). Although it is possible that non-infectious causes play a more important role than previously thought, infections with hitherto unrecognized agents cannot be ruled out.

Aseptic Suppurative Meningitis in Juvenile Boxer Dogs: Retrospective Study of 12 Cases

Immune-mediated central nervous system inflammation is described in a series of 12 juvenile boxer dogs. A diagnosis of steroid-responsive meningitis-arteritis was made based on the clinical presentation and on diagnostic findings. The boxer breed was at a higher risk for this inflammatory condition than other breeds. Long-term follow-up (>2 years) confirmed a better prognosis in this breed than in the beagle and the Bernese mountain dog. Complete resolution of clinical signs without significant deficits or recurrences was obtained in all cases. Early clinical recognition and immunosuppressive treatment resulted in a better response and complete resolution of the disorder.

Meningitis in a dog caused by Prevotella oralis

Prevotella oralis, an obligate Gram-negative anaerobe, was shown to be the cause of meningitis in a two-year-old crossbreed dog. The dog had a six-week history of lethargy and neck pain. On presentation, the animal was reluctant to walk, had a stiff gait and neck pain on flexion. Analysis of cerebrospinal fluid documented a neutrophilic pleocytosis (7488 cells/microl) and the presence of occasional intracellular bacterial coccobacilli. The aetiological diagnosis was confirmed by routine aerobic and anaerobic culture, and identification of the isolates. This report also reviews the literature of the documented cases of bacterial meningitis in dogs.

Diagnosis of inflammatory and infectious diseases of the central nervous system in dogs: a retrospective study

The medical records of 220 dogs with inflammatory/infectious diseases of the central nervous system (CNS) were retrospectively examined. The aims of the study were to determine if clinical and clinicopathologic data (not including biopsy or necropsy examination) could distinguish inflammatory CNS diseases from diseases of other types, and to search for criteria allowing differentiation of specific inflammatory diseases. The signalment, historical findings, extraneural and neurological signs, and the lesion site contributed marginally to a specific diagnosis. Multifocal signs were only noticed in one third of the dogs with inflammatory/infectious diseases. Particular neurological abnormalities were more frequent in certain diseases than in others (eg, myoclonus was frequent in dogs with distemper, but it was also found in those with other meningoencephalomyelitides). Hematologic findings contributed to the diagnosis in certain conditions (eg, canine distemper encephalitis, protozoal encephalomyelitis, steroid-responsive meningitis-arteritis). Cerebrospinal fluid examinations, including immunoglobulin G index and cytology were useful to separate meningoencephalomyelitides from the other CNS diseases and to distinguish certain conditions from others. In most cases a specific diagnosis depended on a combination of clinical signs and ancillary diagnostic aids. Still, a specific diagnosis remained very difficult, if not impossible, in at least one third of the dogs.