Steroid-Responsive Meningitis-Arteritis Average Cost

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Average Cost

$2,500

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What are Steroid-Responsive Meningitis-Arteritis?

The meninges are layers of connective tissue that surround the brain, the spinal cord and cerebrospinal fluid (CSF), and the arteries and vessels contained within them. Steroid-responsive meningitis-arteritis results in the presence of white blood cells in the CSF and it is suspected by researchers that the immune system may be mistakenly attacking the meninges. The condition is known by many other names including aseptic suppurative meningitis, Beagle pain syndrome, necrotizing vasculitis, and canine juvenile polyarteritis syndrome. This condition affects young dogs most often with the typical age of onset being 6 to 18 months, but the age range can go up to approximately seven years. Prognosis ranges from excellent to guarded depending on the age of the dog, the pet’s response to the treatment, and the risk of secondary complications like spinal cord compression.

Steroid-responsive meningitis-arteritis (SRMA) is an inflammatory disease of the central nervous system, affecting the meninges (layers of tissue that surround the brain) and the meningeal arteries. This is a well-recognised disease in the field of veterinary medicine and the prognosis can be very positive with prompt treatment and aggressive therapy.

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Symptoms of Steroid-Responsive Meningitis-Arteritis in Dogs

The symptoms for SRMA can be chronic or present as flares of an intermittent nature. Your pet may be showing signs of stiffness and pain only to have the symptoms disappear. It is best to have your canine family member checked by a veterinarian nonetheless because steroid-responsive meningitis-arteritis can lead to serious complications if not attended to.

  • Back pain
  • Neck pain
  • Vocalization of the discomfort
  • Fever
  • Lowered head
  • Arched back
  • Stiff gait
  • Rigid stance
  • Depression
  • Lethargy
  • Sometimes there may be muscle spasms

Types

Acute

  • This is the most common form
  • Presents with pain along the back
  • Typical signs of fever, stiff gait, and rigid back are seen
  • The dog will remain in a hunched position

Chronic

  • This can occur as the result of the relapse of an acute attack after treatment
  • Secondary complications to chronic SRMA are many, including muscle weakness, seizures, and loss of bodily control

Causes of Steroid-Responsive Meningitis-Arteritis in Dogs

The cause for steroid-responsive meningitis-arteritis is not definitively known but there are concrete suspicions as to why it occurs due to constant research on the condition.

  • There may be a genetic predisposition
  • All breeds can be affected but there is an over-representation in studies of the following breeds: Boxers, Beagles, Weimaraners, Bernese Mountain Dogs, and the Nova Scotia Duck Tolling Retriever
  • The breed disposition may make the prognosis for recovery more guarded for canines of that type
  • Studies show there may be an abnormal immune response to the central nervous system
  • Researchers think there could be a link between a genetic reaction to the environment
  • The condition can accompany immune-mediated polyarthritis suggesting a possible connection
  • Some researchers feel there may be a link between vaccinations and the possible desensitization of the dog to viral antigens
  • There could be a relation to age as older dogs can be less responsive to treatment

Diagnosis of Steroid-Responsive Meningitis-Arteritis in Dogs

When you bring your canine family member to the clinic the veterinarian will do a physical examination. This will be done with great care as no doubt, your pet is most likely in pain even though he may not display the extent of it to you. Along with taking your dog’s temperature, the veterinarian will do an examination that includes looking for neurological abnormalities in your pet’s behavior and mannerisms. Dogs with advanced SRMA will have dramatically increased signs of weakness and possible indications of impending paralytic effects.

Standard tests that may help in the diagnostic process are urinalysis, complete blood count, and serum chemistry. For instance, in the serum chemistry, your veterinarian may see markers that stand out and could mean SRMA, such as acute phase protein (APP), alpha2 macroglobulin, elevated IgG,  and C-reactive protein (CRP). CRP is a marker that is very indicative of an inflammatory process in the body.

Radiographs and MRI could be the next steps in the search for a diagnosis. The veterinarian will need to investigate the stability of the spine which can be compromised in some diseases. The veterinary team will want to rule out illnesses such as discospondylitis, ascertain whether there has been a trauma to the body that could be causing the arched back and pain, and verify that there are no infections or tumors that could bring on intense fever and discomfort.

Once the stability of the spine and joints has been confirmed, a sample of the cerebrospinal fluid will be taken. In addition to checking for bacteria, fungus, or other inflammatory conditions, the analysis of the CSF could indicate that there is an increase in white blood cells. This factor, along with the physical signs, is very indicative of SRMA.

Treatment of Steroid-Responsive Meningitis-Arteritis in Dogs

A dog with a mild case of SRMA can be treated with NSAID’s. Most cases, however, are beyond mild. Young dogs in the acute phase (most commonly seen) are treated with anti-inflammatories and long-term immunosuppressive therapy which lasts between a minimum of 4 months up to 20 months in duration. Prednisolone and prednisone are the usual choices, with a tapering prescription that will be determined in length by follow-up testing and your pet’s clinical response to the medication. A canine who has chronic and recurring SRMA will most likely need a drug therapy given on alternating days which will consist of an immunosuppressive drug and a glucocorticoid. Early in the treatment regimen, pain relief may be necessary also.

Recovery of Steroid-Responsive Meningitis-Arteritis in Dogs

Follow-up appointments will be very important and absolutely necessary with a diagnosis of steroid-responsive meningitis-arteritis. Your veterinarian will determine the schedule of the return visits which will depend on how well your furry family member responds to the treatment. The follow-up will mean repeat blood tests and analysis of the CSF until the veterinarian can see that the markers have returned to normal. This could mean appointments every 4 to 6 weeks for several months. It is imperative that you keep the appointments and do not discontinue the medication even though you may think your dog is feeling better. It should be noted that many pets will need a prescription for gastroprotectants; if you see any side effects from the long-term therapy such as blood in the stool or vomiting, or if you are concerned in any way with your pet’s health, contact the clinic without delay. With SRMA there is a potential for relapse, meaning that continued contact with your veterinarian will be recommended.

Steroid-Responsive Meningitis-Arteritis Questions and Advice from Veterinary Professionals

Milo
Pomeranian
2 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Goose walk
Left hind leg slow reflex
anxious

Medication Used

Altosec
Medrol
Phenobarbital

In the beginning of December 2017 Milo started having tremors, the vet assumed it was due to the Belgium chocolate he stole and ate, then for a few weeks it went away and then it started again much more frequently and much worse, we did an MRI that showed that his brain was swolen, then the vet prescribed the medications and antibiotics, he used to show alot more affection towards people but now he doesn’t, he did well for 2 weeks until the antibiotics was finished and they reduced the cortisone then he relapsed, then the vet put him back on antibiotics and increased the cortisone, now the antibiotics are finished and he is still on the medication listed, what would you suggest we do next, and to help him ?

Dr. Michele King, DVM
Dr. Michele King, DVM
1064 Recommendations
Unfortunately, without knowing more about Milo and his test results, I'm not sure that I can offer any insight into his case. He may need to have a referral to a specialist to discuss further care for him, as well as any details on his prognosis or possible treatment . I hope that he is okay.

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Jesse
Boxer
11 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Gran mal seizures

Hello, my 11 year old Boxer was officially diagnosed with Steroid/antibiotic responsive seizure disorder today but symptoms started Oct. 2017. Gran Mal cluster seizures, sudden onset, 4 times a day. she was treated with 2 antibiotics, Pred, and Pheno. Dx was Antibody flare up, or brain tumor. I was told if she did not respond to Tx that she had 6-2months to live, and likely it was a tumor. I could not afford vet care after that so I finished antibiotics and taped pred and pheno. her seizures returned. Gran -Mal 2-3 times a week, lethargic, confused on no meds. Is it common for a dog of this age to have this disorder? her seizure activity returned. does that not rule out this disorder and basically confirm brain tumor?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2484 Recommendations
A condition like steroid-responsive meningitis-arteritis whilst common in Boxers, normally affects dogs less than two years old; there are many different causes for seizures in dogs which may include head trauma, tumours, poisoning (chronic), autoimmune disease among many other causes. For a diagnosis of brain tumour to be made, all other possible causes for seizures need to be ruled out first (diagnosis of exclusion) or a CT or MRI scan needs to be done to visualise the tumour to confirm the diagnosis. Regards Dr Callum Turner DVM

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Roscoe
Pit bull
7 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Fever
Confusion
Not responsive to name
Walking into walls
Stumbling
Trembling

Medication Used

Something to help stomach from prednisone
antibiotics
prednisone

Roscoe started with a fever and shivers 2 weeks ago on the 16th The vet prescribed Ciprofloxacin. He took them for 4 days until the 20th. then started to stumble, walk aimlessly/pace for hours unless we stopped and held him. Acted confused if he walked behind a door, didn't know what to do until we corrected him. He still ate and drank water and went to the bathroom. We got snowed in from a blizzard on sunday and monday. We were able to get to the vet on tuesday the 23rd. Fever was gone, but all other issues were still happening. They decided to keep him and he'll have been there for a week tomorrow. Last friday the 26th, he seemed especially bad, eyes had a lot of mucus and watery. We visited again today and he still seemed confused and lost. Clean eyes, but watery. I was not specifically given the diagnosis of Meningitis, but symptoms seem almost identical. We live in a small town so I'm not sure if a CSF would be available. I know they are treating him with 6 different pills, prednisone, antibiotic and stomach pills for the prednisone effects. Plus 3 others. Without doing the CSF, is this the best treatment possible? Also, how long until we would have positive results? I know they usually have to take the prednisone for months afterwards. Sorry for the long description, but thank you for any help and information.

Dr. Michele King, DVM
Dr. Michele King, DVM
1064 Recommendations
Thank you for your email. Without being able to examine Roscoe, I really can't comment on whether he has meningitis. Without knowing what medications he is on, I am not sure if that is the best treatment possible, but it does sound like your veterinarian is treating him for his signs. If you have questions about his diagnosis and treatment, it would be best to follow up with your veterinarian, as they can see him, know how he is responding to therapy, and will know if he is improving or if he needs further care or a referral to a specialist. I hope that he recovers soon.

He is on Prednisone, Doxycycline, Famotidine, and Metronidazole. He came home today, after staying at the vets for 9 days. He seems confused, wobbly, restless, but also tired. I know Meningitis can take awhile to recover from. I'm just wondering if/when we might see a positive change. Although I know each dog is different. Thanks

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Delilah
Havanese
6 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Lethargy
Walk Unevenly
Depression

Medication Used

prednisone

My dog was diagnosed with this about a month ago when I noticed that she was walking crooked, could not turn her neck, and was not as happy as usual. We've gotten an MRI, CT scan, and have had her on prednisone. After we left her at the vet for a week in the beginning, she came back fine and had been fine until now. This past week she has been walking even more crooked than before and she seems happy still but not as excited as usual. Sometimes when she's walking, she'll just plop onto the floor and stay like that for a while. Our vet has no idea what's happening to her so I was hoping you may be able to tell me what's wrong.

Dr. Michele King, DVM
Dr. Michele King, DVM
1064 Recommendations
Thank you for your email. Unfortunately, without examining Delilah or knowing more about her, I cannot offer any insight to her diagnosis. SRMA can be a difficult disease to manage, and may need frequent medication adjustments. It would be a good idea to consult with the neurologist who did the MRI and discuss what is happening with her and what options there are - some dogs respond well to steroids and immunosuppresive drugs, and she may need that combination. I hope that she is okay.

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George
Beagle
8 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Pain
Stiffnes
Difficulty Walking

Our 8 year old blue tick beagle began showing signs of this disease almost 2 years ago. Diagnostic tests ruled out any other disease/injury, and so we’ve had him on varying doses/regiments of pred. Lately, the pred has really not been doing the job of treating symptoms. He struggles to get up, and walks in tiny, stiff steps. Are there cases of this disease which do not ever get better, and ultimately lead to having to put the dog down? It kills me to even pose the question, but lately, his quality of life is nonexistent, and I imagine is pain level is high. :(

Dr. Michele King, DVM
Dr. Michele King, DVM
1064 Recommendations
Thank you for your email. I'm sorry that this is happening to George. Sadly, this disease can progress to where it isn't controlled by steroids alone. Some dogs respond to a combination of steroid and cyclosporine, however - that may be something that you can discuss with your veterinarian as an option to keep him comfortable. I hope that he improves, that is very hard to watch happen, I am sure.

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Howie
Sproodle
3 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

Arched back, lowered head, lethargy

Medication Used

Prednisolone

My dog was diagnosed with SRMA when he was one year old. He recovered well following a course of steroids. He had a small relapse quite soon after finishing the meds so went back on them for a couple of months to ensure he was clear. That was nearly 18 months ago and he’s been healthy since. However today he’s started displaying symptoms of SRMA again. My vet had prescribed extra steroids for us to keep just in case so we can administer at first sign of it recurring as they are so fast acting. My question is, is he likely to continue to relapse every so often through his life?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2484 Recommendations
In around a fifth of cases of steroid responsive meningitis-arteritis, a patient will relapse after the conclusion of treatment or during the tapering of steroid dosage; in these cases treatment with another course of steroids or increasing current dosage (under guidance of your Veterinarian) is the best course of action. Regards Dr Callum Turner DVM

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Mr Traddles
Australian Kelpie
7 Years
Critical condition
1 found helpful
Critical condition

Has Symptoms

Fever
Pain
Ataxic

Medication Used

Doxycycline

My 7yo desexed male kelpie has been diagnosed with this, no trace of infection found so immune mediated process likely. Prior to commencing steroids and antibiotic combo therapy, he was very ill. He had a pretty much immobilising ataxia. It has shown slight improvement after 3 days. What is the chance of mobility recovery?

Dr. Michele King, DVM
Dr. Michele King, DVM
1064 Recommendations
Thank you for your question. If he has shown improvement in the three days since starting treatment, that seems a positive indicator. Without being able to examine him or know more about his signs, I can't comment on his chances for recovery of mobility, but if he continues to respond to steroid therapy, he should regain use of his limbs. Your veterinarian will know more about his specific prognosis. I hope that he does well.

I dont know if you have control of advertisements on your page, but I think that dog walking adverts that pop up over the posts are quite insensitive.

Thank you for your sensitive and honest answer. Mr Traddles is indeed improved today and it feels like hope for at least good enough recovery for him is not misplaced.

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Ozzie
Maltese shitzu
3 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Neck stiffness, circling, head pressing

Hi could the removal of a saliva gland and loss of blood pressure and haemorrhaging cause SRM in my Maltese shitzu? He was healthy when taken to the vets. We feel the operation could have caused this.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2484 Recommendations

The exact etiology of steroid-responsive meningitis-arteritis remains unclear but we believe that it is due to an autoimmune condition since the condition responds to treatment with prednisolone. I cannot say that the surgery is related as we have little data about the cause of the condition, but it cannot be ruled out. Regards Dr Callum Turner DVM
www.vetstream.com/treat/canis/diseases/steroid-responsive-meningitis-arteritis-(srma)
http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2009.0337.x/pdf

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