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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.

Steroid-Responsive Meningitis-Arteritis Average Cost

From 43 quotes ranging from $3,000 - $8,000

Average Cost

$2,500

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
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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
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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.

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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.

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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.

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Steroid-Responsive Meningitis-Arteritis Average Cost

From 43 quotes ranging from $3,000 - $8,000

Average Cost

$2,500

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

Need pet health advice? Ask a vet

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Ask a Vet

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Beagle

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Twenty Two Months

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Unknown severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Unknown severity

Has Symptoms

Shaking, Couldn’T Hold Head Up, Stopped Eaing And Drinking.

He is doing better but still doesn’t hold head up like he use to, not active very much anymore and has gained 4 pounds (started at 18 lbs and now 22 lbs). Can I take him on leach walks to help with weight issues?

Aug. 2, 2020

Owner

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Dr. Michele K. DVM

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0 Recommendations

Thank you for your question. Unfortunately, without knowing more about what is going on with him, I cannot comment on whether he can go for leash walks. It would be best to follow up with your veterinarian with this question, as they have examined him, know what is going on with him, and and know what to expect with the medications that he is on. I hope that all goes well for him.

Aug. 2, 2020

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Mixed breed

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Three Years

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Unknown severity

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0 found helpful

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Unknown severity

Has Symptoms

Srma

Our dog Hazel was diagnosed with SRMA a few months ago. She has been taking prednisone to help treat it. However she is due for her yearly vaccinations at the beginning of August. Can she be vaccinated with an auto immune disease? Our vet has suggested doing a half dose then coming back the next week and doing the other dose to keep her vaccinated.

July 14, 2020

Owner

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Dr. Gina U. DVM

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Hello Yes your dog can be vaccinated but many vets opt to hold out on the vaccines until the patient and the disease are stable. Please consult with your veterinarian on what is the best vaccination protocol for your pet. Good luck.

July 14, 2020

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Snoopy

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Beagle

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11 Months

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Muscle Tremors
Shaking
Lethargy
Lowered Head

My dog was diagnosed with SRMA. He first displayed symptoms at 4 months and he’s relapsed three times. He was treated with prednisolone each time, but only for a 3 week period. He would relapse within 1 month of finishing the meds. After his latest relapse we took him to a specialist and she prescribed prednisone and directed us to double the dosage for a week and then continue with half the dosage for 4-6 weeks. Is there a significant difference between prednisone and Prednisolone? His symptoms have abated but he does experience lethargy and shakes in the mornings and late afternoon before we give him his meds. He also lacks any desire to play or be active. Is there any other form of treatment other than prednisone? Is acupuncture a viable option? Will we have to give him steroids for the rest of our dog’s life? What are the potential consequences of continued corticosteroid use?

July 11, 2018

Snoopy's Owner

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0 Recommendations

Prednisone is converted into prednisolone by the body, by giving prednisolone your just skipping a step in the conversion of the medication; corticosteroid therapy may be required for months and tapered off slowly in order to treat this condition. Long term effects of corticosteroid therapy include immunosuppression, increased thirst, increased hunger, lethargy among other side effects. Regards Dr Callum Turner DVM

July 11, 2018

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Just a question

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Bullmastiff

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9 Months

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Moderate severity

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0 found helpful

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Moderate severity

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All

I see that in the description of causes it says that it may be genetic but may be caused from a viral infection from environmental or possibly vaccines ? Do they really know what it is caused from ? Can it me passed from mother and father to puppy ?

June 15, 2018

Just a question's Owner

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0 Recommendations

The cause for steroid responsive meningitis arteritis is still largely unknown with a few theories to the cause and no definitive diagnostic test; some breeds are predisposed to the condition but may occur in any breed. Regards Dr Callum Turner DVM

June 16, 2018

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Milo

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Pomeranian

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2 Years

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Serious severity

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Serious severity

Has Symptoms

Anxious
Left Hind Leg Slow Reflex
Goose Walk

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 ?

April 1, 2018

Milo's Owner

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Dr. Michele K. DVM

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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.

April 2, 2018

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Turbo

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Boxer

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1 Year

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Critical severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Critical severity

Has Symptoms

Arched Back
Fever
Paralysis
Rigid
Lowered Ears

My 12 month old Boxer came down with what we know now is SRMA, he had a sore toe on Monday, went to the vet on Tuesday and a mild pain reliever was given, on Wednesday he was just not himself and later that night I found him in his crate front legs rigid, neck stiff and hind legs not able to move. We rushed him to Medvet where he stayed in ICU for three days and underwent an MRI, spinal tap and other tests to tell us he has SRMA. We were told by the Neurologist there is no reason he should not be walking in a week, he should make a full recovery. We have had him home now for 12 days and he as no response in his hind legs, can not feel pain in his feet and has no control of his bowels or urinating. He is currently on 500mg of Gabepentine every 8 hrs, 50 mg of tramadol every 6 hrs, 60 mg of prednisone every 12 hrs. After several calls to Medvet to speak with the neurologist that cared for him the only thing I was offered by a vet tech (not even a return call from the dr that seen him) was to come back in for a re-evaluation and pay them again for more tests. We are just a loss of what to do for our baby.

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Zoey

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Border Collie/ mastiff/ cattle dog cross

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8 Months

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Serious severity

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Serious severity

Has Symptoms

All Over Body Pain, Unable To Move
All Over Body Pain, High Fever

Our girl Zoey was about 8 months old when she first became unwell. She had a high fever, unable to move without pain, particularly her neck, she seemed like her pain was so bad she was barely responsive when we’d talk to her. Initially she was on antibiotics & meloxicam pain relief as we thought it was an infection related to some small cuts from playing rough with another young dog we’d looked after. She got better within a few days & was back to being herself. It happened a second time about a month later but was even worse this time & she would barely move. This time she was just treated with meloxicam pain relief & again improved almost immediately. It then happened a third time & we knew something was very wrong. She was diagnosed with poly arthritis & started on pred for a month but relapsed 6 weeks later. At this relapse we spoke to a specialist & he suggested it was most likely Steroid Responsive Meningitis. We were living rurally & it was quite a distance to take her to the specialist. They told us of our options to CSF but we decided against stressing Zoey out with travel & just went with their recommendation for treatment & ongoing monitoring by the local vet (who was amazing). Zoey began on pred at 40mg twice daily (80mg a day) and slowly tapered down incrementally. When we first started her on this she experienced severe muscle atrophy. It was quite distressing to see & she looked almost skeletal. Zoey relapsed once more during tapering which as I said was extremely slow (across months - we would keep her on a dose for up to 6-8 weeks before going down to the next). When she relapsed again we just went back up a dose & stayed there for a while before beginning to taper down again. She eventually started to look like herself again after the dose was decreased & her muscles mass started to return. We eventually got her down to 2mg a day, then 1mg, then 0.5mg... In all, I think Zoey was on pred for approximately around 2.5 years. It was a rough time for us being afraid that she might relapse again even on the pred but we are so glad we persisted. Zoey is now 4.5 years old & is a healthy happy dog. She does have issues with her teeth as the cells that form healthy enamel were impacted by her high fevers during development & possibly also by the long use of Pred but she is otherwise well. I just wanted to share our experience to give other people hope. We understand that long term steroid use is not ideal & Zoeys life may be shortened by this but we are just glad she’s still with us & able to live a happy life.

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Penny

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Whippet

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9 Months

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Serious severity

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1 found helpful

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Serious severity

Has Symptoms

Fever
Fever ,Lethargy

My beautiful whippet Penny aged 9 months started standing in a strange way and seemed to be losing muscle condition and weight. She then, a few days after I noticed these symptoms, ran a fever. I took her to a vet who gave a her pain relief. The next day, she was worse and was admitted for fluids and bloods. These came back as unremarkable. She remained on fluids the next day and I brought her home. By the next day, she was much worse, hardly moving, apathetic and not eating. She yelped in pain when touched and I could tell she was in a lot of pain. I took her back to the vet who mentioned that she might have Steroid Responsive Meningitis and this could only be diagnosed with a spinal fluid test and CT scan. We waited two days as it was the weekend and she had the test on the Monday. These all confirmed the high chance that this was the problem. The vet ran a blood test for C reactive protein and we were told this was off the scale. She is on 25mg steroid a day and intially response was good but she seemed to more more unwell after 10 days of treatment and showing the stance with lowered head and some pain. My question is, does this condition fluctuate regardless of the medication? I know that recovery can take some time, is it normal for a small relapse and return of symptoms while being medicated? She is active and happy for some of the day, eats well but seems to be miserable at night and unable to settle. Her stomach seems very upset as well.

Steroid-Responsive Meningitis-Arteritis Average Cost

From 43 quotes ranging from $3,000 - $8,000

Average Cost

$2,500

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