Section: Veterinary Care In-depth
Diagnosis In-depth
Your veterinarian will perform a complete physical and neurologic examination and may order some additional tests:
Complete blood count or hemogram allows your veterinarian to know the extent of the disease process and occasionally yields a diagnosis.
Serum chemistry analysis can help assess the body's overall health status and may assist in choosing specific tests. For instance, toxoplasmosis, neosporosis and mycoses will cause the globulins in the serum chemistry analysis to be markedly elevated.
Urinalysis to assess kidney function and check for organisms in urine.
Depending on the results of the individual tests above, other tests may be required and could include:
Neuroimaging (CT and/or MRI) will assess the brain and/or spinal cord for compressive lesions as well as changes in the parenchyma of the neural tissue. A prognosis based on the morphologic changes in the neural tissue is possible, although tissue diagnosis may be the best.
A myelogram or myelogram and CT may help diagnose compressive lesions in the spinal cord, although these tests will not assess parenchymal damage in the brain and spinal cord.
X-rays of the chest and abdomen
Cerebrospinal fluid (CSF) tap is the most powerful tool to determine the presence of inflammation in the neural tissue. It will occasionally give us a complete diagnosis as in the cases of mycotic diseases if the organism is seen directly in the sample.
Electroencephalogram can assess the electrical activity in the brain
Bacterial and viral cultures of CSF
Serological testing of the blood
Neuroimaging and CSF tap procedures require general anesthesia, which has risks for sick animals
Treatment In-depth
The general goals of treatment are to provide supportive care and relieve symptoms.
Specific treatment is indicated when a cause can be determined.
Broad-spectrum antibiotics may be prescribed for bacterial infections. Oftentimes, your veterinarian will choose an antibiotic empirically before a final culture and sensitivity is returned. A different antibiotic may be added if the culture indicates it.
Anticonvulsants may be given to treat seizures. Some anticonvulsants include phenobarbital, potassium bromide, chlorazepate, valproic acid, gabapentin, felbamate and lamotrigine. Diazepam (valium) is used for emergency or short term use.
Following inflammation, a scar may form on the brain and may be a predisposing factor for seizure disorders even after your pet has completely recovered from the initial illness.
Corticosteroids, such as dexamethazone or prednisone, are used to reduce cerebral edema and inflammation. Corticosteroids should be avoided if there is an active bacterial infection causing the inflammation.
Non-steroidal anti-inflammatory drugs are used to reduce fever and pain.
Supportive care (rest, nutrition, and fluids) allows your pet to fight the inflammation. If your pet cannot tolerate medications, food, or fluids orally, some of these things can be given intravenously.
If seizures develop during or after the meningoencephalomyelitis, anticonvulsants such as phenobarbital can be given to treat these disturbances.
Follow-up
If your pet has been diagnosed with encephalomeningomyelitis or any variant, follow all treatment recommendations and notify your veterinarian if any symptoms worsen or emergency symptoms appear. Keep your pet well-rested, warm and well fed following the illness.
The acute phase of this disease may last for 1 to 2 weeks with resolution of fever and neurologic symptoms. Some neurologic symptoms may require many weeks or months before full recovery is seen.
The outcome of meningoencephalomyelitis varies. Some cases are mild, brief, and have complete recovery. Others are severe and protracted with permanent damage. Death is possible.
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