Aseptic Meningitis

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Aseptic Meningitis

By: Dr. John McDonnell

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Section: Veterinary Care In-depth

Veterinary care should include diagnosis and treatment.

Diagnosis In-depth

Diagnostic tests are needed to determine your pet's general health and to rule-out other diseases that may mimic aseptic meningitis. In addition to obtaining a complete medical history and physical examination your veterinarian will perform the following tests:

Neurological assessment to evaluate your dog's neurologic system

Ophthalmologic examination to evaluate your dog's visual system especially the fundus, or the back of the eye

Laboratory evaluation, including a CBC, chemistry profile and urinalysis

With aseptic meningitis the commonly found abnormalities on the history, physical and neurological examination include fever, lethargy, neck pain and anorexia. There should be no other neurologic abnormalities found besides neck discomfort and proprioceptive deficits (placement of feet).

Abnormalities found on the lab tests may include high white blood cell count, and decreased platelet counts. Other abnormalities may be found secondary to the illness.

Cerebrospinal tap (CSF) evaluating the cerebrospinal fluid that bathes the CNS. A CSF tap requires anesthesia, and the analysis of the fluid must be performed promptly to prevent errors. The CSF tap is typically inflammatory with no bacteria, virus, fungus or other cause visible. The CSF may be cultured to make sure there is not a bacterial component to the signs.

Treatment In-depth

Treatment for aseptic meningitis may include treatment with immunosuppressive drugs, most commonly s prednisone at a dose of at least 2 mg/kg twice a day. Medication is usually given orally unless your dog is too sick. In these cases, your veterinarian may start injectable medications. Treatment may be delayed until the results of the CSF tap are known.

Medications must be given long term – more than 4 weeks is typical. Medication is generally tapered gradually to alternate days over the course of treatment, which is usually several months. Response to treatment is typically seen within 24 to 48 hours of starting medications. Side effects from the medications include increased eating, drinking, urinating, and panting.

Relapses may occur during the tapering course. Relapses usually respond to increasing the medication dose and/or adding a second immunosuppressive drug.

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