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Tierarztl Prax Ausg K Kleintiere Heimtiere 2020; 48(01): 5-12
DOI: 10.1055/a-1069-6795
Original Article

Steroid-responsive meningitis-arteritis in dogs in Germany: Are there epidemiological or clinical factors influencing recurrence rate?

Steroid-responsive Meningitis-Arteriitis bei Hunden in Deutschland: Existieren epidemiologische und klinische Einflussfaktoren auf die Rezidivrate?
Elisabeth Hilpert
1   Department of Small Animal Medicine, University of Leipzig, Leipzig
,
Andrea Tipold
2   Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover
,
Nina Meyerhoff
2   Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover
,
Johannes Schwerdt
3   Data and Knowledge Engineering, Otto von Guericke University, Magdeburg
,
Sandra Winkler
4   Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Applied Molecular Hepatology, University of Leipzig, Leipzig
,
Konrad Jurina
5   Small Animal Clinic Haar, Haar
,
Andrea Fischer
6   Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Munich
,
Marion Kornberg
7   AniCura Animal Clinic GmbH Trier, Trier
,
Birgit Parzefall
8   Animal Clinic Oberhaching, Oberhaching
,
Thomas Flegel
1   Department of Small Animal Medicine, University of Leipzig, Leipzig
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Abstract

Objective Steroid-responsive meningitis arteritis (SRMA) is one of the most common inflammatory diseases of the central nervous system in dogs. The present study examined breed and sex predisposition factors based on the population of dogs in Germany as well as epidemiological and clinical factors regarding the relapse rate of SRMA.

Material and methods Data of 153 dogs with SRMA (SRMA) were analysed retrospectively in this multicentre study. It was investigated whether some dog breeds that suffer from SRMA were disproportionately more often (n ≥ 5) represented when compared to the total population of dogs in Germany. Furthermore it was examined which sex is affected more often. Data provided by “Verband für das deutsche Hundewesen“ (VDH) and „Tasso e. V.“ was used as reference data of the total population. The following factors were investigated with regard to the occurrence of one or more relapses: signalment; body weight; age at first presentation; time period between last vaccination and onset of clinical signs; clinical signs and timepoint of the first SRMA manifestation; results of cerebrospinal fluid (CSF) analysis at first presentation (nucleated cell count and differentiation, protein concentration); immunglobulin A and C-reactive protein (CRP) concentrations in serum and CSF; immunosuppressive medication; follow-up data including response to therapy, occurrence of relapses and mortality including reasons, i. e. due to the disease, therapy or euthanasia.

Results The breed had a statistically significant influence on the development of SRMA (p < 0.05). Beagles and Boxers were affected more often by SRMA than other breeds in relation to the total population in Germany. Relapses occurred in 29.4 % of the 153 dogs of this study. In contrast to the development of SRMA, in which male dogs have a significantly increased risk of developing SRMA (p < 0.05), female dogs are more likely to relapse (p = 0.02). Patients on prednisolone monotherapy had fewer relapses than those with prednisolone and azathioprine in combination (p < 0.05). Younger age (p = 0.071) und lower CRP concentrations (p = 0.081) at first presentation were tentatively associated with a higher incidence of relapses.

Conclusion The determined breed and sex predispositions support the diagnosis of SRMA arteritis and confirm previous observations. This study allows a more accurate explanation to owners about the risk of relapse.

Zusammenfassung

Gegenstand und Ziel Die steroidresponsive Meningitis-Arteriitis (SRMA) ist eine der häufigsten entzündlichen Erkrankungen des zentralen Nervensystems des Hundes. Die Studie untersuchte Rasse- und Geschlechtsprädispositionen anhand der Gesamtpopulation in Deutschland sowie epidemiologische und klinische Einflussfaktoren hinsichtlich der Rezidivrate von SRMA.

Material und Methoden In dieser Multicenterstudie erfolgte eine retrospektive Analyse der Daten von 153 Hunden mit SRMA. Untersucht wurde, ob einzelne Hunderassen (n ≥ 5 Hunde) überproportional häufig im Vergleich zur Gesamtpopulation von Hunden in Deutschland vertreten sind. Als Datengrundlage dienten die Welpenstatistik des Verbandes für das deutsche Hundewesen (VDH) des Jahres 2016 und die Anzahl der bei Tasso e. V. (Stand 2018) gemeldeten Hunde. Des Weiteren wurde überprüft, ob Hunde eines Geschlechts häufiger erkranken. Bezüglich des Auftretens eines oder mehrerer Rezidive wurden folgende Faktoren untersucht: Geschlecht, Körpermasse, Alter bei Erstvorstellung, zeitlicher Abstand zwischen der letzten Impfung und dem Auftreten der klinischen Symptome, Symptombeginn vor Erstvorstellung, Symptome (reduziertes Allgemeinbefinden, zervikale Dolenz, Fieber, neurologische Defizite) sowie Ergebnisse der Zerebrospinalflüssigkeit-Analyse bei Erstvorstellung (Anzahl kernhaltiger Zellen und deren Differenzierung, Eiweißkonzentration), Konzentrationen von Immunglobulin A und C-reaktivem Protein (CRP) in Serum und Zerebrospinalflüssigkeit bei Erstvorstellung, angewendete Immunsuppressiva, Ansprechen auf Therapie und Kontrollzeitraum sowie Todesrate infolge der Erkrankung oder ihrer Therapie oder der daraus folgenden Euthanasie.

Ergebnisse Bei der Rasse zeigte sich ein signifikanter Einfluss auf die Entstehung von SRMA (p < 0,05). Beagle und Boxer erkrankten in Relation zur Gesamtpopulation in Deutschland häufiger als Hunde anderer Rassen. Rezidive traten bei 29,4 % der 153 Hunde auf. Während Rüden ein signifikant höheres Risiko für eine SRMA-Erkrankung aufwiesen (p < 0,05), kam es bei Hündinnen häufiger zu einem Rezidiv (p = 0,02). Bei einer Prednisolon-Monotherapie erlitten die Patienten seltener ein Rezidiv als bei einer Kombination von Prednisolon und Azathioprin (p < 0,05). Eine Tendenz zur Signifikanz bezüglich des Auftreten von Rezidiven zeigte sich sowohl für jüngere SRMA-Patienten bei Erstvorstellung (p = 0,071) als auch für eine niedrigere CRP-Konzentration im Serum (p = 0,081) bei Erstvorstellung.

Klinische Relevanz Die ermittelten Rasse- und Geschlechtsprädispositionen vereinfachen die Diagnosestellung einer SRMA und bestätigen Ergebnisse früherer Studien. Die Resultate dieser Untersuchung ermöglichen eine genauere Besitzeraufklärung und das Risiko eines Rezidivs.

Key words

Dog - relapse - meningitis - central nervous system - SRMA

Schlüsselwörter

Hund - Rezidiv - Meningitis - zentrales Nervensystem - SRMA


Publication History

Received: 31 July 2019

Accepted: 12 November 2019

Article published online:
14 February 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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