Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long-term disability

Gonçalves, R; De Decker, S; Walmsley, G; Maddox, TW

Abstract

Background Meningoencephalitis of unknown origin (MUO) comprises a group of noninfectious inflammatory diseases affecting the central nervous system of dogs. Previous studies have reported individual risk factors for survival but prognostication for MUO remains challenging. Objectives Identify clinical prognostic variables in dogs with MUO. Animals A retrospective study of 447 dogs presented to 2 UK referral hospitals and diagnosed with MUO. Methods Medical records of dogs diagnosed with MUO were retrospectively reviewed. Multivariable logistic regression was used for the identification of risk factors for survival and Cox proportional hazards analysis for the identification of risk factors for clinical relapse. Results Eighty-two percent (366/447) of dogs with presumptive MUO survived to discharge and 63.5% (284/447) were alive at 6 months; 36% of the latter (103/284) had persistent neurological deficits. Breed (pugs; P = .03), epileptic seizures (P < .001), paresis (P < .001), and higher neurodisability scale (NDS) score (P < .001) at presentation were negatively associated with survival to 6 months. Dogs with persistent deficits had higher NDS scores on presentation (P = .001). Median follow-up time was 11 months (interquartile range [IQR], 1-24) and 50.6% (160/316) relapsed during treatment (median time to relapse, 7 months; IQR, 2-15). Incomplete resolution of the clinical signs during the 6 months after diagnosis (P < .001), higher NDS score (P < .001), and longer duration of the clinical signs (P < .001) were associated with relapse. Conclusions and Clinical Importance Knowledge of risk factors associated with survival, incomplete recovery and clinical relapse in MUO can help guide monitoring and treatment and improve owner communications regarding prognosis for this debilitating disease.

Citation

Gonçalves, R., De Decker, S., Walmsley, G., & Maddox, T. (2024). Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long-term disability. Journal of Veterinary Internal Medicine, https://doi.org/10.1111/jvim.17037

• Journal Article Type: Article
• Acceptance Date: Jan 26, 2024
• Online Publication Date: Mar 14, 2024
• Publication Date: 2024
• Deposit Date: Mar 26, 2024
• Publicly Available Date: Mar 26, 2024
• Print ISSN: 0891-6640
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/jvim.17037
• Keywords: canine; mortality; MUO; outcome; prognosis; relapse; FIBRILLARY ACIDIC PROTEIN; MULTIPLE-SCLEROSIS; NECROTIZING MENINGOENCEPHALITIS; CLUSTER SEIZURES; PREDICTORS; EPILEPSY; THERAPY; MS