Focal GME or Granulomatous Meningo-Encephalitis (GME) or MUO

[Jo CIMDA]

Focal GME  or  Granulomatous Meningo-Encephalitis (GME) or MUO (MENINGO-ENCEPHALO-MYELITIS of Unknown Origin)

TYPES OF MUO
There are several different of MUO which tend to be breed related. The main types are:
• Granulomatous Meningo-Encephalitis (GME)
• Necrotising Meningo-Encephalomyelitis (NME)
• Necrotising Leuco-Encephalitis (NLE)
• Idiopathic Tremor Syndrome (ITS)



Case history of  Focal GME

24 Feb a totally normal dog and had just started agility 

26 February woke up not responding to voice or touching, eyes wide open no response straight to the vets, bloods taken only thing they found was a very high fat in the blood he started to look a bit normal and sent home no injection just advices to put him on a low fat diet and treatment him like a normal dog, a bit odd but it was the advice

28 February another episode this time he woke up looking out off it and wobbled down the stairs and stopped in the kitchen non responsive staring at nothing and not hearing me or even being touched luckily I took a video of this as how could I explain it to the vets as he was also when I got him to move he was walking into things door frame kitchen bin... off to the vets

On examination he was walking in circles, bumping into things and a head tilt, more bloods again nothing abnormal Just high fat.  The vet scratched his head went off and called the vet who we saw days before.

A referral to Andersonmoore for the next day as they thought it wasn't an emergency.

Arrived at Andersonmoore and met the vet from Internal Medicine show the videos and history given, they then mentioned his blindness in his left eye news to me.. now feeling worried after more tests they suspect Liver Shunt!

He gets admitted for more bloods etc etc

Next day get a call it's not Liver Shunt and hes transferred to Neurology for MRI and CSF.. now feeling very sick myself.


Next day the MRI scan comes back abnormal changes and CSF sent away results came back 6 days later.

He was started on antibiotics and prednicare 30 mg per day as a starter till the CSF results arrive. Go and collect him 2 days later and he's ok just very sleepy. Results back they mentioned Atopica for life or a course of chemotherapy 4 in total, which meant a 2 night stay and every 4 weeks and 4 injections.

I opted for tablets thinking easy option, 75 mg twice a day, this medication was very regimented around an empty stomach and given 12 hrs apart long with 30 mg steroids. But we just got on with it. He to be honest didn't do much just sleep and being made to being walked.

Next chapter

23 March, back the vets as he's now being sick and had diarrhoea more antibiotics and sent home

5 April, back to the vets not drinking sent home with a vit b injection and don't worry he's just hot but what about the blood in his urine as I thankfully got a sample from him, other advice if hes not better by Monday call Andersonmoore

6 April not drinking or eating called Andersonmoore spoke to his specialist and was advised to rush him back to the vets.... It's nothing to do with his MUO

Arrive with only what I can describe as a very ill dog showing signs of jaundice admitted and put on a drip and a referral back to Andersonmoore luckily they are only 45 mins away and off we go back this time with Pancreatitis and a 6 night stay and they found a grade 2 heart murmur after his heart scan just to be on the safe side before starting chemotherapy

Everyone put there thinking chaps on scratched their heads and argue over reduce his Atopica start chemotherapy ,

10 April his 1st chemo

12 April came home and drop down to 75 mg Atopica per day

15 April steroids drop to 15mg per day

1 May 2nd chemo and drop down to 10 mg steroids per day

16 May Atopica stopped thank god

29 May last chemotherapy

So far the vet bill is £6500 for the MUO and have £1000 left till next Jan and the chemotherapy on average is £550 per go hence only having 3

His pancreatitis bill was £3750


Happy days 27 June back to Andersonmoore they are over the moon with him and in remission and another drop 5 mg steroids per day

Back on the 9th August and fingers crossed another steroids drop.

They have said because the pancreatitis got involved the treatment plan is "bespoke" and as he is young poor boy is only 20 months and fit in his body they thought it was worth trying.

They have given us the provisional diagnoses of Focial GME (as they can never be for sure unless a brain biopsy is done which can't be) as he hasn't had another episode in for months and they say it's the best of the worst condition

I'm happy with that and thank god he's insured I thought £7500 was a lot of money and have only £1000 left but with fingers crossed we won't need it.

Laters,

Keeper the crazy cocker spaniel X



Note from Jo:  For further reading:  http://www.wear-referrals.co.uk/factsheets/GME&Meningitis.pdf

[Keeper]

Keeper update, it's been a week now on 5mg of steroids and OMG he's a different boy.

It's made be think and look back as to why they start on a high dose of steroids.

It made him sleepy which allowed to sleep and get better but I didn't let him thinking it was wrong but as we have reduced the dose he's going and got back to his old self,  he's a 20 month cocker spaniel happily chasing and sniffing out animals in the woods and staying up late.