Acute Progress of Necrotizing Meningoencephalitis in a Dog; Serial Clinical Observation, Magnetic Resonance Imaging, and Histopathological Findings

  • Song, Joong-Hyun (Research Institute of Natural Science, College of Veterinary Medicine, Gyeongsang National University) ;
  • Moon, Jong-Hyun (Centum Animal Medical Center) ;
  • Kim, Hyun-Soo (Busan Animal Medical Center) ;
  • Sur, Jung-Hyang (Department of Pathobiology, Small Animal Tumor Diagnostic Center, College of Veterinary Medicine, Konkuk University) ;
  • Park, Chul (BK21 Plus Team and College of Veterinary Medicine, Chonbuk National University) ;
  • So, Kyung-Min (Animal Nutrition and Physiology Team, National Institute of Animal Science, Rural Development Administration) ;
  • Jung, Dong-In (Research Institute of Natural Science, College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2016.08.16
  • Accepted : 2016.10.13
  • Published : 2016.10.31


A 13-month-old intact female poodle dog presented with an acute history of circling and seizure episodes. On the basis of the results of neurologic examination combined with magnetic resonance imaging and cerebrospinal fluid analysis (CSF), meningoencephalitis of unknown etiology (MUE) was suspected. Therapy with mycophenolate mofetil plus prednisolone was initiated, following which the clinical signs showed improvement for only one month before gradually worsening again. Acute progression of the clinical disease was observed, and the patient was euthanized 91 days after initial presentation. This case was definitively diagnosed as necrotizing meningoencephalitis (NME) according to the results of post-mortem histopathological examination. This report describes the clinical findings, serial magnetic resonance imaging (MRI) characteristics, and histopathological changes in a case of acute NME.


Grant : Functional feed material development and efficacy evaluation for detector dog's ability improvement

Supported by : Rural Development Administration


  1. Barnoon I, Shamir MH, Aroch I, Bdolah-Abram T, Srugo I, Konstantin L, Chai O. Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005-2011). J Vet Emerg Crit Care 2016; 26: 116-124.
  2. Cooper JJ, Schatzberg SJ, Vernau KM, Summers BA, Porter BF, Siso S, Young BD, Levine JM. Necrotizing meningoencephalitis in atypical dog breeds: a case series and literature review. J Vet Intern Med 2014; 28: 198-203.
  3. Cordy DR, Holliday TA. A necrotizing meningoencephalitis of pug dogs. Vet Pathol 1989; 26: 191-194.
  4. Dewey CW, Da Costa RC. Encephalophaties: disorders of the brain. In: Practical guide to canine and feline neurology, 3rd ed. Iowa: Wiley-Blackwell. 2015: 141-236.
  5. Feliu-Pascual A, Matiasek K, De Stefani A, Beltran E, De Risio L. Efficacy of mycophenolate mofetil for the treatment of presumptive granulomatous meningoencephalomyelitis: preliminary results. In: Proceedings of the 20th ECVN Congress Journal of Veterinary Internal Medicine, vol 22. Bern, Switzerland 2008: 509.
  6. Flegel T, Boettcher IC, Matiasek K, Oevermann A, Doherr MG, Oechtering G, Henke D. Comparison of oral administration of lomustine and prednisolone or prednisolone alone as treatment for granulomatous meningoencephalomyelitis or necrotizing encephalitis in dogs. J Am Vet Med Assoc 2011; 238: 337-345.
  7. Granger N, Smith PM, Jeffery ND. Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008. Vet J 2010; 184: 290-297.
  8. Jung DI, Kim JW, Park HM. Long-term immunosuppressive therapy with cyclosporine plus prednisolone for necrotizing meningoencephalitis in a pekingese dog. J Vet Med Sci 2012; 74: 765-769.
  9. Jung DI, Kang BT, Park C, Yoo JH, Gu SH, Jeon HW, Kim JW, Heo RY, Sung HJ, Eom KD, Lee JH, Woo EJ, Park HM. A comparison of combination therapy (cyclosporine plus prednisolone) with sole prednisolone therapy in 7 dogs with necrotizing meningoencephalitis. J Vet Med Sci 2007; 69: 1303-1306.
  10. Jung DI, Lee HC, Ha J, Jung HW, Jeon JH, Moon JH, Lee JH, Kim NH, Sur JH, Kang BT, Cho KW. Unsuccessful cyclosporine plus prednisolone therapy for autoimmune meningoencephalitis in three dogs. J Vet Med Sci 2013; 75: 1661-1665.
  11. Levine JM, Fosgate GT, Porter B, Schatzberg SJ, Greer K. Epidemiology of necrotizing meningoencephalitis in Pug dogs. J Vet Intern Med 2008; 22: 961-968.
  12. Lotti D, Capucchio MT, Gaidolfi E, Merlo M. Necrotizing encephalitis in a Yorkshire terrier: clinical, imaging, and pathologic findings. Vet Radiol Ultrasound 1999; 40: 622-626.
  13. Matsuki N, Fujiwara K, Tamahara S, Uchida K, Matsunaga S, Nakayama H, Doi K, Ogawa H, Ono K. Prevalence of autoantibody in cerebrospinal fluids from dogs with various CNS diseases. J Vet Med Sci 2004; 66: 295-297.
  14. Munana K, Luttgen P. Prognostic factors for dogs with granulomatous meningoencephalomyelitis: 42 cases (1982-1996). J Am Vet Med Assoc 1998; 212: 1902-1906.
  15. Park ES, Uchida K, Nakayama H. Establishment of a rat model for canine necrotizing meningoencephalitis (NME). Vet Pathol 2014; 51: 1151-1164.
  16. Platt SR, Olby NJ. Head tilt and nystagmus. In: BSAVA manual of canine and feline neurology, 4th ed. Quedgeley: British Small Animal Veterinary Association: 2014: 195-212.
  17. Schneider-Gold C, Hartung HP, Gold R. Mycophenolate mofetil and tacrolimus: new therapeutic options in neuroimmunological diseases. Muscle Nerve 2006; 34: 284-291.
  18. Shibuya M, Matsuki N, Fujiwara K, Imajoh-Ohmi S, Fukuda H, Pham NT, Tamahara S, Ono K. Autoantibodies against glial fibrillary acidic protein (GFAP) in cerebrospinal fluids from Pug dogs with necrotizing meningoencephalitis. J Vet Med Sci 2007; 69: 241-245.
  19. Smith PM, Stalin CE, Shaw D, Granger N, Jeffery ND. Comparison of two regimens for the treatment of meningoencephalomyelitis of unknown etiology. J Vet Intern Med 2009; 23: 520-526.
  20. Talarico LR, Schatzberg SJ. Idiopathic granulomatous and necrotising inflammatory disorders of the canine central nervous system: a review and future perspectives. J Small Anim Pract 2010; 51: 138-149.
  21. Timmann D, Konar M, Howard J, Vandevelde M. Necrotising encephalitis in a French bulldog. J Small Anim Pract 2007; 48: 339-342.
  22. Uchida K, Hasegawa T, Ikeda M, Yamaguchi R, Tateyama S. Detection of an autoantibody from Pug dogs with necrotizing encephalitis (Pug dog encephalitis). Vet Pathol 1999; 36: 301-307.
  23. von Praun F, Matiasek K, Grevel V, Alef M, Flegel T. Magnetic resonance imaging and pathologic findings associated with necrotizing encephalitis in two Yorkshire terriers. Vet Radiol Ultrasound 2006; 47: 260-264.
  24. Woolcock AD, Wang A, Haley A, Kent M, Creevy KE, Platt SR. Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007-2012). Vet Med Sci 2016; 2: 125-135.