Comparison of oral administration of lomustine and prednisolone or prednisolone alone as treatment for granulomatous meningoencephalomyelitis or necrotizing encephalitis in dogs

Thomas Flegel Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, D-04103 Leipzig, Germany.

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Irene C. Boettcher Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, D-04103 Leipzig, Germany.

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Kaspar Matiasek Neuropathology Laboratory, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, England.

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Anna Oevermann Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, CH-3001 Bern, Switzerland.

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Marcus G. Doherr Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, CH-3001 Bern, Switzerland.

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Gerhard Oechtering Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, D-04103 Leipzig, Germany.

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Diana Henke Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, CH-3001 Bern, Switzerland.

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Abstract

Objective—To compare oral administration of lomustine and prednisolone with oral administration of prednisolone alone as treatment for granulomatous meningoencephalomyelitis (GME) or necrotizing encephalitis (NE) in dogs.

Design—Retrospective cohort study.

Animals—25 dogs with GME and 18 dogs with NE (diagnosis confirmed in 8 and 5 dogs, respectively).

Procedures—Records of dogs with GME or NE were reviewed for results of initial neurologic assessments and clinicopathologic findings, treatment, follow-up clinicopathologic findings (for lomustine-treated dogs), and survival time. Dogs with GME or NE treated with lomustine and prednisolone were assigned to groups 1 (n = 14) and 3 (10), respectively; those treated with prednisolone alone were assigned to groups 2(11) and 4 (8), respectively.

Results—Prednisolone was administered orally every 12 hours to all dogs. In groups 1 and 3, mean lomustine dosage was 60.3 mg/m2, PO, every 6 weeks. Median survival times in groups 1 through 4 were 457, 329, 323, and 91 days, respectively (no significant difference between groups 1 and 2 or between groups 3 and 4). Within the initial 12 months of treatment, median prednisolone dosage was reduced in all groups; dosage reduction in group 1 was significantly larger than that in group 2 at 6, 9, and 12 months. Combination treatment most frequently caused leukopenia, but had no significant effect on liver enzyme activities.

Conclusions and Clinical Relevance—In dogs with GME and NE, oral administration of lomustine and prednisolone or prednisolone alone had similar efficacy. Inclusion of lomustine in the treatment regimen was generally tolerated well.

Abstract

Objective—To compare oral administration of lomustine and prednisolone with oral administration of prednisolone alone as treatment for granulomatous meningoencephalomyelitis (GME) or necrotizing encephalitis (NE) in dogs.

Design—Retrospective cohort study.

Animals—25 dogs with GME and 18 dogs with NE (diagnosis confirmed in 8 and 5 dogs, respectively).

Procedures—Records of dogs with GME or NE were reviewed for results of initial neurologic assessments and clinicopathologic findings, treatment, follow-up clinicopathologic findings (for lomustine-treated dogs), and survival time. Dogs with GME or NE treated with lomustine and prednisolone were assigned to groups 1 (n = 14) and 3 (10), respectively; those treated with prednisolone alone were assigned to groups 2(11) and 4 (8), respectively.

Results—Prednisolone was administered orally every 12 hours to all dogs. In groups 1 and 3, mean lomustine dosage was 60.3 mg/m2, PO, every 6 weeks. Median survival times in groups 1 through 4 were 457, 329, 323, and 91 days, respectively (no significant difference between groups 1 and 2 or between groups 3 and 4). Within the initial 12 months of treatment, median prednisolone dosage was reduced in all groups; dosage reduction in group 1 was significantly larger than that in group 2 at 6, 9, and 12 months. Combination treatment most frequently caused leukopenia, but had no significant effect on liver enzyme activities.

Conclusions and Clinical Relevance—In dogs with GME and NE, oral administration of lomustine and prednisolone or prednisolone alone had similar efficacy. Inclusion of lomustine in the treatment regimen was generally tolerated well.

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