• 1.

    Braund KG. Granulomatous meningoencephalomyelitis. J Am Vet Med Assoc 1985; 186: 138141.

  • 2.

    Muñana KRLuttgen PJ. Prognostic factors for dogs with granulomatous meningoencephalomyelitis: 42 cases (1982–1996). J Am Vet Med Assoc 1998; 212: 19021906.

    • Search Google Scholar
    • Export Citation
  • 3.

    Jung DIKang BTPark C, et al. A comparison of combination therapy (cyclosporine plus prednisolone) with sole prednisolone therapy in 7 dogs with necrotizing meningoencephalitis. J Vet Med Sci 2007; 69: 13031306.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Von Praun FMatiasek KGrevel V, et al. Magnetic resonance imaging and pathologic findings associated with necrotizing encephalitis in two Yorkshire terriers. Vet Radiol Ultrasound 2006; 47: 260264.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Tipold AFatzer RJaggy A, et al. Necrotizing encephalitis in Yorkshire Terriers. J Small Anim Pract 1993; 34: 623628.

  • 6.

    Higgins RJDickinson PJKube SA, et al. Necrotizing meningoencephalitis in five Chihuahua dogs. Vet Pathol 2008; 45: 336346.

  • 7.

    Feldmann ECNelson RW. Iatrogenic Cushing's syndrome/Addison's disease. In: Feldmann ECNelson RW, eds. Canine and feline endocrinology and reproduction. 3rd ed. St Louis: Saunders, 2004;478479.

    • Search Google Scholar
    • Export Citation
  • 8.

    Harris CWDidier PJParker AJ. Simultaneous central nervous system reticulosis in two related Afghan hounds. Compend Contin Educ Pract Vet 1988; 10: 304310.

    • Search Google Scholar
    • Export Citation
  • 9.

    Adamo PFRylander HAdams WM. Ciclosporin use in multi-drug therapy for meningoencephalomyelitis of unknown aetiology in dogs. J Small Anim Pract 2007; 48: 486496.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Gnirs K. Ciclosporin treatment of suspected granulomatous meningoencephalitis in three dogs. J Small Anim Pract 2006; 47: 201206.

  • 11.

    Coates JRBarone GDewey CW, et al. Procarbazine as adjunctive therapy for treatment of dogs with presumptive antemortem diagnosis of granulomatous meningoencephalomyelitis: 21 cases (1998–2004). J Vet Intern Med 2007; 21: 100106.

    • Search Google Scholar
    • Export Citation
  • 12.

    Menaut PLandart JBehr S, et al. Treatment of 11 dogs with meningoencephalomyelitis of unknown origin with a combination of prednisolone and cytosine arabinoside. Vet Rec 2008; 162: 241245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Smith PMStalin CEShaw D, et al. Comparison of two regimens for the treatment of meningoencephalomyelitis of unkown etiology. J Vet Intern Med 2009; 23: 520526.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Wong MAHopkins ALMeeks JC, et al. Evaluation of treatment with a combination of azathioprine and prednisone in dogs with meningoencephalomyelitis of undetermined etiology: 40 cases (2000–2007). J Am Vet Med Assoc 2010; 237: 929935.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Sauerbrey MLMullins MNBannink EO, et al. Lomustine and prednisone as a first-line treatment for dogs with multicentric lymphoma: 17 cases (2004–2005). J Am Vet Med Assoc 2007; 230: 18661869.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Flory ABRassnick KMAl-Sarraf R, et al. Combination of CCNU and DTIC chemotherapy for treatment of resistant lymphoma of dogs. J Vet Intern Med 2008; 22: 164171.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Fontaine JBovens CBettenay S, et al. Canine cutaneous epitheliotropic lymphoma: a review. Vet Comp Oncol 2009; 7: 114.

  • 18.

    Tew KDColvin OMChabner BA. Alkylating agents. In: Chabner BALongo DL, eds. Cancer chemotherapy and biotherapy: principles and practice. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins, 2001;374414.

    • Search Google Scholar
    • Export Citation
  • 19.

    Oliverio VTWesley MVietzke WM, et al. The absorption, distribution, excretion, and biotransformation of the carcinostatic 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosurea in animals. Cancer Res 1970; 30: 13301337.

    • Search Google Scholar
    • Export Citation
  • 20.

    Flegel TPodell MMarch PA. Ventriculoperitoneal shunt for treatment of secondary hydrocephalus in a Brittany Spaniel. Kleintierpraxis 2002; 47: 95102.

    • Search Google Scholar
    • Export Citation
  • 21.

    Jung DIKim HJPark C, et al. Long-term chemotherapy with lomustine of intracranial meningioma occurring in a miniature schnauzer. J Vet Med Sci 2006; 68: 383386.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Bernengo MGLisa FMeregalli M, et al. Changes in T and B lymphocyte subpopulations before, during and after chemotherapy for malignant melanoma. Int J Tissue React 1984; 6: 505511.

    • Search Google Scholar
    • Export Citation
  • 23.

    Kipar ABaumgärtner WVogl C, et al. Immunohistochemical characterization of inflammatory cells in brains of dogs with granulomatous meningoencephalitis. Vet Pathol 1998; 35: 4352.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Suzuki MUchida KMorozumi M, et al. A comparative pathological study on canine necrotizing meningoencephalitis and granulomatous meningoencephalomyelitis. J Vet Med Sci 2003; 65: 12331239.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Zarfoss MSchatzberg SVenator K, et al. Combined cytosine arabinoside and prednisone therapy for meningoencephalitis of unknown aetiology in 10 dogs. J Small Anim Pract 2006; 47: 588595.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Adamo PFRylander HAdams WM. Ciclosporine use in multi-drug therapy for meningoencephalomyelitis of unknown aetiology. J Small Anim Pract 2007; 48: 486496.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Rassnick KMMoore ASWilliams LE, et al. Treatment of canine mast cell tumors with CCNU (lomustine). J Vet Intern Med 1999; 13: 601605.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Risbon REde Lorimer LPSkorupski K, et al. Response of canine cutaneous lymphoma to lomustine (CCNU): a retrospective study of 46 cases (1999–2004). J Vet Intern Med 2006; 20: 13891397.

    • Search Google Scholar
    • Export Citation
  • 29.

    Williams LERassnick KMPower HT, et al. CCNU in the treatment of canine epitheliotropic lymphoma. J Vet Intern Med 2006; 20: 136143.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

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

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

Search for other papers by Thomas Flegel in
Current site
Google Scholar
PubMed
Close
 Dr med vet, DACVIM
,
Irene C. BoettcherDepartment of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, D-04103 Leipzig, Germany.

Search for other papers by Irene C. Boettcher in
Current site
Google Scholar
PubMed
Close
 Dr med vet
,
Kaspar MatiasekNeuropathology Laboratory, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, England.

Search for other papers by Kaspar Matiasek in
Current site
Google Scholar
PubMed
Close
 Dr med vet
,
Anna OevermannDepartment of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, CH-3001 Bern, Switzerland.

Search for other papers by Anna Oevermann in
Current site
Google Scholar
PubMed
Close
 Dr med vet
,
Marcus G. DoherrDepartment of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, CH-3001 Bern, Switzerland.

Search for other papers by Marcus G. Doherr in
Current site
Google Scholar
PubMed
Close
 Dr med vet, PhD
,
Gerhard OechteringDepartment of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, D-04103 Leipzig, Germany.

Search for other papers by Gerhard Oechtering in
Current site
Google Scholar
PubMed
Close
 Dr med vet
, and
Diana HenkeDivision of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, CH-3001 Bern, Switzerland.

Search for other papers by Diana Henke in
Current site
Google Scholar
PubMed
Close
 Dr med vet

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.

Contributor Notes

Presented in part as an oral presentation at the 20th Annual Symposium of the European Society and College of Veterinary Neurology, Bern, Switzerland, September 2007.

Address correspondence to Dr. Flegel (flegel@kleintierklinik.uni-leipzig.de).