SRMA manifests predominantly within the cervical meninges, and is associated with an aseptic suppurative meningoencephalitis characterized by increased immunoglobulin A (IgA) levels in serum and cerebrospinal fluid (CSF), and a shift of the B:T cell ratio towards a higher percentage of B cells.
Although there is thought to be an infectious agent involved, the cause is unclear, since gene mapping suggests loci associated with this disease are closely related to those observed in dogs with immune-mediated systemic lupus erythematosus.
In a less common, chronic form of SRMA, additional neurological deficits consistent with a spinal cord or a multi-focal neurological disorder may be present, often accompanied by a mononuclear CSF pleocytosis.
The diagnosis is based on histopathological findings. Advanced imaging techniques and the examination of the cerebrospinal fluid are helpful to receive a definitive or presumptive diagnosis. C-reactive protein, haptoglobin and serum amyloid A have been identified as significant diagnostic 'markers' for this disease, however, the presence of D-dimers in CSF samples and elevated levels of cardiac troponin I are characteristic of this disease.
Testing of paired CSF and serum samples for IgA showing rising titres is recommended.
A differential diagnosis would include other causes of meningitis.
The prognosis for young dogs in the acute stage of SRMA is relatively good with early and aggressive anti-inflammatory or immunosuppressive therapy. Prednisolone appears to be more successful drug of choice.
In more protracted, relapsing cases of SRMA the prognosis is guarded, and therapy requires more aggressive, long term immunosuppression.
- Spitzbarth I et al (2012) The role of pro- and anti-inflammatory cytokines in the pathogenesis of spontaneous canine CNS diseases. Vet Immunol Immunopathol 147(1-2):6-24
- Wrzosek M et al (2009) Cerebral extension of steroid-responsive meningitis arteritis in a boxer. J Small Anim Pract 50(1):35-37
- Schwartz M et al(2010) Marked MMP-2 transcriptional up-regulation in mononuclear leukocytes invading the subarachnoidal space in aseptic suppurative steroid-responsive meningitis-arteritis in dogs. Vet Immunol Immunopathol 133(2-4):198-206
- Schwartz M et al (2008) Selective CD11a upregulation on neutrophils in the acute phase of steroid-responsive meningitis-arteritis in dogs. Vet Immunol Immunopathol 126(3-4):248-255
- Schwartz M et al(2011) Pathogenetic factors for excessive IgA production: Th2-dominated immune response in canine steroid-responsive meningitis-arteritis. Vet J 187(2):260-266
- Wilbe M et al(2010) Genome-wide association mapping identifies multiple loci for a canine SLE-related disease complex. Nat Genet 42(3):250-254
- Snyder Ket al (2010) Arrhythmias and elevated troponin I in a dog with steroid-responsive meningitis-arteritis. J Am Anim Hosp Assoc 46(1):61-65
- Tipold A & Schatzberg SJ (2010) An update on steroid responsive meningitis-arteritis. J Small Anim Pract 51(3):150-154
- Nghiem PP & Schatzberg SJ (2010) Conventional and molecular diagnostic testing for the acute neurologic patient. J Vet Emerg Crit Care (San Antonio) 20(1):46-61
- Tipold A & Stein VM (2010) Inflammatory diseases of the spine in small animals. Vet Clin North Am Small Anim Pract 40(5):871-879
- Eckersall PD & Bell R (2010) Acute phase proteins: Biomarkers of infection and inflammation in veterinary medicine. Vet J 185(1):23-27
- Navarro-Cubas J et al (2011) Steroid-responsive meningitis-arteritis with spontaneous echocardiographic contrast and elevated cardiac troponin I in a dog. Vet Rec 169(20):527
- Maiolini A et al (2012) Determination of immunoglobulin A concentrations in the serum and cerebrospinal fluid of dogs: an estimation of its diagnostic value in canine steroid-responsive meningitis-arteritis. Vet J 191(2):219-224
- Lowrie M et al (2009) Steroid responsive meningitis-arteritis: a prospective study of potential disease markers, prednisolone treatment, and long-term outcome in 20 dogs (2006-2008). J Vet Intern Med 23(4):862-870
- Moore SA et al (2012) Extracellular hsp70 release in canine Steroid Responsive Meningitis-Arteritis. Vet Immunol Immunopathol 145(1-2):129-133