Granulomatous Meningoencephalomyeitis
(GME)
GME tends to affect small breed dogs in their prime. Very little is known about this disease except that it seems to be very similar or the same as another disease called inflammatory reticulosis. Signs come on quick, and vary from neck pain to seizures.
The disease can sometimes be controlled with steroids, but usually the prognosis is terrible. Diagnosis is easy if a spinal tap is done...not something done in the routine vet office.
The typical patient is a middle-aged small breed dog of either gender. What sort of neurologic signs are seen depend totally on what area of the nervous system is involved.
Symptoms include just about anything involving the nervous system: Seizures, confusion, neck pain, walking in circles, blindness, listlessness, walking like a drunk (ataxia), muscle twitching, head tilts, dizzyness and weakness can be seen.
I've never diagnosed this disease in our clinic. What we do, once presented with a dog exhibiting neural signs is to rule out the more common possibilities to include viral diseases, liver disease (hepatic encephalitis)
Diagnostics:
Step A. Of course, when you first present your pet to us exhibiting neural symptoms, we might not even have this rather uncommon disease on our mental rule out list. So step one after the physical exam and history is a urinalysis and blood work to rule out more likely problems to include infection, liver disease, kidney disease, diabetes, and tick borne diseases
Step B. Radiographs are typically not helpful in diagnosing neural diseases but it's still important to rule out the possiblity of masses, spinal lesions, heart enlargement, kidney stones, and other possible problems.
Step C. At our general practice, the next step is usually referral to a neurologist. Before MRI imaging became available, the next step was usually a spinal tap to test the cerebrospinal fluid for evidence of viral or parsitic encephalitis. Biopsy of the brain is the only way to make a definitive diagnosis.
Treatment
Prednisone or other Immune-suppressive medications often help alieve the symptoms. Other symptomatic treatment for twitches, seizures, nausea and so forth as needed.
Other medications and treatments (including radiation) for this disease are available but I rely on the neurologist to recommend these as needed; I'm sorry, I don't know enough about this area to risk making any comments.
And finally, there are often secondary problems that need attention to include glaucoma of the eyes.
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