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Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

机译:霉酚酸酯和皮质类固醇激素治疗病因不明的犬脑膜脑脊髓炎:25例(2007-2012年)

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摘要

The use of mycophenolate mofetil (MMF) for a variety of immune‐mediated diseases in veterinary medicine has been described. However, there is only a small number of cases documenting its use in dogs with meningoencephalomyelitis of unknown aetiology (MUE). We hypothesized that the use of MMF and corticosteroids in dogs with MUE results in comparable survival data to other published treatment protocols and is associated with limited adverse effects. A retrospective study of medical case records of dogs clinically diagnosed with MUE recorded signalment, neuroanatomic localization, magnetic resonance imaging findings, cerebrospinal fluid analysis results, medications administered, follow‐up neurologic examinations, survival and adverse events. Variables were compared between dogs which were treated with MMF within 30 days of diagnosis (immediate group) vs. dogs in which MMF therapy was started >30 days after diagnosis (delayed group). Twenty‐five cases of MUE were identified. The overall median survival time from diagnosis was 731 days (range 43–1672 days). After 1 month of MMF treatment, 92% of dogs showed improvement on a neurological examination. There was no significant effect of any recorded parameter on survival, including delayed vs. immediate initiation of MMF treatment. Dogs with delayed treatment had significantly lower clinical remission rates than dogs with immediate treatment at 6 months after starting MMF. Adverse events were identified in two cases (8%) and were characterized by mild gastrointestinal signs (vomiting and decreased appetite). Administration of MMF appears safe in dogs with MUE. The use of MMF results in comparable survival times to alternate immunosuppressive protocols.
机译:已经描述了霉酚酸酯(MMF)在兽医学中用于多种免疫介导的疾病的用途。然而,只有少数病例证明了其在病因不明的脑膜脑脊髓炎(MUE)犬中的使用。我们假设在患有MUE的狗中使用MMF和皮质类固醇可产生与其他已发表治疗方案相当的生存数据,并且不良反应有限。对临床诊断为MUE的犬的病案记录进行的回顾性研究记录了信号,神经解剖定位,磁共振成像发现,脑脊液分析结果,所用药物,后续神经系统检查,生存和不良事件。比较在诊断后30天内接受MMF治疗的狗(中速组)与诊断后30天内开始MMF治疗的狗(延迟组)之间的变量。确认了25例MUE。诊断后的总体中位生存时间为731天(范围43–1672天)。 MMF治疗1个月后,有92%的狗在神经系统检查中表现出好转。没有任何记录的参数对存活率有明显影响,包括MMF治疗的延迟与立即开始。开始MMF后6个月,延迟治疗的狗的临床缓解率明显低于立即治疗的狗。在两个病例(8%)中发现了不良事件,并以轻度胃肠道症状(呕吐和食欲下降)为特征。在患有MUE的犬中服用MMF似乎是安全的。 MMF的使用可产生与其他免疫抑制方案相当的生存时间。

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