Owners of dogs diagnosed with granulomatous meningoencephalomyelitis (GME), one of the most common neurological disorders in canines, may soon have an easier, safer alternative to steroid therapy, said Filippo Adamo, DVM, DECVN. Adamo, an assistant professor at the University of Wisconsin, has successfully used cyclosporine to treat eight client dogs with GME, an autoimmune disease that can be fatal. Results from his study were published in the Oct. 15, 2004, issue of JAVMA. Since submitting the initial study results, which included four cases, Adamo has followed those subjects, added four more and is more confident about the drug’s efficacy.

“I don’t think steroid treatment is a viable option for the disease,” Adamo said and explained that its effects can diminish over time and it can cause serious side effects. “If they [the dogs] don’t die from the disease, they will die from the steroid treatment,” which can cause gastrointestinal ulceration and pancreatitis. Other options include radiation, cytosine arabinoside and procarbazine, which are more expensive and labor-intensive, can cause risky side effects and require frequent check-ups, Adamo said. In comparison, cyclosporine produced no major side-effects though minor effects like temporary hair discoloration and shedding, occurred in two dogs.

GME can be diagnosed with MRI and spinal taps, and it represents 25 percent of all canine inflammatory central nervous system disorders worldwide, Adamo said. It is the most common inflammatory disease in the world after canine distemper virus, he added.

Adamo observed the effectiveness of cyclosporine used for kidney transplants several years ago, and began contemplating its use with GME, since cyclosporine is used after surgery against organ rejection (immune mediated mechanism), and the GME seems to be an immune mediated disease. However, he did not launch the study until a client brought a dog into the teaching hospital to be euthanized. The Chihuahua presented with severe circling and blindness, common clinical signs of GME, and the owner did not want the dog to suffer the side effects of steroid therapy, Adamo said. That was 23 months ago. The Chihuahua gets a dose of cyclosporine daily and is free of symptoms. Improvement was seen within the first few days of treatment, Adamo added.

Seven other clients paid about $1,200 to participate in Adamo’s ongoing study, which includes medication costs and repeated blood tests to gauge the amount of cyclosporine in the system, spinal taps to monitor remission and MRI and CAT scans every three months. Going forward, Adamo will test blood and spinal fluid two or three times per year, which will reduce client costs, he said and added that the study is still in its preliminary stages.

Cyclosporine, an anti immunosuppressant, is more expensive than other drugs but because most dogs affected by GME are toy breeds, the cost is about $80 to $100 per month versus $10 to treat a dog the same size with corticosteroids, Adamo said. He is currently researching ways to lower costs for cyclosporine by mixing it with other drugs. Cyclosporine should be continued for the life of the dog, Adamo said. For more information about the study, email the university.