STEROID RESPONSIVE MENINGITIS ARTERITIS IN A GREAT DANE
A one-year-old, female intact, Great Dane presented to the Emergency Service at Cornell University Hospital for Animals (CUI-IA) for acute onset non-ambulatory tetraparesis with concurrent severe cervical pain. She had a six-day history of intermittent lethargy, anorexia, pyrexia, and persistent neck pain. The patient was admitted to CUI-IA for hospitalization and various diagnostics were performed including basic bloodwork, magnetic resonance imaging (MRI) of her cervical spine, and cerebrospinal fluid analysis. The MRI revealed a locally extensive heterogeneously contrast-enhancing intrarnedullary lesion between the fourth and sixth cervical vertebra along with diffuse cervical meningeal contrast enhancement. The MRI findings were most consistent with cervical meningomyelitis. Infectious disease testing via blood and urine for possible causes of infectious meningomyelitis were negative. Measurement of immunoglobulin A (IgA), in both serum and CSP, revealed concentrations significantly higher than the upper end of the normal reference range. These findings were most consistent with a diagnosis of Steroid Responsive Meningitis Arteritis (SRMA). Given the results of her cervical MRI and cerebrospinal fluid analysis, the patient was immediately started on corticosteroid therapy. The patient showed rapid and marked improvement in clinical signs, especially in regards to cervical pain, over the subsequent days. Five months later, the patient remains mildly tetraparetic and ataxic, but shows marked improvement with no current signs of relapse.