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Disease and Medication Information

At BVNS, we are committed to excellence in how we care for each patient and in how we shape the future of veterinary neurology. To help ensure that more of what we know and understand is shared with you we have compiled this medication and disease resource. Below you will find information on the most common neurologic diseases along with information on medications that relate to these diseases.

We hope that this resource will help to save lives and improve veterinary healthcare. If you have any further questions, comments or suggestions please feel free to contact us or email us.

Disease Information

Atlantoaxial Luxation

This disease occurs when the connection between the first cervical vertebrae (the atlas) which is firmly attached to the skull and the second cervical vertebrae (the axis) fails resulting in damage to the lining of the spinal cord, the spinal cord itself and/or the brainstem. Moderate to severe pain is the most common sign, however, weakness, head turn or tilt and even seizure-like activities can also be signs of this disease. This disease can effect all young small breed dogs with the Yorkie, Chihuahua, Toy Poodle and Japanese Chin being at the highest risk. Want to learn more? Click here. 

Brain Tumor

The cause of brain tumors or cancer in general is not known. However, a genetic or environmental component is suspected due to the higher risk in certain breeds. Because brain tumors can affect any part of the brain, there can be a wide array of symptoms. These can include seizure, poor balance, weakness, head and neck pain, confusion, sedation, coma and even death. Diagnosis depends on an MRI and treatment can include surgery, radiation, chemotherapy, steroid therapy, pain management and seizure medication. The prognosis will vary and is dependent on the type of tumor and its location. Want to learn more? Click here.

Caudal Occipital Malformation Syndrome (COMS)/Chiari-like Malformation/Syringomyelia

Caudal occipital malformation syndrome (COMS or Chiari-like malformation) is an anatomical defect of the skull where there is too little space to contain the hind part of the brain. This defect results in abnormal flow of fluid from the brain into the spinal cord resulting in an abnormal accumulation of fluid in the spinal cord (syringomyelia). Signs include excessive itching of the ears, yelping out spontaneously or when picked-up, weakness, and odd gait and rarely paralysis or in the most severe cases death. This disease primarily affects Cavalier King Charles Spaniels, Brussels Griffon, Japanese Chins and other small breeds of dog.  Want to learn more? Click here. 

Disk Disease

The most common cause of spinal cord disease is compression from a ruptured intervertebral disk. The disk normally sits under the spinal cord and acts as a shock absorber between the bones of the spine (vertebrae). In any breed of dog the disk can degenerate, weaken and rupture into the spinal canal causing compression of the spinal cord. Signs of disk disease can include pain, weakness and wobbliness, and an inability to sense paw position (proprioception). The disease can progress to a complete inability to move the limbs (paralysis) or tail, an inability to urinate or control urination and defecation, and the complete lack of feeling in the limbs (deep pain sensation). Fortunately, disk disease is usually curable with surgery. Want to learn more? Click here.

Diskospondylitis

Diskospondylitis is caused by an infection of an intervertebral disk, adjacent vertebral endplates or the surrounding soft tissue. Without appropriate treatment, this condition can progress to meningitis and spinal canal disease. Symptoms include weakness, gait abnormalities, fever, lack of appetite and weight loss. The best chance at detection and treatment of this disease is when a MRI is performed and there is a culture of the urine, blood or infected area.Treatment includes pain management, antibiotics and occasionally surgery to alleviate spinal cord compression. Want to learn more? Click here.

Meningoencephalitis

Meningoencephalitis (ME) affects the following breeds of dog: Pug, Maltese, Yorkie, Chihuhua and all other small breed dogs aged one through six are at a higher risk. ME means there are more white blood cells in the brain and its lining called the meninges. ME can be caused by infection or non-infection where the immune system attacks the brain for reasons that are not well understood. Some of the forms of non-infectious ME are called necrotizing encephalitis, Pug dog encephalitis, necrotizing leukoencephalitis, Granulomatous meningoencephalotmyelitis (GME) and lymphoma. Because ME can affect any part of the brain signs can include seizure, poor balance, weakness, confusion, sedation, stupor, coma and death. Diagnostics typically include MRI and cerebrospinal fluid analysis (CSF tap). Treatment and prognosis vary widely based on the diagnosis. Want to learn more? Click here.

Seizure

Seizures may affect all pets including cats and can have a variety of causes depending on the age or species of the patient. A seizure event can be divided into three stages, pre-ictus, ictus and post-ictus and further information about these three stages can be found here. A variety of tests including electroencephalogram (EEG), blood testing, MRI and analysis of spinal fluid can all be recommended in order to guide the treatment of anti-seizure medication and to determine the underlying cause of the seizures. Fortunately, seizures can often be controlled with medication and there are many new, effective, safe medications with few to no side-effects. To learn more about seizures and there treatment, please click here.

Steroid Responsive Meningitis Arteritis

Steroid Responsive Meningitis Arteritis (SRMA) is a disease common in large bread dogs like the Boxer, Bernese mountain dog, Newfoundland and Great Pyrenees and typically signs develop at around 8 months of age. The meninges surround the spinal cord and brain and meningitis occurs when white blood cells invade this lining. SRMA is not from an infection but an unwanted immune system attack against the meninges. The cause of this immune attack is unknown. Signs include moderate to high fever, spontaneous yelping, unwillingness to move the neck and/or a short choppy gait in all four limbs. Treatment initially consists of steroid therapy and the prognosis is normally excellent. Want to learn more? Click here.

Vestibular Disease

Vestibular disease or poor balance is often a sign of brain or nerve disease. Symptoms include eye twitching (nystagmus), head tilt, and side-stepping or a drunk appearance while walking. Whether vestibular disease in a particular case is from brain or nerve disease can be determined through a careful examination. This is a very important distinction because the treatments and prognosis can be so different for each of these locations. Generally vestibular disease carries a good prognosis, especially when a specific diagnosis and treatment are obtained. A form of brain inflammation (encephalitis) called granulomatous meningoencephalomyelitis (GME) is a common cause of vestibular disease and requires an early diagnosis and specific treatment for a good outcome. For more detailed information on this disease including the latest information on treatment, please click here. 

Medication Information

Cyclosporine

Cyclosporine is a drug used to reduce or modulate the immune system activity. This drug is used when there is inflammation but no signs of infection or cancer. Cyclosporine at routine doses is very safe and is often used to reduce or eliminate the amount of steroids used during treatment of granulomatous meningoencephalomyelitis (GME) and other immune disease. For more information on how cyclosporine works, when it should be used and side effects, please click here.

Fentanyl

Fentanyl is a potent opiod which provides excellent pain relief with little to no side-effects when delivered at a low but constant dose. Applied via a patch, Fentanyl is often used prior to surgery to anticipate and control pain and aide in recovery. For information on side effects and important precautions, please click here. 

Lomustine

Lomustine is a chemotherapeutic drug that can cross the blood-brain barrier and enter the nervous system. This uncommon property makes Lomustine an important and effective drug in the treatment of central nervous system lymphoma, granulomatous meningoencephalomyelitis (GME)and brain tumors. For more information on side-effects, important warnings regarding usage and more information please click here.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs)are important pain medications because of their safety margin and efficacy. Examples used in people include common drugs like aspirin, celebrex and ibuprofen. Certain NSAIDs are designed specifically for dogs and safer than those designed for people. There are important contraindications, considerations, and things for owners to monitor at home when using this class of medication. For more information about NSAIDs please click here.

Steroids

The steroids that are often prescribed to fight inflammation, suppress the immune system, reduce brain swelling and provide moderate pain relief. The steroids used to achieve these effects are called catabolic and cause muscle loss, unlike anabolic steroids which can be used to build muscle. Catabolic steroids such as prednisone, can cause a variety of side-effects some of which are potentially life threatening. At BVNS, we often use a combination of medications to reduce or eliminate the need for steroids. Steroids should not be taken with NSAIDs as this can cause life threatening side-effects. To learn more about treatment with steroids, please click here.