Hilpert Elisabeth, Tipold Andrea, Meyerhoff Nina, Schwerdt Johannes, Winkler Sandra, Jurina Konrad, Fischer Andrea, Kornberg Marion, Parzefall Birgit, Flegel Thomas
Department of Small Animal Medicine, University of Leipzig.
Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2020 Feb;48(1):5-12. doi: 10.1055/a-1069-6795. Epub 2020 Feb 14.
Steroid-responsive meningitis arteritis (SRMA) is one of the most common inflammatory diseases of the central nervous system in dogs. The present study examined breed and sex predisposition factors based on the population of dogs in Germany as well as epidemiological and clinical factors regarding the relapse rate of SRMA.
Data of 153 dogs with SRMA (SRMA) were analysed retrospectively in this multicentre study. It was investigated whether some dog breeds that suffer from SRMA were disproportionately more often (n ≥ 5) represented when compared to the total population of dogs in Germany. Furthermore it was examined which sex is affected more often. Data provided by "Verband für das deutsche Hundewesen" (VDH) and "Tasso e. V." was used as reference data of the total population. The following factors were investigated with regard to the occurrence of one or more relapses: signalment; body weight; age at first presentation; time period between last vaccination and onset of clinical signs; clinical signs and timepoint of the first SRMA manifestation; results of cerebrospinal fluid (CSF) analysis at first presentation (nucleated cell count and differentiation, protein concentration); immunglobulin A and C-reactive protein (CRP) concentrations in serum and CSF; immunosuppressive medication; follow-up data including response to therapy, occurrence of relapses and mortality including reasons, i. e. due to the disease, therapy or euthanasia.
The breed had a statistically significant influence on the development of SRMA (p < 0.05). Beagles and Boxers were affected more often by SRMA than other breeds in relation to the total population in Germany. Relapses occurred in 29.4 % of the 153 dogs of this study. In contrast to the development of SRMA, in which male dogs have a significantly increased risk of developing SRMA (p < 0.05), female dogs are more likely to relapse (p = 0.02). Patients on prednisolone monotherapy had fewer relapses than those with prednisolone and azathioprine in combination (p < 0.05). Younger age (p = 0.071) und lower CRP concentrations (p = 0.081) at first presentation were tentatively associated with a higher incidence of relapses.
The determined breed and sex predispositions support the diagnosis of SRMA arteritis and confirm previous observations. This study allows a more accurate explanation to owners about the risk of relapse.
类固醇反应性脑膜炎动脉炎（SRMA）是犬中枢神经系统最常见的炎症性疾病之一。本研究基于德国犬只群体，对品种和性别易患因素以及与SRMA复发率相关的流行病学和临床因素进行了研究。
在这项多中心研究中，对153只患有SRMA的犬只数据进行了回顾性分析。研究了与德国犬只总数相比，某些患SRMA的犬种是否出现比例过高的情况（n≥5）。此外，还研究了哪种性别受影响更频繁。由“德国犬业协会”（VDH）和“Tasso e.V.”提供的数据用作犬只总数的参考数据。针对一次或多次复发的情况，研究了以下因素：特征信息；体重；首次就诊时的年龄；上次接种疫苗与临床症状出现之间的时间段；临床症状以及首次SRMA表现的时间点；首次就诊时脑脊液（CSF）分析结果（有核细胞计数及分类、蛋白质浓度）；血清和脑脊液中的免疫球蛋白A和C反应蛋白（CRP）浓度；免疫抑制药物治疗情况；随访数据，包括治疗反应、复发情况和死亡率及原因，即因疾病、治疗或安乐死导致的情况。
品种对SRMA的发病有统计学显著影响（p<0.05）。与德国犬只总数相比，比格犬和拳师犬患SRMA的情况比其他品种更常见。本研究的153只犬中有29.4%出现了复发。与SRMA的发病情况不同，雄性犬患SRMA的风险显著增加（p<0.05），而雌性犬更易复发（p = 0.02）。接受泼尼松龙单一疗法的患者复发次数少于接受泼尼松龙与硫唑嘌呤联合治疗的患者（p<0.05）。首次就诊时年龄较小（p = 0.071）和CRP浓度较低（p = 0.081）与较高的复发率初步相关。
确定的品种和性别易患因素有助于SRMA动脉炎的诊断，并证实了先前的观察结果。本研究能够向犬主更准确地解释复发风险。
