{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T03:08:51Z","timestamp":1763780931829,"version":"3.45.0"},"reference-count":30,"publisher":"American Veterinary Medical Association (AVMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The use of cyclosporine as an add-on therapy for meningitis or meningomyelitis of unknown origin (MUO) with only spinal cord involvement has never been described in dogs. The objective of this retrospective study was to evaluate the potential efficacy of cyclosporine combined with prednisolone compared with prednisolone alone in dogs with suspected spinal MUO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on dogs with a presumed diagnosis of spinal MUO treated with prednisolone and cyclosporine (group A) or prednisolone alone (group B) from 2018 to 2023. A positive outcome was defined as a resolution of clinical signs for at least 1 year after diagnosis, and a negative outcome was defined as lack of improvement or relapses within 1 year of presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>47 dogs were included. Twenty-one dogs were included in group A: 16 (76%) recovered, but clinical relapses were observed in 3 (14%). Twelve (57%) showed a positive outcome. Twenty-six patients were enrolled in group B: initial recovery was observed in all dogs, but 16 (62%) showed clinical relapses, 1 (4%) died due to pulmonary complications, and 9 (35%) had a positive outcome. The side effects were mostly mild: 48% in group A and 31% in group B. No significant associations were found between the outcome and the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prednisolone alone was significantly associated with a higher recovery rate but with a greater frequency of relapses compared with cyclosporine\/prednisolone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Cyclosporine could be considered a valid additional treatment in dogs with spinal MUO, potentially leading to a lower recurrence rate than prednisolone alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.25.06.0387","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:36:39Z","timestamp":1756316199000},"page":"1-6","source":"Crossref","is-referenced-by-count":0,"title":["Cyclosporine and prednisolone treatment leads to fewer relapses compared with prednisolone alone in dogs with suspected meningomyelitis of unknown origin"],"prefix":"10.2460","volume":"263","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1832-9691","authenticated-orcid":true,"given":"Tania","family":"Al Kafaji","sequence":"first","affiliation":[{"name":"Veterinary Neurological Center \u201cLa Fenice,\u201d Selargius, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Corda","sequence":"additional","affiliation":[{"name":"Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Biggio","sequence":"additional","affiliation":[{"name":"Veterinary Neurological Center \u201cLa Fenice,\u201d Selargius, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Gallucci","sequence":"additional","affiliation":[{"name":"Veterinary Neurological Center \u201cLa Fenice,\u201d Selargius, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"Vet J.","first-page":"37","article-title":"Clinical presentation, diagnostic findings, prognostic factors, treatment and outcome in dogs with meningoencephalomyelitis of unknown origin: a review","volume":"244","author":"Cornelis I","year":"2019","unstructured":"Cornelis I, Van Ham L, Gielen I, De Decker S, Bhatti SFM. Clinical presentation, diagnostic findings, prognostic factors, treatment and outcome in dogs with meningoencephalomyelitis of unknown origin: a review. Vet J. 2019;244:37-44. doi:10.1016\/j.tvjl.2018.12.007"},{"key":"ref2","series-title":"Top Companion Anim Med.","first-page":"22","article-title":"Immune-mediated central nervous system disease\u2014current knowledge and recommendations","volume":"34","author":"Vitale S","year":"2019","unstructured":"Vitale S, Foss K. Immune-mediated central nervous system disease\u2014current knowledge and recommendations. Top Companion Anim Med. 2019;34:22-29. doi:10.1053\/j.tcam.2018.11.003"},{"issue":"3","key":"ref3","series-title":"J Small Anim Pract.","first-page":"174","article-title":"Clinical presentation, diagnostic findings and outcome in dogs diagnosed with presumptive spinal-only meningoencephalomyelitis of unknown origin","volume":"58","author":"Cornelis I","year":"2017","unstructured":"Cornelis I, Volk HA, Van Ham L, De Decker S. Clinical presentation, diagnostic findings and outcome in dogs diagnosed with presumptive spinal-only meningoencephalomyelitis of unknown origin. J Small Anim Pract. 2017;58(3):174-182. doi:10.1111\/jsap.12622"},{"issue":"5","key":"ref4","series-title":"Vet Clin North Am Small Anim Pract.","first-page":"871","article-title":"Inflammatory diseases of the spine in small animals","volume":"40","author":"Tipold A","year":"2010","unstructured":"Tipold A, Stein VM. Inflammatory diseases of the spine in small animals. Vet Clin North Am Small Anim Pract. 2010;40(5):871-879. doi:10.1016\/j.cvsm.2010.05.008"},{"issue":"10","key":"ref5","series-title":"J Small Anim Pract.","first-page":"509","article-title":"Meningomyelitis in dogs: a retrospective review of 28 cases (1999 to 2007)","volume":"49","author":"Griffin JF","year":"2008","unstructured":"Griffin JF, Levine JM, Levine GJ, Fosgate GT. Meningomyelitis in dogs: a retrospective review of 28 cases (1999 to 2007). J Small Anim Pract. 2008;49(10):509-517. doi:10.1111\/j.1748-5827.2008.00588.x"},{"issue":"6","key":"ref6","series-title":"Vet Clin North Am Small Anim Pract.","first-page":"1157","article-title":"Perspectives on meningoencephalomyelitis of unknown origin","volume":"44","author":"Coates JR","year":"2014","unstructured":"Coates JR, Jeffery ND. Perspectives on meningoencephalomyelitis of unknown origin. Vet Clin North Am Small Anim Pract. 2014;44(6):1157-1185. doi:10.1016\/j.cvsm.2014.07.009"},{"key":"ref7","series-title":"Front Vet Sci.","first-page":"925774","article-title":"Treatment with cytarabine at initiation of therapy with cyclosporine and glucocorticoids for dogs with meningoencephalomyelitis of unknown origin is not associated with improved outcomes","volume":"9","author":"Barber R","year":"2022","unstructured":"Barber R, Downey Koos L. Treatment with cytarabine at initiation of therapy with cyclosporine and glucocorticoids for dogs with meningoencephalomyelitis of unknown origin is not associated with improved outcomes. Front Vet Sci. 2022;9:925774. doi:10.3389\/fvets.2022.925774"},{"issue":"3","key":"ref8","series-title":"Vet J.","first-page":"290","article-title":"Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008","volume":"184","author":"Granger N","year":"2010","unstructured":"Granger N, Smith PM, Jeffery ND. Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008. Vet J. 2010;184(3):290-297. doi:10.1016\/j.tvjl.2009.03.031"},{"issue":"3","key":"ref9","series-title":"Vet Clin North Am Small Anim Pract.","first-page":"797","article-title":"Glucocorticoids, cyclosporine, azathioprine, chlorambucil, and mycophenolate in dogs and cats: clinical uses, pharmacology, and side effects","volume":"52","author":"Viviano KR","year":"2022","unstructured":"Viviano KR. Glucocorticoids, cyclosporine, azathioprine, chlorambucil, and mycophenolate in dogs and cats: clinical uses, pharmacology, and side effects. Vet Clin North Am Small Anim Pract. 2022;52(3):797-817. doi:10.1016\/j.cvsm.2022.01.009"},{"issue":"1","key":"ref10","series-title":"J Vet Intern Med.","first-page":"1","article-title":"Oral cyclosporine treatment in dogs: a review of the literature","volume":"28","author":"Archer TM","year":"2014","unstructured":"Archer TM, Boothe DM, Langston VC, Fellman CL, Lunsford KV, Mackin AJ. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med. 2014;28(1):1-20. doi:10.1111\/jvim.12265"},{"issue":"9","key":"ref11","series-title":"J Small Anim Pract.","first-page":"486","article-title":"Ciclosporin use in multi-drug therapy for meningoencephalomyelitis of unknown aetiology in dogs","volume":"48","author":"Adamo PF","year":"2007","unstructured":"Adamo PF, Rylander H, Adams WM. Ciclosporin use in multi-drug therapy for meningoencephalomyelitis of unknown aetiology in dogs. J Small Anim Pract. 2007;48(9):486-496. doi:10.1111\/j.1748-5827.2006.00303.x"},{"issue":"8","key":"ref12","series-title":"J Am Vet Med Assoc.","first-page":"1211","article-title":"Use of cyclosporine to treat granulomatous meningoencephalitis in three dogs","volume":"225","author":"Adamo FP","year":"2004","unstructured":"Adamo FP, O\u2019Brien RT. Use of cyclosporine to treat granulomatous meningoencephalitis in three dogs. J Am Vet Med Assoc. 2004;225(8):1211-1216. doi:10.2460\/javma.2004.225.1211"},{"issue":"4","key":"ref13","series-title":"J Small Anim Pract.","first-page":"201","article-title":"Ciclosporin treatment of suspected granulomatous meningoencephalomyelitis in three dogs","volume":"47","author":"Gnirs K","year":"2006","unstructured":"Gnirs K. Ciclosporin treatment of suspected granulomatous meningoencephalomyelitis in three dogs. J Small Anim Pract. 2006;47(4):201-206. doi:10.1111\/j.1748-5827.2006.00065.x"},{"issue":"12","key":"ref14","series-title":"J Vet Med Sci.","first-page":"1303","article-title":"A comparison of combination therapy (cyclosporine plus prednisolone) with sole prednisolone therapy in 7 dogs with necrotizing meningoencephalitis","volume":"69","author":"Jung DI","year":"2007","unstructured":"Jung DI, Kang BT, Park C,  A comparison of combination therapy (cyclosporine plus prednisolone) with sole prednisolone therapy in 7 dogs with necrotizing meningoencephalitis. J Vet Med Sci. 2007;69(12):1303-1306. doi:10.1292\/jvms.69.1303"},{"issue":"3","key":"ref15","series-title":"Vet Rec.","first-page":"89","article-title":"Improved survival time in dogs with suspected GME treated with ciclosporin","volume":"164","author":"Pakozdy A","year":"2009","unstructured":"Pakozdy A, Leschnik M, Kneissl S,  Improved survival time in dogs with suspected GME treated with ciclosporin. Vet Rec. 2009;164(3):89-90. doi:10.1136\/vr.164.3.89"},{"issue":"6","key":"ref16","series-title":"J Vet Med Sci.","first-page":"765","article-title":"Long-term immunosuppressive therapy with cyclosporine plus prednisolone for necrotizing meningoencephalitis in a Pekingese dog","volume":"74","author":"Jung DI","year":"2012","unstructured":"Jung DI, Kim JW, Park HM. Long-term immunosuppressive therapy with cyclosporine plus prednisolone for necrotizing meningoencephalitis in a Pekingese dog. J Vet Med Sci. 2012;74(6):765-769. doi:10.1292\/jvms.11-0468"},{"issue":"12","key":"ref17","series-title":"J Vet Med Sci.","first-page":"1661","article-title":"Unsuccessful cyclosporine plus prednisolone therapy for autoimmune meningoencephalitis in three dogs","volume":"75","author":"Jung DI","year":"2013","unstructured":"Jung DI, Lee HC, Ha J,  Unsuccessful cyclosporine plus prednisolone therapy for autoimmune meningoencephalitis in three dogs. J Vet Med Sci. 2013;75(12):1661-1665. doi:10.1292\/jvms.12-0503"},{"issue":"10","key":"ref18","series-title":"Aust Vet J.","first-page":"491","article-title":"Survival time and relapse in dogs with meningoencephalomyelitis of unknown origin treated with prednisolone and ciclosporin: a retrospective study","volume":"98","author":"Brady SL","year":"2020","unstructured":"Brady SL, Woodward AP, le Chevoir M. Survival time and relapse in dogs with meningoencephalomyelitis of unknown origin treated with prednisolone and ciclosporin: a retrospective study. Aust Vet J. 2020;98(10):491-498. doi:10.1111\/avj.12994"},{"issue":"4","key":"ref19","series-title":"Vet Clin North Am Small Anim Pract.","first-page":"951","article-title":"Myelitis and meningitis","volume":"22","author":"Sorjonen DC","year":"1992","unstructured":"Sorjonen DC. Myelitis and meningitis. Vet Clin North Am Small Anim Pract. 1992;22(4):951-964. doi:10.1016\/S0195-5616(92)50086-9"},{"key":"ref20","article-title":"Plumb\u2019s Veterinary Drug Handbook","author":"Plumb DC","year":"2018","unstructured":"Plumb DC. Plumb\u2019s Veterinary Drug Handbook. 8th ed. PharmaVet Inc; 2018."},{"issue":"11","key":"ref21","series-title":"J Small Anim Pract.","first-page":"644","article-title":"Association of spinal cord compression seen on magnetic resonance imaging with clinical outcome in 67 dogs with thoracolumbar intervertebral disc extrusion","volume":"47","author":"Penning V","year":"2006","unstructured":"Penning V, Platt SR, Dennis R, Cappello R, Adams V. Association of spinal cord compression seen on magnetic resonance imaging with clinical outcome in 67 dogs with thoracolumbar intervertebral disc extrusion. J Small Anim Pract. 2006;47(11):644-650. doi:10.1111\/j.1748-5827.2006.00252.x"},{"key":"ref22","series-title":"Cowell and Tyler\u2019s Diagnostic Cytology and Hematology of the Dog and Cat","first-page":"210","article-title":"Cerebrospinal fluid and central nervous system cytology","author":"Levine GJ","year":"2020","unstructured":"Levine GJ, Cook JR. Cerebrospinal fluid and central nervous system cytology. In: Valenciano AC, Cowell RL, eds. Cowell and Tyler\u2019s Diagnostic Cytology and Hematology of the Dog and Cat. 5th ed. Elsevier; 2020:210. doi:10.1016\/B978-0-323-53314-0.00014-6"},{"key":"ref23","series-title":"Handb Clin Neurol.","first-page":"563","article-title":"Overview of cerebrospinal fluid cytology","volume":"145","author":"Rahimi J","year":"2017","unstructured":"Rahimi J, Woehrer A. Overview of cerebrospinal fluid cytology. Handb Clin Neurol. 2017;145:563-571. doi:10.1016\/B978-0-12-802395-2.00035-3"},{"key":"ref24","series-title":"Front Vet Sci.","first-page":"1303084","article-title":"Case report: necrotizing leukomyelitis and meningitis in a Pomeranian","volume":"11","author":"Santifort KM","year":"2024","unstructured":"Santifort KM, Garosi L, Weerts EAWS. Case report: necrotizing leukomyelitis and meningitis in a Pomeranian. Front Vet Sci. 2024;11:1303084. doi:10.3389\/fvets.2024.1303084"},{"key":"ref25","series-title":"Acta Vet Scand.","first-page":"46","article-title":"Investigation of side effects to treatment and cause of death in 63 Scandinavian dogs suffering from meningoencephalitis of unknown origin: a retrospective study","volume":"65","author":"Heidemann PL","year":"2023","unstructured":"Heidemann PL, Erhald B, Koch BC, Gredal H. Investigation of side effects to treatment and cause of death in 63 Scandinavian dogs suffering from meningoencephalitis of unknown origin: a retrospective study. Acta Vet Scand. 2023;65:46. doi:10.1186\/s13028-023-00709-7"},{"key":"ref26","series-title":"Front Vet Sci.","first-page":"1167002","article-title":"Perspectives on pharmacologic strategies in the management of meningoencephalomyelitis of unknown origin in dogs","volume":"10","author":"Beasley MJ","year":"2023","unstructured":"Beasley MJ, Shores A. Perspectives on pharmacologic strategies in the management of meningoencephalomyelitis of unknown origin in dogs. Front Vet Sci. 2023;10:1167002. doi:10.3389\/fvets.2023.1167002"},{"issue":"1","key":"ref27","series-title":"J Neuroimmunol.","first-page":"60","article-title":"Effects of cyclosporin A treatment on clinical course and inflammatory cell apoptosis in experimental autoimmune encephalomyelitis induced in Lewis rats by inoculation with myelin basic protein","volume":"97","author":"McCombe PA","year":"1999","unstructured":"McCombe PA, Harness J, Pender MP. Effects of cyclosporin A treatment on clinical course and inflammatory cell apoptosis in experimental autoimmune encephalomyelitis induced in Lewis rats by inoculation with myelin basic protein. J Neuroimmunol. 1999;97(1):60-69. doi:10.1016\/S0165-5728(99)00047-8"},{"issue":"1","key":"ref28","series-title":"J Neurol Sci.","first-page":"7","article-title":"Cyclosporin A treatment modulates cytokine mRNA expression by inflammatory cells extracted from the spinal cord of rats with experimental autoimmune encephalomyelitis induced by inoculation with myelin basic protein","volume":"187","author":"Harness J","year":"2001","unstructured":"Harness J, Pender MP, McCombe PA. Cyclosporin A treatment modulates cytokine mRNA expression by inflammatory cells extracted from the spinal cord of rats with experimental autoimmune encephalomyelitis induced by inoculation with myelin basic protein. J Neurol Sci. 2001;187(1):7-16. doi:10.1016\/S0022-510X(01)00505-6"},{"issue":"20","key":"ref29","series-title":"Vet Rec.","first-page":"527","article-title":"Meningoencephalitis of unknown origin: investigation of prognostic factors and outcome using a standard treatment protocol","volume":"172","author":"Lowrie M","year":"2013","unstructured":"Lowrie M, Smith PM, Garosi L. Meningoencephalitis of unknown origin: investigation of prognostic factors and outcome using a standard treatment protocol. Vet Rec. 2013;172(20):527. doi:10.1136\/vr.101431"},{"issue":"1","key":"ref30","series-title":"Vet Clin Pathol.","first-page":"119","article-title":"Suppurative spinal meningomyelitis in a dog with intra-neutrophilic cerebrospinal fluid cells Ehrlichia canis morulae","volume":"52","author":"Frankar H","year":"2023","unstructured":"Frankar H, Le Boedec K, Beurlet S, Cauzinille L. Suppurative spinal meningomyelitis in a dog with intra-neutrophilic cerebrospinal fluid cells Ehrlichia canis morulae. Vet Clin Pathol. 2023;52(1):119-122. doi:10.1111\/vcp.13148"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/263\/12\/javma.25.06.0387.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/263\/12\/javma.25.06.0387.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/263\/12\/javma.25.06.0387.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T03:05:29Z","timestamp":1763780729000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/263\/12\/javma.25.06.0387.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":30,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.2460\/javma.25.06.0387","relation":{},"ISSN":["0003-1488"],"issn-type":[{"type":"print","value":"0003-1488"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}