{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T01:03:25Z","timestamp":1772327005771,"version":"3.50.1"},"reference-count":40,"publisher":"American Animal Hospital Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 4 yr old, intact female cocker spaniel was presented for investigation of acute, progressive lethargy\/hypersomnia; vestibular signs; and cataplexy. A narcolepsy-cataplexy episode with associated hypertension and bradycardia was triggered during examination. There was no evidence of arrhythmia on electrocardiography during the episode. Hematology, serum biochemistry, and thoracic and abdominal imaging were unremarkable. MRI of the brain and cerebrospinal fluid analysis were compatible with meningoencephalitis of unknown origin affecting the mesencephalon, pons and rostral medulla oblongata. The dog was started on immunosuppressive treatment with prednisolone and cytosine arabinoside, which was subsequently switched to cyclosporine. Narcolepsy-cataplexy episodes could initially still be triggered by offering food; however, they gradually became shorter and less frequent until they completely subsided along with all other clinical signs after 3 wk. No relapse occurred over a 32 mo follow-up period from the diagnosis. Repeated MRI revealed marked reduction in the lesion size; cerebrospinal fluid analysis revealed no abnormalities. Although very rare, symptomatic narcolepsy\/cataplexy can occur in dogs and can be secondary to brainstem encephalitis. Cardiovascular changes can occur in association with narcolepsy\/cataplexy and should be considered when dealing with patients presenting with these specific clinical signs.<\/jats:p>","DOI":"10.5326\/jaaha-ms-6892","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T11:17:56Z","timestamp":1579605476000},"page":"e562-01","source":"Crossref","is-referenced-by-count":3,"title":["Symptomatic Narcolepsy\/Cataplexy in a Dog with Brainstem Meningoencephalitis of Unknown Origin"],"prefix":"10.5326","volume":"56","author":[{"given":"Lorenzo","family":"Mari","sequence":"first","affiliation":[{"name":"From the Neurology\/Neurosurgery Service, Centre for Small Animal Studies, Animal Health Trust, Suffolk, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Shea","sequence":"additional","affiliation":[{"name":"From the Neurology\/Neurosurgery Service, Centre for Small Animal Studies, Animal Health Trust, Suffolk, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3280","reference":[{"key":"bib1","series-title":"N Engl J Med","first-page":"2654","article-title":"Narcolepsy","volume":"373","author":"Scammell\n              TE","year":"2015","unstructured":"Scammell\n              TE\n            \n          . Narcolepsy. N Engl J Med2015;373:2654\u201362."},{"key":"bib2","series-title":"Cell","first-page":"365","article-title":"The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene","volume":"98","author":"Lin\n              L","year":"1999","unstructured":"Lin\n              L\n            , FaracoJ, LiR, et al.\n          The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene. Cell1999;98:365\u201376."},{"key":"bib3","series-title":"Lancet","first-page":"39","article-title":"Hypocretin (orexin) deficiency in human narcolepsy","volume":"355","author":"Nishino\n              S","year":"2000","unstructured":"Nishino\n              S\n            , RipleyB, OvereemS, et al.\n          Hypocretin (orexin) deficiency in human narcolepsy. Lancet2000;355:39\u201340."},{"key":"bib4","series-title":"Proc Natl Acad Sci U S A","first-page":"322","article-title":"The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity","volume":"95","author":"de Lecea\n              L","year":"1998","unstructured":"de Lecea\n              L\n            , KilduffTS, PeyronC, et al.\n          The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity. Proc Natl Acad Sci U S A1998;95:322\u20137."},{"key":"bib5","series-title":"Vet Rec","first-page":"375","article-title":"Review of pathophysiology and clinical management of narcolepsy in dogs","volume":"161","author":"Tonokura\n              M","year":"2007","unstructured":"Tonokura\n              M\n            , FujitaK, NishinoS. Review of pathophysiology and clinical management of narcolepsy in dogs. Vet Rec2007;161:375\u201380."},{"key":"bib6","series-title":"Genome Res","first-page":"531","article-title":"Identification and functional analysis of mutations in the hypocretin (orexin) genes of narcoleptic canines","volume":"11","author":"Hungs\n              M","year":"2001","unstructured":"Hungs\n              M\n            , FanJ, LinL, et al.\n          Identification and functional analysis of mutations in the hypocretin (orexin) genes of narcoleptic canines. Genome Res2001;11:531\u20139."},{"key":"bib7","series-title":"Neurobiol Dis","first-page":"525","article-title":"Hypocretin levels in sporadic and familial cases of canine narcolepsy","volume":"8","author":"Ripley\n              B","year":"2001","unstructured":"Ripley\n              B\n            , FujikiN, OkuraM, et al.\n          Hypocretin levels in sporadic and familial cases of canine narcolepsy. Neurobiol Dis2001;8:525\u201334."},{"key":"bib8","series-title":"Exp Neurol","first-page":"292","article-title":"Development of cataplexy in genetically narcoleptic Dobermans","volume":"152","author":"Riehl\n              J","year":"1998","unstructured":"Riehl\n              J\n            , NishinoS, CederbergR, et al.\n          Development of cataplexy in genetically narcoleptic Dobermans. Exp Neurol1998;152:292\u2013302."},{"key":"bib9","series-title":"Curr Neurol Neurosci Rep","first-page":"235","article-title":"The pathophysiologic basis of secondary narcolepsy and hypersomnia","volume":"11","author":"Kanbayashi\n              T","year":"2011","unstructured":"Kanbayashi\n              T\n            , SagawaY, TakemuraF, et al.\n          The pathophysiologic basis of secondary narcolepsy and hypersomnia. Curr Neurol Neurosci Rep2011;11:235\u201341."},{"key":"bib10","series-title":"Sleep Med Rev","first-page":"269","article-title":"Symptomatic narcolepsy, cataplexy and hypersomnia, and their implications in the hypothalamic hypocretin\/orexin system","volume":"9","author":"Nishino\n              S","year":"2005","unstructured":"Nishino\n              S\n            , KanbayashiT. Symptomatic narcolepsy, cataplexy and hypersomnia, and their implications in the hypothalamic hypocretin\/orexin system. Sleep Med Rev2005;9:269\u2013310."},{"key":"bib11","series-title":"J Vet Intern Med","first-page":"545","article-title":"Pituitary macrotumor causing narcolepsy-cataplexy in a dachshund","volume":"31","author":"Schmid\n              S","year":"2017","unstructured":"Schmid\n              S\n            , HodshonA, OlinS, et al.\n          Pituitary macrotumor causing narcolepsy-cataplexy in a dachshund. J Vet Intern Med2017;31:545\u20139."},{"key":"bib12","series-title":"Zentralbl Veterinarmed A","first-page":"301","article-title":"A case of narcolepsy-cataplexy associated with distemper encephalitis","volume":"46","author":"Cantile\n              C","year":"1999","unstructured":"Cantile\n              C\n            , BaroniM, ArispiciM. A case of narcolepsy-cataplexy associated with distemper encephalitis. Zentralbl Veterinarmed A1999;46:301\u20138."},{"key":"bib13","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              N","year":"2010","unstructured":"Granger\n              N\n            , SmithPM, JefferyND. Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008. Vet J2010;184:290\u20137."},{"key":"bib14","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\n              M","year":"2013","unstructured":"Lowrie\n              M\n            , SmithPM, GarosiL. Meningoencephalitis of unknown origin: investigation of prognostic factors and outcome using a standard treatment protocol. Vet Rec2013;172:527."},{"key":"bib15","series-title":"Handb Clin Neurol","first-page":"745","article-title":"Encephalitis lethargica (von Economo's encephalitis)","volume":"123","author":"Berger\n              JR","year":"2014","unstructured":"Berger\n              JR\n            , VilenskyJA. Encephalitis lethargica (von Economo's encephalitis). Handb Clin Neurol2014;123:745\u201361."},{"key":"bib16","series-title":"Brain","first-page":"1831","article-title":"Clinical analysis of anti-Ma2-associated encephalitis","volume":"127","author":"Dalmau\n              J","year":"2004","unstructured":"Dalmau\n              J\n            , GrausF, VillarejoA, et al.\n          Clinical analysis of anti-Ma2-associated encephalitis. Brain2004;127:1831\u201344."},{"key":"bib17","series-title":"Nat Rev Neurol","first-page":"386","article-title":"Cataplexy--clinical aspects, pathophysiology and management strategy","volume":"10","author":"Dauvilliers\n              Y","year":"2014","unstructured":"Dauvilliers\n              Y\n            , SiegelJM, LopezR, et al.\n          Cataplexy--clinical aspects, pathophysiology and management strategy. Nat Rev Neurol2014;10:386\u201395."},{"key":"bib18","series-title":"Sleep Med","first-page":"40","article-title":"Autonomic dysfunction in primary sleep disorders","volume":"19","author":"Miglis\n              MG","year":"2016","unstructured":"Miglis\n              MG\n            \n          . Autonomic dysfunction in primary sleep disorders. Sleep Med2016;19:40\u20139."},{"key":"bib19","series-title":"Sleep Med Rev","first-page":"43","article-title":"Cardiovascular autonomic dysfunctions and sleep disorders","volume":"26","author":"Calandra-Buonaura\n              G","year":"2016","unstructured":"Calandra-Buonaura\n              G\n            , ProviniF, GuaraldiP, et al.\n          Cardiovascular autonomic dysfunctions and sleep disorders. Sleep Med Rev2016;26:43\u201356."},{"key":"bib20","series-title":"J Sleep Res","first-page":"458","article-title":"Sympathetic and cardiovascular activity during cataplexy in narcolepsy","volume":"17","author":"Donadio\n              V","year":"2008","unstructured":"Donadio\n              V\n            , PlazziG, VandiS, et al.\n          Sympathetic and cardiovascular activity during cataplexy in narcolepsy. J Sleep Res2008;17:458\u201363."},{"key":"bib1","series-title":"N Engl J Med","first-page":"2654","article-title":"Narcolepsy","volume":"373","author":"Scammell\n              TE","year":"2015","unstructured":"Scammell\n              TE\n            \n          . Narcolepsy. N Engl J Med2015;373:2654\u201362."},{"key":"bib2","series-title":"Cell","first-page":"365","article-title":"The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene","volume":"98","author":"Lin\n              L","year":"1999","unstructured":"Lin\n              L\n            , FaracoJ, LiR, et al.\n          The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene. Cell1999;98:365\u201376."},{"key":"bib3","series-title":"Lancet","first-page":"39","article-title":"Hypocretin (orexin) deficiency in human narcolepsy","volume":"355","author":"Nishino\n              S","year":"2000","unstructured":"Nishino\n              S\n            , RipleyB, OvereemS, et al.\n          Hypocretin (orexin) deficiency in human narcolepsy. Lancet2000;355:39\u201340."},{"key":"bib4","series-title":"Proc Natl Acad Sci U S A","first-page":"322","article-title":"The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity","volume":"95","author":"de Lecea\n              L","year":"1998","unstructured":"de Lecea\n              L\n            , KilduffTS, PeyronC, et al.\n          The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity. Proc Natl Acad Sci U S A1998;95:322\u20137."},{"key":"bib5","series-title":"Vet Rec","first-page":"375","article-title":"Review of pathophysiology and clinical management of narcolepsy in dogs","volume":"161","author":"Tonokura\n              M","year":"2007","unstructured":"Tonokura\n              M\n            , FujitaK, NishinoS. Review of pathophysiology and clinical management of narcolepsy in dogs. Vet Rec2007;161:375\u201380."},{"key":"bib6","series-title":"Genome Res","first-page":"531","article-title":"Identification and functional analysis of mutations in the hypocretin (orexin) genes of narcoleptic canines","volume":"11","author":"Hungs\n              M","year":"2001","unstructured":"Hungs\n              M\n            , FanJ, LinL, et al.\n          Identification and functional analysis of mutations in the hypocretin (orexin) genes of narcoleptic canines. Genome Res2001;11:531\u20139."},{"key":"bib7","series-title":"Neurobiol Dis","first-page":"525","article-title":"Hypocretin levels in sporadic and familial cases of canine narcolepsy","volume":"8","author":"Ripley\n              B","year":"2001","unstructured":"Ripley\n              B\n            , FujikiN, OkuraM, et al.\n          Hypocretin levels in sporadic and familial cases of canine narcolepsy. Neurobiol Dis2001;8:525\u201334."},{"key":"bib8","series-title":"Exp Neurol","first-page":"292","article-title":"Development of cataplexy in genetically narcoleptic Dobermans","volume":"152","author":"Riehl\n              J","year":"1998","unstructured":"Riehl\n              J\n            , NishinoS, CederbergR, et al.\n          Development of cataplexy in genetically narcoleptic Dobermans. Exp Neurol1998;152:292\u2013302."},{"key":"bib9","series-title":"Curr Neurol Neurosci Rep","first-page":"235","article-title":"The pathophysiologic basis of secondary narcolepsy and hypersomnia","volume":"11","author":"Kanbayashi\n              T","year":"2011","unstructured":"Kanbayashi\n              T\n            , SagawaY, TakemuraF, et al.\n          The pathophysiologic basis of secondary narcolepsy and hypersomnia. Curr Neurol Neurosci Rep2011;11:235\u201341."},{"key":"bib10","series-title":"Sleep Med Rev","first-page":"269","article-title":"Symptomatic narcolepsy, cataplexy and hypersomnia, and their implications in the hypothalamic hypocretin\/orexin system","volume":"9","author":"Nishino\n              S","year":"2005","unstructured":"Nishino\n              S\n            , KanbayashiT. Symptomatic narcolepsy, cataplexy and hypersomnia, and their implications in the hypothalamic hypocretin\/orexin system. Sleep Med Rev2005;9:269\u2013310."},{"key":"bib11","series-title":"J Vet Intern Med","first-page":"545","article-title":"Pituitary macrotumor causing narcolepsy-cataplexy in a dachshund","volume":"31","author":"Schmid\n              S","year":"2017","unstructured":"Schmid\n              S\n            , HodshonA, OlinS, et al.\n          Pituitary macrotumor causing narcolepsy-cataplexy in a dachshund. J Vet Intern Med2017;31:545\u20139."},{"key":"bib12","series-title":"Zentralbl Veterinarmed A","first-page":"301","article-title":"A case of narcolepsy-cataplexy associated with distemper encephalitis","volume":"46","author":"Cantile\n              C","year":"1999","unstructured":"Cantile\n              C\n            , BaroniM, ArispiciM. A case of narcolepsy-cataplexy associated with distemper encephalitis. Zentralbl Veterinarmed A1999;46:301\u20138."},{"key":"bib13","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              N","year":"2010","unstructured":"Granger\n              N\n            , SmithPM, JefferyND. Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008. Vet J2010;184:290\u20137."},{"key":"bib14","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\n              M","year":"2013","unstructured":"Lowrie\n              M\n            , SmithPM, GarosiL. Meningoencephalitis of unknown origin: investigation of prognostic factors and outcome using a standard treatment protocol. Vet Rec2013;172:527."},{"key":"bib15","series-title":"Handb Clin Neurol","first-page":"745","article-title":"Encephalitis lethargica (von Economo's encephalitis)","volume":"123","author":"Berger\n              JR","year":"2014","unstructured":"Berger\n              JR\n            , VilenskyJA. Encephalitis lethargica (von Economo's encephalitis). Handb Clin Neurol2014;123:745\u201361."},{"key":"bib16","series-title":"Brain","first-page":"1831","article-title":"Clinical analysis of anti-Ma2-associated encephalitis","volume":"127","author":"Dalmau\n              J","year":"2004","unstructured":"Dalmau\n              J\n            , GrausF, VillarejoA, et al.\n          Clinical analysis of anti-Ma2-associated encephalitis. Brain2004;127:1831\u201344."},{"key":"bib17","series-title":"Nat Rev Neurol","first-page":"386","article-title":"Cataplexy--clinical aspects, pathophysiology and management strategy","volume":"10","author":"Dauvilliers\n              Y","year":"2014","unstructured":"Dauvilliers\n              Y\n            , SiegelJM, LopezR, et al.\n          Cataplexy--clinical aspects, pathophysiology and management strategy. Nat Rev Neurol2014;10:386\u201395."},{"key":"bib18","series-title":"Sleep Med","first-page":"40","article-title":"Autonomic dysfunction in primary sleep disorders","volume":"19","author":"Miglis\n              MG","year":"2016","unstructured":"Miglis\n              MG\n            \n          . Autonomic dysfunction in primary sleep disorders. Sleep Med2016;19:40\u20139."},{"key":"bib19","series-title":"Sleep Med Rev","first-page":"43","article-title":"Cardiovascular autonomic dysfunctions and sleep disorders","volume":"26","author":"Calandra-Buonaura\n              G","year":"2016","unstructured":"Calandra-Buonaura\n              G\n            , ProviniF, GuaraldiP, et al.\n          Cardiovascular autonomic dysfunctions and sleep disorders. Sleep Med Rev2016;26:43\u201356."},{"key":"bib20","series-title":"J Sleep Res","first-page":"458","article-title":"Sympathetic and cardiovascular activity during cataplexy in narcolepsy","volume":"17","author":"Donadio\n              V","year":"2008","unstructured":"Donadio\n              V\n            , PlazziG, VandiS, et al.\n          Sympathetic and cardiovascular activity during cataplexy in narcolepsy. 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