Steroid Responsive Meningitis and vaccination/worming - coincidence?

Re: Steroid Responsive Meningitis and vaccination/worming - coincidence?

Mark Holmes — Wed, 30 Jan 2013 14:42:10 GMT

1/52 cases of SRMA will start within a week of a vaccination in annually vaccinated dogs. Unless you are seeing more than this I would be cautious about assuming a cause and effect. If it is recurrant I would consider trying azothioprine. It takes about 4 weeks to work but can be useful.

Re: Steroid Responsive Meningitis and vaccination/worming - coincidence?

Anthony Dennison — Wed, 30 Jan 2013 14:00:43 GMT

[quote user="Mark Lowrie"]I would suggest the 2 week course of steroids may be the problem.[/quote]

It has previously been on long courses of pred, but thanks for the information Mark. I've asked the owner to call us when she starts tapering the dose, so I'll get her to continue at the lower dose.

Do you think that if I rang Pfizer about this possible reaction to their Vanguard 7 vaccine they would do anything?

Re: Steroid Responsive Meningitis and vaccination/worming - coincidence?

Mark Lowrie — Wed, 30 Jan 2013 13:53:58 GMT

[quote user="Anthony Dennison"] the signs returned with neck pain, lethargy and inappetance. Temperature today was 39.5degC, the dog resented moving the neck in all directions. Cranial nerve responses were normal and there was no proprioceptive deficits noted in a quick basic neuro exam. As everything seems to be pointing to a flare up I have started the dog on steroids again, approximately a 2 week course including tapering[/quote]

I would suggest the 2 week course of steroids may be the problem. These dogs tend to require a fairly long course of tapering immunosuppressive treatment - I usually advise at least 6 months (from 1mg/kg q12h down to tiny doses given every 3rd day) - although I do see 'referral' cases and I can believe there are milder forms of SRMA out there that respond to far less. However, if repeated relapses are a problem as seems the case here then longer courses would be appropriate.

[quote user="Anthony Dennison"] Is it too much of a coincidence that clinical signs both seemed to appear after being wormed with Milbemax[/quote]

For Milbemax, I think yes this is a coincidence and other factors are at play. However, I am cautious with vaccinations in a dog with SRMA. Whilst it is probably ok to vaccinate I have seen a number of dogs relapse within days of their vaccination. There is no scientific evidence prving a link and so I am always cautious with 'recommending' against vaccination but I do inform the owners of the risks of vaccinating vs not vaccinating leaving them to decide on their favoured course of action.