Steroid Responsive Meningitis Arteritis (SRMA)

Introduction to Steroid Responsive Meningitis Arteritis

Steroid Responsive Meningitis Arteritis (SRMA) is a disease that usually causes spinal pain, most often in the neck, and fever.

In SRMA, the immune system is attacking the covering of the spinal cord (meninges) and joints like there is an infection, but there is no infection. This is what we call an auto-immune disease. Basically, the immune system has made a mistake and is attacking the body like it’s an enemy invader. We treat this disease with immunosuppressive drugs.

Which Dogs Are Prone to SRMA

This is a group of diseases that affect mostly young medium to large breed dogs. It is particularly common in Boxers and Beagles.

Symptoms of SRMA

Please contact your veterinarian if your pet develops new symptoms or if existing symptoms seem to be getting worse. Symptoms include:

Pain not controlled by medications
Difficulty walking
Seizures
Change in behavior
Reluctance to eat or drink
Vomiting or diarrhea

Diagnosing SRMA

SRMA is diagnosed with imaging (CT or MRI scan), a spinal tap and by ruling out infections with special blood work. In some pets we will also recommend a joint tap and culture. MRI may show inflammation of the covering of the spinal cord after contrast or may be normal. Spinal fluid will show too many white blood cells when examined by a pathologist. In rare cases, this is caused by an infection. However, most dogs have an autoimmune disease. Infectious tests may take up to 10 business days to come back from the lab, so if suspect infection is a possibility we will start patients on broad spectrum therapy (both steroids and antibiotics) while we wait for test results.

Will my pet be okay?

Treatment of Inflammatory Brain Disease

There are a lot of different treatment regimens that can be used to treat SRMA, but most involve using a type of steroid, for instance prednisone or dexamethasone. Some pets will also be placed on a second medication to help control the immune system if their symptoms are not controlled on steroids alone or if they cannot tolerate steroids. This second medication lets us use less steroid over time, which is helpful because steroids can have side effects when used long term and/or at high dose. Examples of the second medication that your veterinarian might recommend include mycophenolate, cyclosporin, azathioprine, and leflunomide. Your pet will be less able to fight infections on these drugs and vaccination may not be recommended.

Regular check ups with your veterinarian will be important in monitoring your pet’s health, especially early on. Dr. Jurney typically rechecks her patients 1 week after the initial diagnosis, and then monthly for the first several months. Further recheck schedules will be dependent on how severely your dog is affected.

These diseases are treatable. Most dogs will do well, becoming normal in the first month of treatment. We very slowly lower their drug doses over a period of about 6 to 8 months. Ideally, before we stop drugs entirely, we will repeat a spinal tap and/or joint taps. Some dogs do need a small amount of medication lifelong. Very rarely a patient does not respond to therapy.