NAVLE Nervous

Canine Granulomatous Meningoencephalitis (GME) Study Guide

Granulomatous meningoencephalomyelitis (GME) is an idiopathic, non-suppurative inflammatory disease of the central nervous system (CNS) in dogs.

Overview and Clinical Importance

Granulomatous meningoencephalomyelitis (GME) is an idiopathic, non-suppurative inflammatory disease of the central nervous system (CNS) in dogs. It is characterized by perivascular accumulation of mononuclear cells (primarily macrophages and lymphocytes) forming granulomatous lesions within the brain and/or spinal cord. GME is the second most common inflammatory CNS disease in dogs after canine distemper virus encephalitis, accounting for 5-25% of all CNS disorders.

The disease predominantly affects young to middle-aged (4-8 years), small breed dogs, with a potential female predisposition. The etiology remains unknown, though an immune-mediated pathogenesis is strongly suspected. Without treatment, GME is typically progressive and fatal.

High-YieldOn the NAVLE, when you see a young to middle-aged, small breed dog (especially Poodles or Terriers) presenting with acute, progressive, multifocal neurologic signs and mononuclear pleocytosis on CSF analysis, GME should be at the top of your differential list. Remember: definitive diagnosis requires histopathology, but presumptive diagnosis is commonly made based on signalment, clinical signs, MRI, and CSF findings after excluding infectious causes.
Parameter Characteristics
Age 4-8 years (young to middle-aged); can occur at any age
Sex Possible female predisposition reported in some studies
Breed Small and toy breeds overrepresented; can affect any breed

Etiology and Pathogenesis

The exact etiology of GME remains unknown (idiopathic). However, several pathogenic mechanisms have been proposed:

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