Q. My Maltese had a GME relapse 2 weeks ago. Are there any ways to keep it under control and to detect a relapse? Is there any diet that we can follow?
Dr. Brian Loon: Granulomatous meningoencephalitis (GME) is a serious disorder. It involves inflammation of one or more parts of the central nervous system (CNS) – the brain, spinal cord, and their outer lining (meninges).
Symptoms
When specific white blood cells (mononuclear cells) engulf and destroy these areas of the CNS, we will see neurological signs related to the affected area of these organs. They can range from lethargy, walking in circles or loss of balance to loss of vision or seizures.
Diagnosis
Diagnosis of GME usually requires advanced imaging, such as an MRI or CT scan, along with an analysis of the fluid lining the CNS (cerebrospinal fluid).
Treatment
Unfortunately, GME is not regarded as a curable condition. It is almost always rapidly or slowly progressive. Thus, it is important to understand that this is a serious and complicated condition.
Long-term treatment and veterinary monitoring of the condition is necessary. Treatment mainly involves suppressing inflammation, usually with corticosteroid therapy and sometimes other immunosuppressive medication.
If seizures are present, we can control them with anticonvulsant therapy. Acupuncture can also be very effective in managing neurological conditions along with western therapy.
Observation
You will need to go for regular rechecks with your vet to track the progression and control of the condition. That is by examining clinical signs and potential side effects of the medical therapy.
The goal of treatment is to control the progression of clinical signs. Unfortunately, some signs may not fully resolve, and a few dogs may not respond to even the most aggressive therapy.
Relapses may also occur after an initial response to treatment. Without treatment, signs usually worsen and may be life-threatening within weeks to months.
Dietary advice
A complete and balanced diet is essential to support general health. However, there is no current scientific evidence of specific dietary therapy that helps with GME.
When on immunosuppressive therapy, the risks of life-threatening opportunistic infections are highly increased. Hence, all food should be well cooked and not fed raw to reduce the risk of gastrointestinal infections, such as Salmonella.
Some supplements may help with supporting nervous system health. They include omega 3 fish oil and SAM-e (S-Adenosyl methionine), as well as taurine and GABA to assist with seizure control.
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