Inflammatory diseases of the brain and central nervous system are among the most serious neurological conditions we see in dogs. They can develop rapidly, cause profound clinical signs, and understandably be very frightening for owners. The good news is that, with the right diagnostic approach and carefully tailored treatment, many dogs can respond extremely well.
At Movement Referrals, inflammatory brain disease is something our neurologists diagnose and manage every day. Our approach is grounded in evidence, refined by years of clinical experience, and always centred on doing the right thing for each individual patient.
What do we mean by inflammatory brain disease?
Inflammatory brain disease is a broad term that encompasses several conditions in which the immune system causes inflammation within the brain, spinal cord, or surrounding tissues. In dogs, the most common group is meningoencephalitis of unknown origin (often shortened to MUO), which includes conditions such as granulomatous meningoencephalomyelitis and necrotising encephalitis.
These diseases are not caused by bacteria or viruses, but by an inappropriate immune response targeting the central nervous system. Without treatment, they are typically progressive and can be life-threatening.
Why accurate diagnosis matters so much
At Movement Referrals, we are strong advocates of contextualised care. This means we recognise that every family, every pet, and every situation is different. In many neurological conditions, it is reasonable to consider presumptive treatment when advanced diagnostics are not possible, and we regularly help owners navigate those decisions.
Inflammatory brain disease is different.
In this group of conditions, reaching the most accurate diagnosis possible is critically important. Magnetic resonance imaging (MRI), often combined with cerebrospinal fluid analysis, allows us to confirm that inflammation is present, identify which parts of the brain or spinal cord are affected, and rule out other conditions that can look similar but require very different treatment.
Treating inflammatory brain disease without MRI confirmation can be extremely challenging. The clinical signs can mimic brain tumours, strokes, infections, or metabolic disease; and inappropriate treatment can lead to poorer outcomes. For this reason, inflammatory brain disease is one of the few neurological conditions where we strongly recommend MRI whenever it is achievable.
That said, if MRI is genuinely not possible, our neurologists can still guide owners through presumptive treatment pathways, ensuring decisions are made with full understanding of the limitations and risks involved.
How inflammatory brain disease is treated
Treatment focuses on suppressing the inappropriate immune response while supporting the brain during recovery. Corticosteroids form the foundation of therapy, but for many dogs this is not enough on its own.
Our neurologists have been at the forefront of developing and refining treatment protocols using cytarabine administered as a constant rate infusion (CRI). This method of delivery has important advantages over traditional injection-based protocols, including more consistent drug exposure and improved outcomes.
These protocols were not adopted lightly. They are based on clinical research, careful outcome monitoring, and long-term follow-up of affected dogs. As a result, the cytarabine CRI protocol remains one of the most effective ways to manage inflammatory brain disease and is now widely recognised as best practice.
Importantly, treatment is never “one size fits all”. Some dogs require aggressive early immunosuppression, while others benefit from a more cautious approach. At Movement Referrals, we place great emphasis on tailoring treatment plans to the individual patient, their disease severity, and their family’s circumstances.
Steroid-responsive meningitis-arteritis (SRMA): a related but distinct condition
Inflammatory brain disease also includes other important conditions affecting the central nervous system, one of the most common being steroid-responsive meningitis-arteritis (SRMA).
SRMA typically affects young dogs, often under two years of age. These dogs usually present with severe neck pain, stiffness, lethargy, and a high temperature. Neurological deficits are often mild or absent, which can make the condition confusing and distressing for owners.
SRMA is one of the most treatable inflammatory neurological conditions when recognised early. Treatment with prednisolone is usually highly successful, and most dogs go on to make an excellent recovery.
One of the key advances in managing SRMA has been the use of serum C-reactive protein (CRP) as both a diagnostic and monitoring tool. Dogs with SRMA often have markedly elevated serum CRP concentrations at diagnosis, frequently far exceeding what we would expect in other inflammatory disease.
Serum CRP is particularly valuable because it can be measured quickly using in-house analysers, allowing us to monitor response to treatment without repeated invasive testing. As treatment takes effect, serum CRP levels typically fall rapidly, often before all clinical signs resolve.
This is especially helpful when dogs become lethargic after starting prednisolone. In these cases, a low or falling serum CRP supports that the disease is under control and that the lethargy is more likely related to medication effects rather than disease progression. Conversely, a rising serum CRP can act as an early warning sign of relapse, sometimes before other tests or clinical signs change.
This approach allows treatment to be adjusted promptly and confidently, improving outcomes and reducing unnecessary interventions.
Why experience and evidence matter
Inflammatory neurological diseases are complex, unpredictable, and emotionally taxing for owners. At Movement Referrals, our neurologists combine cutting-edge diagnostics with treatment protocols that are grounded in published research and decades of clinical experience.
Our commitment to evidence-based medicine, contextualised care, and careful long-term monitoring is why so many referring vets and owners trust us with these challenging cases. The goal is always the same: to reach the most accurate diagnosis possible and to give each pet the best chance of recovery.
References supporting our approach
Lowrie M, Smith PM, Garosi L. (2013) Meningoencephalitis of unknown origin: investigation of prognostic factors and outcome using a standard treatment protocol. Veterinary Record.
Lowrie M, Thomson S, Smith P, Garosi L. (2016) Effect of a constant rate infusion of cytosine arabinoside on mortality in dogs with meningoencephalitis of unknown origin. Journal of Veterinary Internal Medicine.
Stee K, Broeckx B, Targett M, Gomes S, Lowrie M. (2020) Cytosine arabinoside constant rate infusion without subsequent subcutaneous injections for the treatment of dogs with meningoencephalomyelitis of unknown origin. Veterinary Record.
Lowrie M, Penderis J, Eckersall PD, McLaughlin M, Mellor D, Anderson TJ. The role of acute phase proteins in diagnosis and management of steroid-responsive meningitis arteritis in dogs. Veterinary Journal.
Lowrie M, Penderis J, McLaughlin M, Eckersall PD, Anderson TJ. (2009) Steroid responsive meningitis-arteritis: a prospective study of potential disease markers, prednisolone treatment, and long-term outcome in 20 dogs (2006-2008). Journal of Veterinary Internal Medicine.