# Gme/nme



## italianna82 (Aug 17, 2012)

I have been reading posts regarding GME and NME and am wondering how exactly this is diagnosed. Being the worry worm that I am, I'm paranoid about Gucci getting it. I've tried to read some things about it, but it's almost another language trying to understand it all.
Are there symptoms??? Do they get it at a young age??? How is it diagnosed???


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## jmm (Nov 23, 2004)

Most dogs are young adults when diagnosed. 
It is diagnosed by looking for lesions on an MRI scan along with looking at the cells from a CSF tap under the microscope. It is a presumptive diagnosis that can only be positively diagnosed on necropsy. 
Symptoms can range from very vague "not doing right" to drastic neurological signs like trouble walking and seizures. 
Granulomatous Meningoencephalitis


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## pammy4501 (Aug 8, 2007)

*This is from a brochure that Jackie (JMM) and I produced last year before the National Specialty Show. Just for informational purposes only. The study referenced has been completed*. 

Maltese as a breed appear to be pre-disposed to certain types of encephalitis. It is suspected that there is a genetic component to these diseases. In this handout we will talk about 2 common types of encephalitis in Maltese: *GME *and *NME*. Then we will discuss how you can help with current research into the potential hereditary components of these diseases 
*Important Terms: *
*Encephalitis *is a general term for in-flammatory conditions affecting the brain. 
*Meningitis *is a general term for inflammatory conditions affecting the covers of the brain and spinal cord. 
*MRI *refers to a non-invasive imaging scan. For animals, the scan requires they be placed under a general anes-thetic to insure the animal remains per-fectly still. Typically when a veterinarian is expecting to diagnose a form of en-cephalitis, they request views or the brain and cervical spinal cord. 
*CSF Tap *refers to sampling of some of the fluid near the spinal cord. This is often done on the neck or back of the dog. This test also requires anesthesia. 
*Necropsy *is an autopsy (examination after death) on an animal. 
*What is GME? *
GME stands for Granulomatous Meningoencephalomyelitis. The name describes the type of inflammatory cells and the parts of the body it can affect. Symptoms of GME can vary and be vague. Some symptoms can include back pain, neck pain, lethargy, de-creased appetite, seizures, difficulty walking, circling, and vision problems. GME is diagnosed by MRI and CSF tap under the supervision of a veterinary neurologist. Based upon the appear-ance of lesions on the MRI and the types of cells found on the CSF tap, a presumptive diagnosis of GME can be made. A definitive diagnosis would re-quire biopsy of the lesions. This is only done after the death of a patient at the necropsy. 
*What are the treatment options and prognosis for dogs diag-nosed with GME? *
The most successful treatment options for GME are a combination of immune-suppressive steroids and chemothera-peutic agents. The precise combina-tions and dosages will vary from dog to dog. 
GME is typically considered fatal. The goal of treatment is to place the dog in a remission (a period of time where the dog is free of symptoms). With newer therapies, many dogs survive months or even a year a more. This is a massive leap from 10 years ago when dogs were typically given weeks to months on steroid therapy alone. 
The individual prognosis of a dog pre-sumed to have GME will depend on their lesions (MRI results) and response to treatment. 
*What is NME? *
NME stands for Necrotizing Meningoencephalitis. The name refers to necrotic (dying) lesions in the central nervous system. NME is typically considered more se-vere than GME. It has a quick, severe onset of symptoms like GME (see above). Like GME, NME is presumptively diag-noses by MRI and CSF tap under the supervision of a veterinary neurologist. The most common difference between the two illnesses on the tests is the appearance of the lesions in the brain on the MRI. Like GME, NME can only be definitively diagnosed at necropsy. 
*What are the treatment options and prognosis for dogs diag-nosed with NME? *
Treatment protocols are similar to those for dogs with GME. Some veteri-narians will be even more aggressive with their treatment if they suspect NME. NME is considered fatal, with a shorter lifespan after diagnosis than GME. Most dogs survive weeks to months after diagnosis. 
*What should I do if I am con-cerned my Maltese has a neuro-logical disorder? *
Talk to your regular veterinarian first. Based upon your dog’s presentation they can help you decide if your dog needs to have a consultation with a veterinarian who is board-certified in neurology. 
Veterinary neurologists can be found in private practice (often near big cities) or at veterinary schools throughout the United States. Your local veterinarian can refer you to the closes neurologist nearby. 
Time is of the essence! Don’t wait if you are concerned that your dog may have neurological symptoms (such as trouble walking, seizures, back or neck pain, etc.). Call your veterinarian or closest emergency clinic and seek treatment immediately. Time is of the essence with these diseases. Maltese are also prone to epilepsy, hydrocephalus, and Chiari Malformation. Without proper diagnostics, your vet will not be able to distinguish what disease process is present. While diagnostics can be expensive, they are necessary. 
*What are the treatment options and prognosis for dogs diag-nosed with NME? *
Treatment protocols are similar to those for dogs with GME. Some veteri-narians will be even more aggressive with their treatment if they suspect NME. NME is considered fatal, with a shorter lifespan after diagnosis than GME. Most dogs survive weeks to months after diagnosis. 
*What should I do if I am con-cerned my Maltese has a neuro-logical disorder? *
Talk to your regular veterinarian first. Based upon your dog’s presentation they can help you decide if your dog needs to have a consultation with a veterinarian who is board-certified in neurology. 
Veterinary neurologists can be found in private practice (often near big cities) or at veterinary schools throughout the United States. Your local veterinarian can refer you to the closes neurologist nearby. 
Time is of the essence! Don’t wait if you are concerned that your dog may have neurological symptoms (such as trouble walking, seizures, back or neck pain, etc.). Call your veterinarian or closest emergency clinic and seek treatment immediately. Time is of the essence with these diseases. Maltese are also prone to epilepsy, hydrocephalus, and Chiari Malforma-tion. Without proper diagnostics, your vet will not be able to distinguish what disease process is present. While diag-nostics can be expensive, they are nec-essary. 
*How Can You Help? *
*How can I help with research into the genetic components of GME and NME in Maltese? *
The University of Georgia, Dr. Scott Schatzberg, Dr. Renee Barber, and a team of other researchers are currently collect-ing samples of normal and affected Mal-tese dogs to research potential genetic markers for these types of encephalitis. Maltese dogs that have died from pre-sumed GME or NME can have their brain and DNA submitted to the study. Owners will receive a necropsy report on the brain with a definitive diagnosis. Maltese dogs that are live and presumed affected by GME and NME can submit their DNA and test results to be part of the study. There will be no results given to owners. Maltese dogs that are live and normal, age 5-12, can submit their DNA as a "normal" for the study. The study needs lots of normal dogs! At AMA Nationals we have special permission to sample 25 nor-mal dogs regardless of age. See us as the table if you are interested! Submission forms will be available at the in-formation table at Nationals and on the AMA website: 

*(American Maltese Association) *

Questions: 
Will the study share my informa-tion or my dog’s information? 
Nope! Unless you submit a sample of necropsy, there will be no information returned to you. All submissions remain confidential. Nobody will know your dog partici-pated. No information or result with your dog’s name will be published. Even request for sampling material remains confidential. Nobody will know your name or that you re-quested DNA swabs or information. If you have questions or need to re-quest DNA swabs, please contact Jackie Nelson ([email protected]) or via phone at XXX XXX XXXX. 
Donations for this research may be made to the Morris Animal Foundation: 
http://maf.convio.net/goto/lolagme.fund


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## jmm (Nov 23, 2004)

Pam you rock!


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