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STEROID-responsive meningitis arteritis (SRMA) is a common disorder in canine medicine that normally affects young animals, with a breed predisposition reported for beagles, boxers and Weimaraners among others (Bathen-Noethen and others 2008, Lowrie and others 2009a, Tipold and others 2010). The aetiology of the disease is presumed to be immune-mediated, and this is supported by clinicopathological evidence and the response to immunosuppressive treatment (Lowrie and others 2009a, b, Tipold and Schatzberg 2010).
The systemic consequences of SRMA are not always recognised, and this short communication is novel in describing the occurrence of spontaneous echocardiographic contrast (SEC) with SRMA and the normalisation of a previously elevated serum cardiac troponin I (cTnI) after treatment of SRMA.
An 18-month-old female entire Whippet was presented with a five-day history of reluctance to exercise, anorexia, lethargy and fever. On examination, the dog was quiet but alert and responsive with a rectal temperature of 39.9°C. The findings of the physical and orthopaedic examinations were otherwise unremarkable. The finding of a neurological examination was also unremarkable apart from resentment of neck flexion to the left.
Haematology showed an inflammatory picture with mild mature neutrophilia and monocytosis (Table 1). Biochemistry revealed a mild hypoalbuminemia and hypocalcaemia. Acute phase protein assessment showed marked elevation in haptoglobin and C-reactive protein (CRP) (Table 1). cTnI was increased, which is consistent with myocardial damage (Table 1). Urinalysis showed a normal protein:creatinine ratio (0.4; reference range, <0.5).
Cervical radiographs and abdominal ultrasonography showed no abnormalities; thoracic radiographs showed generalised cardiomegaly (vertebral heart score; 12.75) without evidence of specific chamber enlargement, consistent with a pericardial effusion.
Echocardiography showed no left ventricular enlargement (left ventricular internal diameter in diastole, 39 mm; reference range (mean±2sd) for an 11 kg Whippet, 29.4 to …