GME (granulomatous meningo-encephalomyelitis) is a fancy name in medical terminology for a kind of inflammation affecting the brain, the spinal cord and the meninges (the covering of the spinal cord and brain). The classic patient is a middle-aged, small breed dog of either sex – however, all ages and breeds can be affected. What kind of neurological signs seen will depend on what area of the nervous system that is involved. Seizures, neck pain, drunken gait, walking in circles, blindness, listlessness, tilted head, facial abnormalities, tremors, wobbliness, and weakness can all be symptoms. This is not a disease that can be definitively diagnosed without a biopsy of the affected brain tissue! Please remember, if you are being told by a veterinarian (even a veterinary neurologist) that your pet has GME, and a biopsy of your pet’s brain has not been done, it is not a confirmed diagnosis. This should actually bring you some relief, because if you search on the internet for GME, you will find very discouraging information. An internet search through Google, Yahoo and Bing, etc.. will likely lead to results telling you that a dog with GME will die. If you are “internet savvy” and can read through some of this information, you will find that a lot of this information is coming from necropsy (autopsy for dogs) reports. Necropsy is a way that we can definitively diagnose GME because we are examining the brain under a microscope.
If your dog has signs of inflammation in his/her nervous system (brain or spinal cord), or you have been told that your dog has GME or a GME-like disease, I would STRONGLY recommend you seek a consultation with a veterinary neurologist. A veterinary neurologist is a veterinarian that has gone through extensive training, post veterinary school, to learn about diagnosing and treating diseases that affect the nervous system of animals. I would like to humbly explain at this point that there are NO GME SPECIALISTS! There are no veterinarians or veterinary neurologists who have any advanced training in treating this disease. There are universities and researchers that are studying the underlying cause of this disease more than others. Some of these veterinarians are also studying different treatments, and how they get into the nervous system to help treat this disease.
Veterinary neurologists meet once a year to hear the results of all of this research and to discuss different treatment successes and failures, and then we bring this information back to help treat our patients. Due to the variety of medications available, and different disease processes causing GME-like signs, there are many different approaches to treating inflammation of the brain and spinal cord. To put it in different terms – if your child falls and scrapes a knee – sometimes they need stitches, sometimes they just need a bandaid, other times, ice, antibiotics and elevation of the leg is recommended. The last thing you want to do is put stitches in a wound that only needs a band-aid! Therefore, it is best to find a veterinary neurologist that will treat your dog based on their clinical signs, diagnostic testing results, and response to treatments. After much discussion with veterinary neurologists all over the world, there appears to be similar success rates in treating inflammation in the brain and spinal cord – no matter what our approach is!
Please remember, most of us Veterinary Neurologists refer to this problem as a more generic name such as “Inflammatory brain disease”. Do not be frustrated by a more generic term – I can promise you, the neurologist that is using a generic term like the one listed above is being 100% honest with you, because GME is confirmed only by biopsy. We do our best to diagnose and treat what we know without bringing additional risk to our patients, so we treat what we know… inflammation.
This post was written/edited by
Stephanie Kube, DVM, DACVIM (Neurology)
Tammy Stevenson, DVM, DACVIM (Neurology)