The Truth About Meningitis in Dogs: Causes, Symptoms, and Treatment
Meningitis is a dangerous condition that can cause inflammation of the meninges, the membranous covering of the brain and spinal cord, and inflammation of the brain, known as encephalitis. It's a condition that strikes fear into the hearts of dog owners everywhere, but what causes it, and how can you tell if your dog is affected? In this episode, we will be exploring the world of meningitis in dogs and answering all of your most asked questions relating to this frightening infection.
Listen in as I describe the various causes of meningitis, including infections by bacteria, viruses, fungi, protozoa, rickettsia, or parasites. I will examine which breeds are more predisposed to this disease, when in their life they may be infected, and the clinical signs to watch out for, which can include neck or back pain, fever, lethargy, seizures, and more. Identifying these signs early can be crucial to your dog's survival, and we will explain what steps you should take if you suspect your furry friend may have meningitis.
What You’ll Learn:
What meningitis is.
What causes meningitis.
Clinical signs to look out for in your pets.
How to tell if your dog is experiencing neck or back pain.
The importance of flea prevention regardless of where you live.
Which breeds are more predisposed to meningitis.
How veterinarians diagnose meningitis.
How to treat meningitis.
Ideas Worth Sharing:
“If your dog is struggling to walk upstairs or look up at you, they may have meningitis and it is important to take them to the vet right away.” - Tyler Sugerman
“It is really important for people with pets (regardless of where you live) to have flea prevention so that your pets don’t get tapeworms that can cause meningitis.” - Tyler Sugerman
“Luckily, meningitis is not very common, but it is still common enough that you should be aware of the signs to look out for in your dogs.” - Tyler Sugerman
Resources Mentioned:
ASPCA 888-426-4435 or pet poison helpline 855-764-7661
Read The Transcript:
Welcome to Vetsplanation. I'm your veterinary host, Tyler, or you can call me Suggs. This podcast is about educating pet parents about what is going on with their furry little loved ones. As an emergency veterinarian, I understand how hard it is to explain complex diseases in terms that are understandable for pet parents in a few short minutes before the next critical case comes in.
In this podcast, we can dive deeper into understanding of what our pets are going through and break down those complex medical terms into easier to understand chunks of information.
Just a quick disclaimer: this podcast is for informational purposes only. This is not meant to be a diagnosis of your pet. If you have questions about diagnostics or treatment options, please talk to your veterinarian about those things.
Remember, we are all practicing veterinary medicine, and medicine is not an exact science. Your veterinarian may have different treatment options. The information I provide here is to help pet parents, and it's not related to my place of work. I'm here for you guys to provide free information and knowledge.
If you like our podcast, consider sharing this podcast with at least one friend or someone else who has pets and could benefit from this.
Now, let's jump into this week's episode.
Tyler Sugerman: Hey everybody, welcome back to our podcast. First, I wanted to say thank you to some of the new people who have joined us, who have started following the podcast on social media. I love seeing everybody's pictures because I'll see a lot of people with their animals as their profile picture, which is just amazing. There's some very cute kitties and puppies out there.
I'm also going to apologize in advance because my newly adopted dog (we adopted her about two weeks ago), is in the room with me. She usually has been upstairs, but she realized that I was down here and freaked out and wanted to come down with me.
And so, she snores a lot when she sleeps, which I'm sure you could probably hear right now. So, I'm apologizing in advance, but she'll be our background noise and hopefully, she doesn't put you to sleep.
So, we're going to talk today about Meningitis. So, the reason why I chose this, is one of my receptionists actually had asked me about meningitis because she didn't know what it was either. And I am going to preface this with I am not a neurologist.
That is not my specialty, I do emergency medicine, but I still have to deal with meningitis. Like I still have to be the one that tries to help get them to this diagnosis before they can go see a neurologist. So, I'm going to talk about meningitis from my perspective of this, and then not go into as many details as potentially a neurologist would.
But in order to know what meningitis is, like it's just a big scary word to people and most people just think it means that there's something wrong with their brain and that's actually not the case.
So, we're going to go into a little bit of anatomy, what meningitis is, what the definition of it is, some clinical signs, some things that cause meningitis, how to diagnose it, and then how we treat it. So, we're to start with our anatomy.
So, we have to think about what's inside our skull first, I think that's usually the easiest way to understand what meningitis is. So, first, you have your skin that covers your skull and then you have the bony part of your skull.
And now, inside from there, you have this space that's going to be between the meninges, the skull, and the brain. So, it goes skull, meninges, and then brain.
Now, there are three different layers of the meninges, and you don't necessarily need to know all of these things, but I just think they're cool and ties in with human medicine on a lot of terms that we might hear in human medicine.
So, three layers of meninges — so, meninges are going to be this membrane. So, the best analogy I have for these different layers is kind of like a bed.
So, you have your space on top of the bed, your first layer is going to be your comforter, your next layer is going to be your blanket, the next one is going to be your sheet. The next one after that is going to be your fitted sheet that goes on top of your mattress, and then your mattress.
So, if we think of our comforter as being our first layer, that's going to be our skull, that's going to be the actual bony part of our head, the skull part. Our blanket is going to be our first meninge, that one is called the dura mater. I'm going to get into them a little bit more in just a minute, but I just want you to understand what these layers look like.
So, comforter is the skull, the blanket is the dura mater, the middle layer is going to be our sheet. So, our sheet is going to be what's called the arachnoid mater. The fitted blanket on top of our mattress is going to be our pia mater because it is the closest to what our mattress is, which is going to be our brain.
So, like I said, just to reiterate, we have our comforter is going to be our skull, our blanket is the dura mater, sheet — arachnoid mater, fitted sheet is pia mater, mattress is our brain. We don't need to know all of the specific terms like I said, but it's going to help you understand when I'm talking about each one of these areas.
So, if our comforter is our skull, the area between the comforter and our blanket, there's space there. Like it's not squished together, like there's absolutely no air or anything between them. There's going to be some space that's there.
Now, that space is actually called the epidural space above the dura, that's what that means. Epi is above dura, is the meninge or that membranous cover. Now, the moms out there probably know that term, the epidural space because that is where you get an epidural to be able to help make sure that you don't feel so much when you're giving birth.
Which kind of a cool fact real quick is dura, it actually comes from the term hard mother. So, I mean like you've got an injection in your back like I feel like that is as hard as a mother can get. But anyways, so the epidural space, so now, we have the space between our comforter, which is our skull, and the blanket, which is our dura is called the epidural space.
Now, the space between the blanket and our sheet is going to be called the subdural space because it is below (sub) the dura. That space usually doesn't have a lot of space really to it, but just for some human terms, like people will say like when they've had a stroke and stuf,f that they'll call it the subdural hematoma.
So, that there was some bleed that was created in the subdural space, which is that space that we've discussed has been between the blanket and the sheet. So, that it is between the blanket, which is our dura and our sheet, which is our arachnoid mater.
Arachnoid actually just means it's a spider-like appearance. So, it's kind of cool because it looks like a web essentially if you look at that layer, that sheet. And then the next space is going to be between our sheet and our fitted sheet.
So, that's basically the space where you lay, that's where you sleep. And that is the space where the cerebral spinal fluid hangs out. That space is called the subarachnoid space. Just means again, sub — under, arachnoid is that meninge, is called the arachnoid mater.
And then the fitted sheet that we talked about is the pia mater. It is almost like shrink wrap to a brain, it is very fitted just like our fitted blankets are or our fitted sheets are.
So, we have all of these different spaces, we have all of these different things called the meninges. The spaces generally house something. The meninges are actually there to help protect it, they're there to protect the brain.
Now, I said specifically talking about the brain first because I just think it's easier to understand when we think about the brain, but the meninges and all of these species run through the brain and all the way down the spinal cord.
They're there to help protect the brain and the skull, spinal cord runs down our back through our vertebrae. So, these meninges are not just in the brain, it's through the whole spinal cord as well. Now that we have some idea of like what I'm talking about as like this bed analogy, so let's talk about what meningitis actually is.
So, meningitis means inflammation of the meninges or basically, inflammation of that membranous cover of the brain and spinal cord. As far as our bed goes, that means it's inflammation of the blanket, the sheet, and the covered sheet.
All of those are having some sort of inflammation to them. It could be every layer, it could be one layer, two layers, they're all so closely related, it is almost impossible to be able to tell you which one is the one that's going to be the most inflamed. We just know that those coverings are inflamed.
Meningitis is the one that we usually talk about, but some of the things that fall under the same category, but we don't really specifically describe them as such, we usually will just group them under meningitis.
But encephalitis is another one. Encephalitis is actually inflammation of the brain. The encephala is the brain, so the encephalitis is going to be inflammation of the brain. And then our last big category is called meningoencephalitis.
So, that basically is putting the two together with inflammation of the cover of the brain and the spinal cord, which are the meninges, and we have inflammation of the brain itself. And so, now just based on what is actually inflamed tells us what the clinical signs are likely going to be.
So, of meningitis, just of those coverings of the brain and the spinal cord, usually if we have inflammation there, we're going to have a couple of things. One is the dog is usually going to be lethargic.
Now, as I’m sure you’ve heard on every single other episode I’ve talked about (besides amphetamines), the dog is always lethargic, there is always a symptom, which always makes this so hard, especially when people come in and they say, “Well, my dog is lethargic, it's just tired.”
Well, there's thousands of things that can cause this and this is one of them. So, it makes it really difficult to kind of narrow things down at first. But usually, they start out being a little lethargic, they'll usually have a fever. So, there's usually so much inflammation that it causes the body to react to that and their temperature goes up.
So, they do usually have a fever, which is great, you can take your dog or your cat's temperature at home. You can just go to the local store, get one of the rectal thermometers in the baby section, get some lube, and then use that.
It has to be rectally, don't put it under their tongue, don't put it in their ear or anything, it's not going to work — or their armpit. It has to be rectally to be able to determine if they have a fever or not. And a fever for a cat is usually above 102.5. That's when we start worrying about it becoming a fever.
Another big thing is we start noticing that they have neck or back pain. For neck pain, a lot of the times, they have a really difficult time looking up at you. That's one thing I'll actually ask people, like if they're standing in front of you and you call them, will they look up at you?
Because for me, it's a little bit hard to tell, but a lot of times at home is when they're going to be kind of the biggest babies, they're going to want you to fix them. And so, they'll show you different signs, than they'll show me sometimes.
So, I'll ask about are they having difficulty looking up. I'll still try to move their head and neck around, but some dogs are just really resistant to me moving their necks, so it makes it really difficult.
They may also be having back pain, so I'll a lot of times ask as well, “Are they having difficulty going up or down the stairs or jumping up and down?” Because sometimes it'll help me determine between neck pain and back pain versus abdominal pain or pain in the belly.
Think about when just like the way that their anatomy is when I'm pushing down on their spine, I'm essentially pushing down on their abdomen or their belly as well. And if I'm pushing up on their belly, I'm essentially pushing up on their spine as well.
So, sometimes, it's a little bit hard to determine whether this is neck and back pain or if this is abdominal pain. So, a lot of times asking you like, “Is the dog vomiting? Are they having diarrhea? Are they eating okay? Are they having trouble going up and down stairs?” Like those are a lot of things that'll give me clues as to whether this might be back or neck pain versus abdominal pain.
Another thing is you'll see that they're really stiff when they're walking, it almost looks like they’re hurt every single step that they take. You can also see some muscle spasms that happen right over the spine. It'll be like literally right next to the spine, it won't be like kind of muscle spasms everywhere because think about where the meninges are, they're in the spine.
So, if I push on the spine, those muscles are really tense because they're like firing constantly, they're just in so much pain. And then sometimes, they'll have vomiting as well, which again complicates these things for us.
But they're in so much pain that they'll start vomiting from it. So, that's specifically meningitis. So, that is the ones that are just inflammation of the covers or essentially (in our bed analogy), inflammation of those blankets, the sheet and the fitted sheet.
The other things that we might potentially see are going to be things more related to meningoencephalitis. So, that's the inflammation of the sheet covering the spinal cord and brain, and inflammation of the brain itself.
Now, think about people who have had a stroke, depending on where that blood vessel broke, where they had the bleeding at, it depends on what kind of symptoms they have. Some people will be unscathed from having a stroke because it didn't really hit anything that was a really big problem.
It might be that some people have lost a lot of their memory after having a stroke or some people have lost the ability to walk, or some people have lost the ability to talk. It really just depends on what part of the brain is actually affected.
And we have the same thing for when we have meningoencephalitis. So, inflammation of the brain and the covering of the brain in spinal cord. It depends on exactly what part of the brain is being affected.
But some of the things that we'll see are maybe they're just really depressed, they do not want to get up, they just seem very depressed. It could be that it causes blindness, you might see some paralysis of their face, like kind of droopy of their face. Or you might even see that they can't use one whole side of their bodies, they can't use their right, front, and back legs.
You might see them look like they're really drunk, you could see seizures, behavioral changes. So, some people will state that their pet became extremely aggressive for no reason all of a sudden. It could cause them to have severe agitation.
They're painful, their head hurts, like imagine the worst migraine of your life and that is what they're going through. They're agitated, they do not want other dogs near them. Like other dogs will usually play with them, they'll play back. They're going to be like, “No, get away from me,” and snap at them, which is not a normal thing for them.
You might have head tilts or circling to one side, they could have difficulty eating because their muscles that they need to use to be able to eat are usually going to be all attached to the skull. And if you put a lot of pressure then that's putting pressure on those meninges, which is painful.
So, sometimes they won't eat, and you could even have them go into a coma just like a person would when they have some sort of brain bleed. And what are the causes of this? So, there are many causes we're going to go over some of them, and I'll go into a little bit detail on a couple of them.
So, causes can be some sort of bacterial infection, a virus, fungus, some sort of parasite, certain chemicals can cause meningitis, autoimmune disorders meaning their own body is attacking itself. Or it could be what we call idiopathic, meaning we don't know, nobody knows, it's an unknown cause. We've gone through all the testing, we have no idea why there's inflammation of those meninges, we just have to treat them accordingly.
So, the most common causes in dogs are usually going to be a viral infection, a protozoa, which is a type of parasite, a rickettsial disease, which is a type of bacteria that specifically comes from ticks and a fungus.
Now, notice bacteria was not on that list. It can be something that happens, it's just not the most common in dogs and we'll discuss that why in just a second. But for dogs, they said viruses are usually the most common and viruses can be lots and lots of different viruses.
There are certain viruses that we are a little more concerned about. So, rabies is one of them, which is why everybody's like required to do rabies vaccines and stuff. The only way that we can test for rabies is we have to test the brain. There is no blood test that we can do to test for rabies. We have to test the brain because that's where rabies likes to go. It loves the brain and loves the brain tissue. So that's where it's going to want to go.
And then it causes inflammation of the meninges, which causes meningitis. You can have other things like parvovirus, adenovirus, which is one of the things that we vaccinate for in that four-way or five-way or whatever one that you get — it's called the DAPP or DHAPP or DAPPL. There's many variations on it, but all of those vaccinate for parvovirus and adenovirus.
Now, usually, it's very hard for viruses to get into the brain and the reason why is because we have something called the blood-brain barrier. Like you can think of it as like a sieve basically, or even a colander.
So, if I was to cook rice in water, I boil it, cook it, and then I need to get all the water out and just keep my rice — that colander, that sieve is essentially like the blood-brain barrier. Water is small enough, it can go through there, but my rice is not going to go through those tiny little holes.
So, usually, there aren't a lot of things that can go in there unless it catches a ride on something else. So, in the blood-brain barrier, it can catch a ride on certain cells like certain small white blood cells can pass through. So, if it can catch a ride on one of those, then that virus is able to pass through the blood-brain barrier and attack the meninges.
Now, let's say that there's something wrong with that sieve or with that colander, there's a big hole in it. My kid grabbed a pen, stabbed it through and now, we have a hole in it. Now, if I went to go dump out that rice, we're not going to just have water that's able to go through, we're going to have water and some rice.
Like it's going to be a big enough hole that rice is going to be able to pass through it. So, the same thing happens with our viruses. If there's a big enough hole, then definitely bigger viruses can pass through that hole into the blood-brain barrier.
And that hole can happen from things like if there's just a weakening or an injury to that blood-brain barrier, then that'll allow those viruses to be able to pass through. The virus that we worry about for cats like is very specifically something called FIP or feline infectious peritonitis, and I'll do a podcast on that later because that's a huge topic.
But there are two forms of it, one called the wet form, which is usually just that we see fluid in some body cavity like the abdomen or in their chest. But the dry form typically affects things like their brain, and it causes this meningitis, inflammation of the meninges.
We talked about some parasites; some parasites can cause this as well. So, things like heartworm from mosquitoes, those can cause an infection in the brain or in the meninges. Roundworms, so we always treat for roundworms, roundworms can go to the brain as well.
Cuterebra are those weird little parasites that burrow into the skin from things like bot flies and stuff. If you don't know what it is, you should YouTube cuterebra and it's just weird. But cuterebra can do it and also tapeworms.
So, tapeworms come from fleas and it's not that every flea has a tape worm and it's not that all dogs have fleas. It could be that the dog has one flea that jumps on them, they bite that flea, eat it, and then that flea happened to have a tapeworm packet in it, creating the dog now to have tapeworms but tapeworms can then go to places like our brain.
So, it is really important — like I was talking about like flea prevention and stuff for in all areas because everybody's like, well there's no fleas here, it's too cold, but there are still fleas here. So, it is good to make sure we have flea prevention and stuff so that we don't get tapeworms that don't cause meningitis.
Not a very common thing by the way, I will mention that. It's a pretty rare thing that you have tapeworms that cause meningitis, but just another way to easily prevent it.
And then another big reason is going to be our autoimmune disorders. So, this is where our own body is attacking itself. It might be attacking a certain cell, it might be attacking some part of our body, but for some reason, our own body is attacking itself and one of those places can be the meninges. It attacks its own blankets and its own sheets basically, and that can cause an autoimmune problem.
The autoimmune ones tend to be most common in Pugs, Maltese, Yorkies, Pointers, and Greyhounds. And then the least common one, like I said is going to be usually the bacterial infections.
And the reason why is for that blood-brain barrier that we've already talked about. Some of these bacteria are too big to be able to pass through there, but if my kid punches a hole in the sieve, that hole becomes bigger and now it is more likely that that bacteria can cross the blood-brain barrier.
You'll most commonly see these being spread from places like the sinuses, the inner ears, the vertebrae, down our spine, or even the discs of our spine. And again, thinking about where those are all located — they're all located either next to the brain or the spinal cord.
So, any sort of infection that goes from one of those areas can easily spread to the brain or the spinal cord. This could also be from some migrating foreign bodies, so grass awns is probably the most common one.
So, those little grass seed things, if the dog goes out and sniffs one up in their nose and we don't notice it, it can actually migrate through the sinuses into the brain. It could also be from bite wounds or other traumatic injuries to the spine or the head, and a dog that had been stabbed, literally right next to the spinal cord. So, I was very worried about that dog getting meningitis, so I had to treat him appropriately because of that.
One of the common questions I will say real quick just on bacterial infections and viral infections is a lot of people will ask like, “Is this something that is contagious?”
And the majority of the time, no, it is usually not contagious. The ones that I say will potentially be contagious to people are going to be those parasites. So, things like the roundworms or the tapeworms, or even something else called toxoplasma gondii — I'll probably talk about that again in another podcast later on.
But those are usually the ones that are going to be the contagious ones, not the bacterial infections or the fungus or things like that.
“Are there certain breeds that are predisposed to having meningitis?” That's pretty much a yes for all of these.
So, yes, the most common breeds are going to be Beagles, Birdie Mountain dogs, Pugs, German Shorthaired Pointers, Nova Scotia Duck Tolling Retrievers, Golden Retrievers, Rottweilers, Maltese, Yorkies and Greyhounds.
Now, anybody can get meningitis, these just happen to be the ones that are more predisposed to it. I don't know why but I guess that the majority of the ones that I have seen have actually been German Shepherds.
I don't know why, I've just happened to see a lot German Shepherds have it. But like I said, anybody can get them. They're usually affected by meningitis between like ages two to four-years-old, but again, it can be anybody. It can be a young dog, it can be a geriatric dog, doesn't matter.
Now, once you've brought them in, because let's say you bring them into the vet and you're like, “Hey my dog is just really stiff, they just seem extremely painful, they're having a hard time eating and going up and down the stairs,” we take their temperature, we notice they have a fever, I push on their back and I'm like, “Ah, this is really painful for them, something big is going on here.” Then we need to start ruling out things that this could be.
So, a lot of times we're going to start out by doing blood work and X-rays, and this is actually more to rule things out than to necessarily rule things like meningitis in. So, the reason why is because all of these signs can lead to us thinking that they might be other things.
So, one thing this is very commonly mistaken for is something called IVDD or Intervertebral Disc Disease. Again, I'll do another podcast on this, but that basically means that there is a disc that's between each one of our vertebras in our spine, and it's there for compression.
So, if the dog jumps down off of the furniture, it's able to compress that disc rather than hitting bone to bone. So, that's what it's there for, but sometimes those discs will then push into the spinal cord and then create inflammation of the spinal cord that way.
So, it looks a lot like meningitis because we're pushing into that coating of the spinal cord, those meninges, and it is causing inflammation but only in one spot, not the whole area. And it is mostly the spinal cord that we're worried about, not necessarily the meninges.
But it can often very much look like IVDD. It can look like something called polyarthritis, which is where there's a lot of joints that are inflamed. So, if I'm pushing near their spine where their shoulders are, I might think that their shoulders are painful, and then I push near their hips and that's really painful.
So, I might think that their hips are painful. So, I worry now does do they have polyarthritis? Pancreatitis is another big one. When I push on their back, I'm also pushing on their abdomen or their belly. If I push on their belly, I'm also pushing on their back.
So, sometimes if I push in an area like let's say where their ribs kind of end, if I push on the spine in that area, I might think that the dog has pancreatitis because that's about where the pancreas sits, and pancreatitis is inflammation of the pancreas.
You can go back and listen to that one from episode 10, but it could be that I think that it might be pancreatitis instead of it being meningitis. So, we do blood work and X-rays so we can start ruling some of those things out.
We're looking for signs of the pancreas being really inflamed. It could be that I'm worried about maybe a kidney infection, so I'm looking for the kidney values being elevated and I'm looking at a urinalysis to see if there's any bacteria in there.
So, we're trying to see if that there's something else that's causing this. The reason why I'm looking for other things is because actually diagnosing meningitis can be difficult. The most accurate way and most reliable way to diagnose a meningitis is actually to get a fluid sample from the cerebral spinal fluid.
So, that's called a CSF tap, and if you remember back from our anatomy in the beginning of this, the cerebral spinal fluid is basically where you would lay in bed. So, between where our fitted sheet is and where our regular sheet is. Now, that's pretty deep.
Think about all the layers that I just had to go through. I had to go through the blanket, I had to go through the sheet, and then I had to go through to that space between the sheet and the fitted sheet and that fitted sheet is right next to the brain or the spinal cord.
That's a lot of layers so it can be really difficult to get sometimes. They have to be asleep in order for us to be able to do this, like they have to be under anesthesia. They'll usually like shave a spot in the back. And I will say that there are other areas, not just that subarachnoid space that have cerebral spinal fluid, but you have to go in very specific parts of the back in order to be able to find those spaces.
So, once we shave that area, you cleaned it really well and then you stick a needle in and have to get in between those little teeny tiny spaces. Like can you imagine if you were trying to get through the spaces of that bed and not being able to see the bed, you are just hoping that you are in the correct space of where you would potentially sleep with a needle to be able to get that fluid. It’s a very difficult thing to do.
So, there's not a lot of regular veterinarians or even a lot of emergency veterinarians that do it, a lot of times they will refer out to a neurologist because if we go too far, you're going to hit the spinal cord, if we don't go far enough, we're not going to get the right fluid. If we go in the wrong spot, you're going to get a lot of blood.
So, it's really intricate when they do need to have this done. But like I said, it's the most accurate way to do this. So, typically, they'll get that that fluid (the sample of the cerebral spinal fluid) and they'll send it out for a bunch of different testing. They'll usually do a culture of it, meaning that they'll put up some of it like on a petri dish, they'll see if it can grow. And if it grows anything, then that tells us that there is bacteria in there.
They'll usually then tell us what type of antibiotics to use and then we can use the appropriate antibiotics for it. The other things that they're going to be doing is looking at a fluid analysis. So essentially, they're telling us how many of each type of white blood cell (which we just talked about, white blood cells in the different types of them from the previous episode).
But they're going to tell us what types of white blood cells are in there, which will then lead us to is this a bacterial problem, is this a parasite problem, or is this a viral problem? And it'll also tell us too if there could potentially be some bacteria in there as well.
The last thing it's going to do is they're usually going to do what’s called a PCR. So, it's a basically looking for the DNA of different things. So, the DNA of different types of bacteria, the DNA of different types of viruses to tell us what one of those might be causing the problem and then we can treat according to whatever it is that they're able to find from that cerebral spinal fluid tap.
And then the last test is going to be potentially an MRI. One of the problems with meningitis is — think about the brain and you have the whole spinal cord, like that's a lot of area. Just because that there's inflammation of the meninges in one area does not mean there's inflammation of the meninges in the whole spinal cord.
So, it might be that we take a fluid sample from the cerebral spinal fluid way down below, like towards the butt, and we don't actually get anything back from it but we know that that dog is really painful. Doing an MRI can then sometimes show us that there's actually a very specific spot that's causing that pain. It's causing that inflammation which you can see on an MRI, not an X-ray. But then they can get a sample from that specific spot to then be able to figure out what is causing the meningitis.
Just to recap on the diagnostics; usually, we're starting out blood network and X-rays because we're trying to rule other problems out, and then potentially, sending the pet over to a neurologist to do a spinal fluid tap and even potentially, an MRI.
Not always do we have to send them out, there are certain doctors who do the spinal fluid taps and if they do great, at least you can get some sort of diagnostic before you potentially have to go over to do an MRI if that's the next step.
Now, how do we treat these? This is difficult because I just named all these different things as to what causes this. So, it just depends on what it is that they find is the cause. So, let's say that they find that this is an autoimmune disorder, our own body is attacking itself or the dog's own body is attacking itself.
Usually, that means that we're going to put them on either steroids or some other medication that's going to stop the immune response, it's going to stop your own or their own body from attacking in the cells.
It could be that there is an infection and with the infections like certain bacterial infections, certain types of protozoa or parasites or bacteria we might be giving an antibiotic for. So, we need to know which type of bacteria, or which type of rickettsial disease usually coming from some sort of tick-borne disease, which type is causing that so we know which type of antibiotic to give.
It could be that there's a fungal infection in there. If that's the case, we want to give a very specific fungal medication that's going to cross that blood-brain barrier and be able to fight off that fungal infection.
Now, they can have some pretty dramatic side effects depending on which ones and depending on how sick the pet is, and if the pet has any other problems. So, it's not something we just want to throw at them for no reason, like we want to know that there is a fungal infection. Otherwise, a lot of this is going to be supportive care.
So, doing things like IV fluids to keep them hydrated, giving them really good pain control, so good pain relief so that they're not so painful and can do things like eating again, it's giving them nutritional support.
Sometimes, we can get them to eat just by giving them medication that kind of tricks them into eating, or sometimes we actually have to put in a tube, usually from like the nose into the stomach to help feed them. So, we make sure we get nutrition into them even though they're having a hard time eating.
It could mean that we need to provide them with physical therapy. Physical therapy can even be just like having them move their legs while they're laying down, because again, they're really painful, they don't want to move, they don't want to walk. And if they're in a kennel for a week, two weeks, it's really going to be hard for them to try to get back up and get back into moving again.
Imagine if you were just like bedridden for two weeks, try to get you back to going snowboarding isn't going to happen the day that you seem like you feel better, it's going to take some time to get you back there, and it's the same thing with our dogs.
The other thing to note about treatment is this is a long-term thing. This is not going to be that you get medication for a week and they're suddenly better. This is going to be medication for months. Depending on which type it is, it could be antibiotic for months or it could be an anti-inflammatory for months like a steroid.
If it is a steroid, you have to be prepared that you're going to be on high doses at first and will eventually, start to taper down. When they are on high doses of steroids, you should expect that they're going to drink more, they're going to pee more, they're going to eat more, and that's going to be until they're off that steroid. And even then, this could potentially come back.
We don't know how easy it is to be able to take them off the medication. Some dogs need to be on it for years before they are actually even able to be taken off, and there's no way for us to know that even by doing an MRI again, we're likely not going to know what their response is by taking them off.
Or it could be that they do well, we take them off of their antibiotic or off of their steroid, and then they suddenly relapse later. So, that is a potential you have to be prepared that that could potentially happen and just know to watch for those signs. What is the prognosis of this?
Well, again, that kind of depends. We don't know was there long-lasting damage from this, from all that inflammation. Was there some sort of scar tissue that had formed there? Was there something else that just made this to where it's going to be a long-term problem?
Let's say they started having seizures and they're potentially going to have seizures for the rest of their life after that. There's just no way for us to know besides treating them first and then seeing what the potential side effects, the potential long-term damage might be.
The other thing is not knowing like how severe it is. If this is a really severe thing, there's more likely that there's going to be long-term damage versus if this is not as severe, then maybe we have less side effects and a better prognosis. But again, there's no way to know besides treating it and seeing if there are long-term effects from it.
I'm just going to get into some of the common questions that I get. So, one of the most common questions is how common is this? So luckily, meningitis is not very common. this is not a disease that I diagnose every day, every week, every month.
It's usually every couple of months that I'm usually diagnosing a pet with meningitis. And that's just a lot going off of what I think the clinical signs are, and then sending them over to the neurologist. So, it's not even a hundred percent confirmed, those are at least the ones that I suspect have been a meningitis. So, luckily not very common, but still common enough that we have to think about it.
“Why don't regular veterinarians perform the CSF taps?” That's another very common one. “Well, if I know that that's the diagnostic that you should do, why don't you do it?” Well again, like I said, there's a lot of really intricate things to it. Like I might be wasting your money trying to get that diagnosis if I'm not going to be able to do it correctly.
Like I said, if you were to blindfold somebody, you give them a big needle and then you tell them to stick that needle through the sheets and get it exactly to the sheet that you would be able to sleep under, that's almost impossible, It is really hard to do.
You'd have to do it over and over and over and over again to be able to feel what each one of those layers would feel like to know which one you've gone through to get to where that cerebral spinal fluid is.
So, it's constantly doing it over and over again. And if that's not something I do regularly, if I only diagnose this potentially once every couple of months, there's not a lot of practice doing those things.
So, I would rather leave it to somebody who that is their job, that is a neurologist professional opinion, and also, they might see your dog's symptoms and say, “I don't think this matches with meningitis, I think this matches with something else,” and maybe we don't do the cerebral spinal fluid testing and they do some other testing instead.
The next question that you typically get is, “Well, I don't have the money to go to see a neurologist, so can we just give the dog all the medications and hope that we fix it?” So, yes and no. There are definitely complications that can occur from this.
So, if somebody doesn't have the funds, they say like, “Look, this is just either we try something or unfortunately, we have to put the dog to sleep,” then I'm going to just try something.
I'm usually not going to start out with an antifungal medication (maybe some others do, but I don't). I'm usually going to start by doing either a steroid or a steroid and an antibiotic. It just depends on what exposure of certain things that I think that could be caused.
Like if you told me that there was a dog fight wound that was somewhere by the back, or you said that there was a lot of sniffling a month ago, that the dog was sneezing a ton and then was fine after that, then I start might start worrying maybe there's a grass awn or something that's in there, and then maybe I'm going to do antibiotic for those things.
But in general, if the problem is if you decide you're going to go see a neurologist after I started doing medications, let's say I started with a steroid. If I start with a steroid and you decide a month later, you're going to go see a neurologist, now I've masked whatever the cause was causing that meningitis.
So, let's say we give the steroid, it actually ends up being some sort of parasite, we've decreased all that inflammation, we've decreased a lot of those white blood cells, and now, that neurologist cannot tell you what caused that in the first place.
So, it's not a great idea if you think that there's even the slightest possibility that you'll go see a neurologist because I might make it to where they don't get a diagnosis.
So, if somebody says like I … there's just no way. I cannot afford it, I cannot go see a neurologist, then like I said, I'm going to start out with doing steroids and possibly an antibiotic.
The problem with doing just steroids is that if this is not an autoimmune problem and I'm giving just steroids, then if for some reason, they ended up having an infection, I might make that infection way worse. Or let's say I give antibiotics and I give steroids, but I might not pick the right antibiotic.
I'm just guessing as to what the most likely bacteria is that could be in there. And then guessing as to which is the most likely antibiotic that's going to kill that bacteria that I'm guessing at. So, I may not pick the correct ones.
So, ideally, it's going to see a neurologist doing, the cerebral spinal fluid tap, if that's what they think is necessary. And then doing medications after that. But again, if somebody doesn't have the funds, then I'm going to just do the medications because I at least want to try something to try to help that pet.
And then also pain medication too, we're always sending home pain medication because again, it is a very painful thing. And then usually, the last question I get is, “Well, how come you couldn't see the meningitis on x-rays?”
So, X-rays, you cannot see past bone in an x-ray. So, our skull is made out of all bone, so there's no way I can see the brain on an x-ray. And then our spinal cord is wrapped inside our spine. It's that way for protection, it's there for a reason.
It's wrapped in bones that we can protect our spinal cord. So, there's no way for me to see past that vertebrae either or our spine in order to be able to see inflammation of these teeny, tiny little sheets that are covering our spinal cord.
That's like having your comforter on top of your bed, and then asking me what is the color of the sheet? I have no idea. If it's covering the bed, there's no way for me to tell you what color of that sheet is. So, same thing for when we're looking at an x-ray, I can't see those tiny little layers. We can't see meninges.
Alright, I think that that is kind of all that I need to cover for as far as meningitis. I know that was kind of a lot, but if you have questions about it, you can always email me and ask me any questions, and I'm happy to go over those.
I'm going to do my quick cool animal facts for the day. This one is just kind of a couple ones put together, but this is about cats’ whiskers. So, I hear a lot of people say … well, they'll ask me like, “Is it okay if I cut my cat’s whiskers?” And they balance really well. There's really no reason for them to have their whiskers.
And that's not necessarily why cats have whiskers. They actually have like multiple whiskers, not just like the ones that you see on their face, but they also have them like above their eyes. They also have them behind their wrists. And that's all for like just trying to help them kind of know where things are in their environment.
So, one of the things that it does is that it's almost like a measuring tape. So, if you ever see a cat like put their head into a vase or put their head into a box or something first, that's because actually they're using their whiskers to measure whether they will be able to fit into that object or not.
So, they put their head in and if their whiskers kind of rub up against the box or the edges or something, there are little vibrations that get sent in through their whiskers into these nerves that are under their skin, which tells their brain like how big this box is. If it's a lot of vibration, then that box is too small, they're not going to be able to fit into it.
But if there's a little vibration, then there's a good chance that they'll be able to fit into it and be able to get back out of it. So, almost kind of like a measuring tape for them.
The other things that it can help with, like I was talking about there's more whiskers than just what's on their face. They even have whiskers that are kind of on the back of their wrists, if you can kind of look at those at the back. And those are actually used for things like hunting. They're actually not very good at seeing things really close. They're better at seeing things far away.
But in order to know where their prey is, they actually feel if they're running past their whiskers or are feeling where the air is coming from around their whiskers on their feet. So, that way they know where the prey is and can catch it.
And then the last big thing I'm going to mention about whiskers, is it actually also helps them “see” at night. So, they don't have like a ton better vision than us. Yes, they do have better vision than us at night. They do have like their eyes are shaped differently so that they can see better at night.
But also, they're not bumping into things when it's pitch black because of the way that their whiskers are situated. So, their whiskers again, can like feel lots of air movement and vibrations and stuff. So, if you have air bouncing off of things, so it's bouncing off of like your couch, they're going to easily pick up on that from their whiskers and be able to tell that there is an object there and not to run into it.
So, it's almost like one of those canes for the blind, like that's essentially what they're using their whiskers for at night.
Alright, super cool information. I always just think it's really interesting because I just get a lot of people saying, “Can I cut their whiskers?” Don't cut their whiskers because then they won't accurately be able to measure things, they're not going to be able to understand where things are visually at night, so just leave their whiskers alone, and just cut the rest of their hair if you need you to do that.
Alright, thanks guys. Again, thank you so much for listening and getting through all this information with me. I know it was a lot. Meningitis is a really big topic, but hopefully, you understand it a little bit better now. And again, if you have any questions, you just wanna say hi, please feel free to pop by any of our social media or email us.
You can go to the website at vetsplanationpodcast.com, you can find in the “contact us” section, you can just email me directly from there. Any questions, any comments, any topics that you want me to do or just say hi. Alright, thanks guys. Have a great day.
Thanks for listening this week. If you have any questions, comments, suggestions, or you just want to say hi, feel free to email me at suggs@vetsplanationpodcast.com.
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Thank you all again for listening and we'll see you back here next week.