Steroid-responsive meningitis arteritis (SRMA) is an auto-immune condition where the immune system starts to attack the blood vessels within the layers of tissue that surround the brain and spinal cord. It seems to occur at ‘random’ in young dogs under 2 years of age and some breeds of dog such as Whippets are predisposed to the condition.

The typical signs of SRMA include lethargy and neck pain with a high temperature identified on clinical examination, which is exactly how seven-month-old Whippet, Bear, presented to us a few months ago. He was a very sad boy, reluctant to move, lift his head or even wag his tail and his temperature was high at 39.5°C, which prompted our vet Rosy to get a blood sample to assess his general health further. One of Beau’s inflammatory markers, C-reactive protein (CRP), was increased to 116.94mg/L when it should be less than 10! The CRP value added to our suspicions of SRMA, so Beau was booked in for some more tests with vet Louisa.

To diagnose SRMA we need to rule out other causes of neck pain, then sample the fluid that surrounds the brain and the spinal cord, cerebrospinal fluid (CSF), by performing a spinal tap. A spinal tap is similar to a lumbar puncture in people, but because Beau had neck pain, we took the sample from the base of his skull instead. For this Beau needed to be put under general anaesthesia. Whilst he was asleep, we also took some samples from his wrist, knee and ankle joints. This is because sometimes neck pain is due to inflammation in the spinal joints of the neck (a type of arthritis) and some dogs with SRMA will also have another similar auto-immune inflammatory process involving multiple other joints in the body (a type of polyarthritis). Differentiating between the two is somewhat academic in the first instance but important to know for Beau’s long-term health, and understanding the risk of the condition coming back in the future. Thankfully, Beau’s spinal fluid sample was full of inflammatory cells, consistent with SRMA and his joints were normal.

Beau has started his treatment for SRMA which involves controlling the over-reaction of his immune system with steroids, along with other supportive care such as pain relief and modifications to his environment, like raising his food and water bowls, and using a harness when going for a walk, which his owners were doing already.

The steroids start at very high doses and are tapered, roughly every three weeks for several months, guided by clinical assessment of Beau’s neck pain and temperature and rechecking his CRP blood values. So far Beau is responding to treatment well; he is back to his lively self with a very waggy tail, a comfortable neck, a normal temperature and his CRP blood value dropped from 116.94 to 2.

As we taper Beau’s steroids, there is a risk he might have a relapse and show signs of neck pain again, so it is important that we continue to monitor him closely and support his recovery.

We have everything crossed for Beau and it is great to see him so happy again.