Abstract
Meningoencephalomyelitis of unknown origin (MUO) is an umbrella term describing inflammatory changes of the central nervous system (CNS) with suspected non-infectious etiology. Diagnosis of MUO mostly remains presumed in a clinical setting. Histopathological and immunohistochemical examination of CNS tissue represent additional tools for detection of inflammation and the exclusion of specific infectious agents. While MUO is well-described in canine patients, only little is known about MUO in cats. Previous reports of feline MUO involve either clinical findings or histopathological examination but not both. The present case series is the first report describing both clinical and histopathological findings of feline MUO: Four cats (age: 1.7–17.8 years) showed acute to chronic progressive neurological signs of encephalopathy or myelopathy. Three cats had extraneural signs (hyperthermia, weight loss, hyporexia, leukocytosis). Magnetic resonance imaging (MRI) showed multifocal intraparenchymal lesions in forebrain, brainstem or spinal cord with homogenous contrast enhancement (2/2). Cerebrospinal fluid (CSF) examination was normal or displayed albuminocytologic dissociation. Histopathology revealed a multifocal, lympho-histiocytic meningoencephalitis in three cases and a lympho-histiocytic myelitis in one case. Immunohistochemistry for feline parvovirus, feline coronavirus, feline herpesvirus, tick borne encephalitis virus, Borna disease virus, morbillivirus, rabies virus, suid herpesvirus-1, and Toxoplasma gondii were negative in all cases.One Sentence SummaryThis case series is the first one reporting both clinical and histopathological findings in cats with MUO. Feline MUO incorporates heterogeneous subtypes of sterile CNS inflammation.
Highlights
Meningoencephalomyelitis of unknown origin (MUO) is an umbrella term describing inflammatory changes of the central nervous system (CNS) with suspected non-infectious etiology (1)
Median age was 7 years, which is older than the median age of cats which presented to the clinic due to infectious encephalitis (1–4.88 years, Table 1)
Breed distribution of the presented cases was comparable with general clinical population, while in cats with infectious encephalitis pedigree cats seemed to be more common (Table 1)
Summary
Meningoencephalomyelitis of unknown origin (MUO) is an umbrella term describing inflammatory changes of the central nervous system (CNS) with suspected non-infectious etiology (1). The definitive diagnosis of a noninfectious meningoencephalomyelitis can only be made via histopathological examination and exclusion of known infectious agents using immunohistochemistry and/or molecular methods (1). A broad range of different MUO are well-described and classified as for example granulomatous meningoencephalitis, necrotizing meningoencephalitis, or eosinophilic meningoencephalitis (1–5). Encephalitis is frequently caused by infectious organisms (6, 7). Reports of MUO in cats are rare and focus on either clinical (8) or pathological aspects (9) of the disease and a classification system for feline MUO is missing. Cases of feline meningoencephalitides are described, in which the authors suggest an infectious agent, but the agent itself was not detected (6, 7, 10)
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