title: Procarbazine as adjunctive therapy for treatment of dogs with presumptive antemortem diagnosis of granulomatous meningoencephalomyelitis: 21 cases (1998-2004).
abstract: BACKGROUND
  Granulomatous meningoencephalomyelitis (GME) is an idiopathic inflammatory disease of the central nervous system. Remission often is short-lived in dogs treated with glucocorticoids. Procarbazine is T cell-specific and crosses the blood-brain barrier.
  
  
  OBJECTIVE
  Dogs with presumptive antemortem diagnosis of GME given procarbazine as adjunctive therapy to prednisone will have improved long-term outcome compared with dogs given no treatment or glucocorticoids alone.
  
  
  METHODS
  Two groups were studied: (1) Dogs with presumptive antemortem diagnosis of GME treated with procarbazine and prednisone (n = 21); (2) Dogs that had a histologic diagnosis of GME at postmortem examination and received no treatment (n = 11).
  
  
  METHODS
  Dogs with presumptive GME treated with procarbazine were identified retrospectively from medical records of 2 veterinary referral hospitals. Selection criteria required all dogs have a neurologic examination, blood work, cerebrospinal fluid analysis, and brain imaging (MRI or CT).
  
  
  RESULTS
  Median survival time for all dogs studied was 5.0 months. Median survival time for dogs treated with procarbazine was 14.0 months and for untreated dogs, 0.73 months. Treatment with procarbazine was significantly correlated with survival time (P < .001). Procarbazine was the only independent predictor of survival. Prednisone was reduced in dosage or discontinued in 17 dogs. Adverse reactions to procarbazine therapy included myelosuppression in 7 dogs and hemorrhagic gastroenteritis in 3 dogs.
  
  
  CONCLUSIONS
  These data suggest that procarbazine treatment of presumptive GME may result in greater improved long-term outcome than has been previously reported for glucocorticoid treatment alone and may complement other immunomodulatory therapies. Procarbazine-treated dogs must be monitored for adverse reactions.
authors.affiliation: Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia 65211, USA. Coatesj@missouri.edu
authors.forename: Joan R
authors.initials: JR
authors.lastname: Coates
authors.forename: Georgina
authors.initials: G
authors.lastname: Barone
authors.forename: Curtis W
authors.initials: CW
authors.lastname: Dewey
authors.forename: Christina L
authors.initials: CL
authors.lastname: Vitale
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Holloway-Azene
authors.forename: John K
authors.initials: JK
authors.lastname: Sessions
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004359:Drug Therapy, Combination; D008590:Meningoencephalitis / Q000188:drug therapy / Q000662:veterinary*; D011241:Prednisone / Q000627:therapeutic use*; D011344:Procarbazine / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D011344:Procarbazine; D011241:Prednisone