Costs of MUE/GME

This was a hard page to even consider putting together. We would have done ANYTHING to get Piper into remission.

That said, it is an important discussion to have as the diagnosis and treatment are expensive, averaging between $5,000 - $10,000. 

In some cases, if you do not have financial means, you may be able to find a veterinarian who will move forward with treatment if you can't afford the MRI but many will not treat if you don't get the MRI. 

Embrace Pet Insurance covered a claim or $5,251.32 for a total bill of $6,685.93 for GME diagnosis and treatment, but will not cover a pre-existing condition if you do not already have their insurance.

While we did not track every cost for Piper's diagnosis and care we have provided some estimates below so you know what to expect.
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Costs to Diagnosing MUE/GME

The costs associated with diagnosing meningoencephalitis of unknown etiology (MUE), granulomatous meningoencephalomyelitis (GME), or one of the other types of MUE can vary depending on a variety of factors, including the specific diagnostic tests that are ordered.

These are estimated ranges for the common components of the diagnostic process and their associated costs AFTER you go to a specialist

You likely had costs prior to going to the specialist for treating mis-diagnosis that we did not include below. 

Note that your veterinary practice costs may be above or below these ranges.

  1. $150 - $250: Initial Medical Consultation with Speciality Clinic: The cost of veterinary visits and the consultation with a canine neurologist can vary depending on the provider and location.

    In Piper's case, she was admitted through the emergency room which costs more, but was well worth it as it got her immediate care by the neurologist after multiple wrong diagnosis by her general practice veterinarian.

  2. $200 - $1,000: Laboratory Tests: Your veterinairan will need to conduct some extensive testing to rule out other causes of disease.

    This may include the following types of testing (depending on age/breed):
    1. Blood tests to assess inflammatory markers, detect infectious agents, evaluate other potential causes, and check the initial complete blood count (CBC).
    2. Serum chemistry panels.
    3. Urinalysis.
    4. X-rays. 
    5. Serum bile acid analysis.
    6. C-reactive protein testing.
    7. Infectious disease screening.
    8. Abdominal ultrasound 

  3. $2,000 - $3,500: Neuroimaging: Imaging tests, such as an magnetic resonance imaging (MRI) to scan the brain, spinal cord, and optic nerve is performed to look for characteristic changes in the brain such as inflammation, the formation of  granulomas (small masses of inflammatory cells in the case of GME), or lesions of dead or damaged cells (in the case of NME).

    The cost of these tests can also vary depending on the facility, location, and whether contrast agents are used.

    Some canine neurologists will treat for MUE without an MRI and some will require it. If you simply do not have the funds to have the imaging you may try to find another neurologist will better understands your financial situation and will still treat based upon the clinical signs present.

  4. $500 - $1,200: Cerebrospinal Fluid (CSF) Analysis: CSF analysis involves collecting a sample of the cerebrospinal fluid that surrounds the brain and spinal cord through a lumbar puncture (spinal tap) or from the back of the neck area. It is used to rule out infectious disease and further clarify the diagnosis.


Cost can vary depending on the location and facility. You may be able to find lower cost options at a university hospital.

Costs to Treat MUE

The costs associated with treating meningoencephalitis of unknown etiology (MUE), granulomatous meningoencephalomyelitis (GME), or one of the other types of MUE can vary depending on a variety of factors,

Here are some common components of the treatment for GME and their associated costs:

  1. $200 - $2,000: Medications: Treatment may involve medications such as corticosteroids, immunosuppressive drugs, and chemotherapy.

    The cost of these medications can vary widely depending on the specific drug, dosage, duration of treatment, and whether generic or brand-name versions are used. Some medications used in the treatment of GME can be expensive, and costs can range from a few hundred to several thousand dollars per month.

  2. $400 - $2,000: Hospitalization and Procedures: Chemotherapy will have to be administered in the hospital.

    In some cases, hospitalization may be necessary for close monitoring, intravenous medications, or other interventions. For example, Piper had to be admitted due to side effects from the high dose prednisone so she could get IV anti-nausea medication.

    The cost of hospitalization can vary widely depending on the duration of stay, location, and level of care required. 

  3. $200 - $1000: Follow-up Care and Monitoring: You will need to have regular bloodwork completed prior to chemotherapy to check bloodwork. The frequency and duration of follow-up care can vary depending on your dog's condition and response to treatment.

  4. $50 - $100: Other Costs: Other costs associated with treating MUE may include transportation to and from medical appointments. Piper's veterinary neurologist is approximately an hour away from our house. Well worth the commute for an experienced veterinary neurologist! 

It's important to note that the costs mentioned above are approximate and can vary widely depending on many factors.

Long Term Maintenance Medication Costs

Your dog or cat may need lifetime medication to manage seizures as a result of the damage from MUE as well as supplements:

  1. Medications: Anti-seizure medications like Keppra, may be part of the daily routine.

    The cost of these medications can vary widely depending on the specific drug, dosage, duration of treatment, and whether generic or brand-name versions are used. Piper's Keppra was $20 for a 60-day supply - she weighed 8 pounds but was at a high dose.

  2. Follow-up Care and Monitoring: At a minimum, you should have bloodwork completed every year to monitor liver enzymes and other factors as part of the routine follow-up care and monitoring so you know if liver support is needed.

  3. Supplements: You may need to add supplements or have other out of pocket costs. We had liver support supplements, mushrooms for brain health, and hip/joint supplements. 

GME Medications

You may be able to save money by getting prescriptions filled at Sam's Club or a similar discount pharmacy.