Diagnosing MUE

(or GME, NME, NLE, SRMA)

A thorough review of the medical history and a detailed examination of the clinical signs by a veterinarian can provide important clues, an MRI is necessary to actually diagnose MUE. Many neurologists will often recommend also getting spinal fluid analysis.

If your neurologist says your dog or cat needs an MRI...

Do not waste time.

Get the MRI!

Time is Critical

MUE and GME must be treated quickly and aggressively to achieve remission.

Delaying treatment can result in irreversible neurological damage.

The diagnosis of MUE can be complex.

It requires ruling out other potential causes of the symptoms and even then, it is a suspected case as it can't be confirmed without an autopsy.

A veterinary neurologist can come to a fairly certain “presumptive diagnosis” of the disease using the tests described below so they can then quickly proceed with the live-saving treatment.

We highly recommend finding a veterinary neurologist if you are concerned your dog or cat may have MUE.

Many veterinarians do not have experience treating MUE and make critical mistakes:

  • Misdiagnose for more familiar ailments such as slipped discs, luxating patellas, urinary tract infections, ear infections, tick-borne bacterial meningitis, stroke, or cancer
  • Do not treat aggressively enough to achieve remission
  • Titer prednisone to early


If MUE is suspected, it may be advantageous to go to an emergency hospital who has a veterinary neurologist on staff to get in quickly.

This is the typical path to diagnosis:

  1. Neurological examination: A comprehensive neurological examination will be performed to assess your dog's reflexes, muscle strength, coordination, and overall neurological function. This can help identify any abnormal findings that may suggest MUE or other neurological disorders.

  2. Blood tests: Blood tests will be done to rule out other potential causes of symptoms and to assess general health.

    These tests may include a complete blood count (CBC), blood chemistry panel, tests to check for infectious diseases like tick-borne diseases, serum chemistry panel, urinalysis, and more which may have similar clinical signs to GME or MUO. 

  3. Imaging studies: Imaging studies, such as x-rays, abdominal ultrasound, and magnetic resonance imaging (MRI).

    The MRI scan of the brain, spine, 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).

    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. 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.

    The CSF is examined for abnormalities such as abnormally high concentrations of lymphocytes and other white blood cells in the dog's spinal fluid, elevated protein levels, and changes in glucose levels, which may suggest GME or MUO.

    The CSF must also examined to look for any infectious agents which may cause encephalitis such as distemper, bacterial meningitis, viral meningitis, and others to rule those out as a diagnosis.

It is not uncommon for other diseases to be diagnosed when MUE is suspected after the testing is completed. Learn more about those here.
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Piper with Angela

Do Not Waste Time

Our biggest regret when Piper was first having symptoms was not understanding what those symptoms meant and wasting valuable time which resulted in some permanent neurological damage.
  • We wasted nearly a month when Piper first starting having neurological issues getting her treated for luxating patellas, ear infections, and UTIs
  • We lost nearly a week after seeing the neurologist because we were afraid to put Piper under anesthesia to have the MRI and were hoping the anti-seizure medication would help

If we could go back in time, as soon as we started seeing the carpet hopping, the lack of interaction, confusion, and other symptoms, we would get her to a neurologist and get the MRI done as soon as it was suggested so we could start treatment.

Piper lived in remission for 6 years. She was very happy and so much fun; but, we did notice she wasn't "the same" after GME as she was before.

Don't get me wrong... she was still Piper and we still adored her but she was more intense, stopped playing some of the games she used to love, was less patient with puzzle games, had declined vision, and other small things.

We were so blessed to have Piper in remission for nearly 6 years. She was still our little precious Piper and we are still so grateful to Dr. Debbie Ruehlmann, DVM, Diplomate ACVIM (Neurology) at the team at Metropolitan Veterinary Specialists in Louisville, KY for giving us more years with our girl.