Responsiveness of the neurodisability scale for meningoencephalitis of unknown origin in dogs.

Abstract

Objectives: To determine the responsiveness of the neurodisability scale during the treatment of meningoencephalitis of unknown origin in dogs.

Materials and methods: The neurodisability scale score was determined at initial presentation and then repeated at each reassessment during treatment. At each visit, a subjective clinical evaluation of the response to treatment was also recorded. Responsiveness of the neurodisability scale between timepoints was evaluated using the receiver operating characteristics method and correlation analysis. Responsiveness was calculated between the neurodisability scale score at initial assessment and the first re-examination after starting treatment (T₁). It was also calculated between the neurodisability scale score at T₁ and a second reassessment (T₂) where the score had changed either due to relapse or further improvement (if no changes occurred, the last available assessment was used).

Results: Thirty-eight dogs were included. Median time between T₀ and T₁ was 3 weeks, and 35/38 had shown clinical improvement. Median time between T₁ and T₂ was 6 months; 13 dogs were suspected to have clinical relapse. The neurodisability scale demonstrated excellent responsiveness at both timepoints, with area under the curves of 0.96 (95% CI = 0.89 to 1) at T₁ and 0.93 (95% CI = 0.85 to 1) at T₂. There was also an excellent negative correlation coefficient produced by the change in score and the dogs' subjective clinical evaluation (T₀ - T₁ Gamma = -0.8 and T₁ - T₂ Gamma = -0.88).

Clinical significance: The neurodisability scale is a responsive monitoring tool during meningoencephalitis of unknown origin treatment and relapse. Our results support the utility of the neurodisability scale as a clinician-reported outcome measure for use in clinical trials.