I found this information on this site:
Quote:
Granulometous meningoencephalomyelitis (GME) comes in three forms: localized, generalized and ocular.
Localized GME refers to the fact that a discrete area of the brain is affected. It can cause problems in a single activity or more generalized problems, depending on the exact area of the brain involved.
Generalized GME means that there is wide involvement of the brain tissue (diffuse damage). There are usually signs of several neurologic problems occurring at one time with this form of the disease.
Ocular GME affects the eyes, causes blindness and may or may not progress to one of the other forms.
Localized and ocular GME have a better prognosis than generalized GME. Dogs with local or ocular GME may live for years. Localized GME is often responsive to corticosteroids for very long times, as well, so the dog may have a good quality of life in addition to a longer life. Ocular GME doesn't seem to respond well to treatment based on limited experience with it -- but most dogs adjust to visual impairment pretty well so this may not be an important issue.
Unfortunately, generalized GME has a poor prognosis. The symptoms will sometimes resolve, or nearly resolve, pretty rapidly with therapy but it is necessary to continue using immunosuppressive medications, usually corticosteroids, life long. In most cases, the disease will become unresponsive to medications within a few weeks to several months and most pet owners opt for euthanasia when the signs become progressive and stop responding to therapy. When paralysis is present the most likely areas of the brain to be affected are the brain stem, but the cervical spinal cord can also sometimes be involved in the disease process. If the brain stem is involved, some dogs will be severely depressed or can even become comatose, if the response to therapy isn't good.
The differential diagnosis list for GME is pretty short. It can be confused with other forms of encephalitis (infectious, toxic) and with cancers affecting the brain. Hepatic encephalopathy can look a lot like GME but usually there are obvious signs of liver disease which make it possible to distinguish that toxic effects of liver disease are causing the neurologic signs.
There is no sure way to diagnose GME other than biopsy samples of the brain, which isn't a common procedure in veterinary medicine. Cerebrospinal fluid analysis can be helpful in ruling out other problems and hinting at GME. Computerized tomography (CT) scans or MRI scans can help rule out cancer and can help in identifying focal (local) areas of brain involvement.
Both local and generalized GME usually have to be treated continuously and treatment can not generally be withdrawn without a recurrence of symptoms. Generalized GME is almost always fatal. In most cases the prognosis for generalized GME is poor, but I have gotten at least one letter complaining that I was too pessimistic in my opinion of GME, based on a case in which one person's dog had been living with the disease well controlled for over a year.
It is usually necessary to use high doses of prednisone or other corticosteroids to get the symptoms to resolve but it is sometimes possible to use lower dosages for maintenance. An effort should be made to see if a lower dose will control the signs once they are well under control. Radiation therapy has been reported to help in a limited number of cases of GME.
I hope that this information is useful to you. I understand that sometimes people subscribe when they really want to hear better news than this. We will refund the subscription price under these circumstances if a request to do so is made.
Mike Richards, DVM
10/12/2003
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Please tell the vet what the dog is doing that is worrying you. Medicines take some time before results are seen. Have you thought about getting a second opinion??
I am so sorry you are going thru this. As for pain, I do not know. Call the vet and ask please. This is serious. You should not feel that you are being cruel to the dog. Ask your vet how long it will take to see improvement. Did the sleeping meds cause the dog to scream and walk into wall?
You pay alot for the vet, get him to answer ALL of your questions, please.
I do hope and pray for a quick recovery.