Multiple limb lameness Flashcards
Describe panosteitis
inflammatory condition in multiple long bones. Most common in the young male (<2 years) German shepherd dog
List the causes of multiple limb lameness (10)
generalised osteoarthritis
panosteitis
septic arthritis
lyme disease
endocarditis and associated polyarthritis
pulmonary osteopathy
metaphyseal osteopathy
rickets
nutritional hyperparathyroidism
immune mediated arthritis
What is the most common cause of multiple limb lameness
immune mediated arthritis
what causes of multiple limb lameness are young dogs/ cats most likely to have
young dogs are more prone to vaccine associated polyarthritis, panosteitis and viral causes such as calici virus infection in the cat
which limbs should you radiograph in cases of multi limb lameness
radiograph all the joints showing clinical signs and others
Which joints is arthrocentesis generally performed on
carpus
elbow
tarsus
stifle
what would you expect to see on cytology of synovial fluid in immune mediated diseases
increased white cells, predominantly neutrophils
what are active foamy macrophages in synovial fluid in multi limb lameness case suggest
consistent with degerneative joint disease
List the 2 erosive forms of immune mediated polyarthritis
rheumatoid arthritis
chronic feline erosive progressive polyarthritis
when there is a multi limb lameness with pyrexia what should be considered
immune mediated polyarthritis if no obvious cause is identified
Describe type 1 immune mediate non-erosive polyarthritis
no underlying disease detected (idiopathic-the most common form)
Describe type 2 immune mediate non-erosive polyarthritis
- associated with infection elsewhere e.g. respiratory or urinary tract infection. May spontaneously resolve with treatment of the underlying condition or require immunosuppression
Descrribe type 3 immune mediate non-erosive polyarthritis
associated with GI disease
Describe type 4 immune mediated non-erosive polyarthiris
associated with neoplasia
Describe Shar Pei fever
common and characteristic of the breed
juvenile onset
pyrexia
Swollen hock joint although swelling is primarily periarticular
What occurs in rheumatoid arthritis
Loss of articular surfaces and collapse of joint space and subluxation of the joints
it is severe and debilitating
Describe how to diagnose rheumatoid arthritis
Synovial biopsies show typical changes
Several diagnostic criteria need to be satisfied to make this diagnosis
Describe the porgnosis of rheumatoid arthritis
poor and euthanasia is often required but is better in the cat
Describe treatment for erosive polyarthritis
very few work- euthanasia is often recommended
Describe erosive feline chronic progressive polyarthritis
A rare condition most common in the young male
A destructive polyarthritis.
Will see marked proliferative reaction around the joints
aggressive and debilitating condition
Responds poorly to treatment
What do you see with polyarthritis due to endocarditis
Intermittent pyrexia, lethargy and weight loss associated with several bacterial isolates
Rapidly developing cardiac murmur often diastolic
Describe how to diagnose polyarthritis due to endocarditis
echocardiography and blood culture ( at least 3 samples taken at periods of pyrexia)
Describe how to treat endocarditis (polyarthritis)
long courses of ABs due to culture and anti-thrombotics
Describe how to treat immune-mediated multi limb lameness
treatment of the underlying cause in Types II, III and IV may result in the resolution of the signs but often immunosuppression is required (generally prednisolone)
Describe the clinical signs seen with myopathies
short strides (signs seen in polyartitis)
muscle atrophy
pyrexia in inflammatory myopathies
pain in the temporal muscles
reduced muscle tone and local reflexes
List 3 inflammmatory myopathies
Masticatory muscle myositis (MMM)
Immune mediated disease
protozoal infections
List 4 non-inflammatory groups of myopathies
genetic disorders
corticosteroid induced
endocrine associated
metabolic abnormalities
Describe how to diagnose myopathies
clinical exam
muscle biopsy- most important diagnostic step
Which muscles do you take muscle biopsies from
quadriceps
biceps femoris
triceps
collect them along the length of the fibres
Describe how to treat inflammatory myopathies
Antibiotics for protozoal infections e.g. clindamycin
Immunosuppressive doses of corticosteroids if autoimmune disease suspected
Describe how to treat non-infalmmatory myopathies (Breed associated genetic myopathies )
diagnose with muscle biopsy
no treatment
Describe how to treat non-infalmmatory myopathies (metabolic conditions(
dietary modifications may help these conditions
Describe how to treat non-infalmmatory myopathies (endocrine associated myopathies)
treat the underlying condition
Describe myotonias
increased tone and poor relaxation after muscle stimulation
Persistent dimpling after percussion with a hammer
Chow chows and miniature schnauzers
Describe how to treat myotonias
procainamide mixelitine and phenytoin
is primary or secondary osteoarthritis more common
secondary
does septic arthritis occur in older or younger animals
in younger dogs it occurs more in multiple joints
in older dogs it occurs more in a single joint
what pathogen causes Lyme disease
Borrelia burgdorferi
what is pulmonary osteopathy
paraneoplastic syndrome with proliferative new bone on the limbs - aetiology unclear
How long can it take for Borelia infection to become apparent
2-5 months
