Polyarthritis - Green

Question 1

What are the 3 classifications of Polyarthritis?

Answer 1

• Infectious
• Non-erosive Immune mediated
• Erosive Immune mediated

Question 2

What is the most common type of polyarthritis in dogs & cats?

Answer 2

Inflammatory

(Non-erosive)

Question 3

What is often the cause of Infectious Polyarthritis?

Answer 3

Bacterial

Question 4

Which form of septic arthritis is more common?

Answer 4

Direct inoculation of joint

via bite, puncture wound, trauma or SX

Question 5

C/S of Septic Arthritis?

Answer 5

• Systemically ill ⇒ febrile, depressed
• Painful joint(s)
• Swollen joint(s)
• Large, proximal joints (hematogenous)

Question 6

What should “normal” joint fluid look like?

What should the normal nucleated cell count be?

Will neutrophils dominante?

Answer 6

• Clear to straw yellow & “sticky”
• < 3,000 nucleated cells
• < 10% neutrophils present

Question 7

What tissues should you culture if you suspect septic arthritis?

Answer 7

• Synovial fluid
• Blood
• Urine

Question 8

What should you do if you suspect hematogenous infection?

Answer 8

• Search for the septic site!
  
  • Thoracic & Abdominal Rads
  • Abdominal U/S
  • Spinal radiographs
  • ECG
• Culture!

Question 9

How do you TX Septic Arthritis?

Answer 9

• Long term Abs. (4-6 wks) based on culture
  
  • Broad spectrum, Beta-lactamase resistent
    
    • Cephalexin
    • Clavamox
  • Gram (-) ⇒ Fluoroquinolones
  • Anaerobic bacT ⇒ Metronidazole

Question 10

What is a common side effect of septic arthritis?

Answer 10

Secondary DJD

Question 11

How common is Immune Mediated Erosive Polyarthritis?

Answer 11

VERY RARE

< 1% of polyarthritis cases

Question 12

What is the most common form of Immune Mediated Polyarthritis in the DOG?

Answer 12

Non-erosive Idiopathic Polyarthritis

Question 13

Be weary of _____ drugs in Dobies, as it can cause non erosive IMPA.

Answer 13

Sulfa drugs

(SMZ-TMP)

Question 14

What other drugs can cause Non-erosive IMPA?

Answer 14

• Phenobarbital
• Penicillin
• Cephalexin
• Vaccines

Question 15

How can you DX Systemic Lupus Erythematosus (SLE)?

Answer 15

Can say has SLE if:

• 2 major signs + Antinuclear AB titer (ANA)
• 1 major sign + 2 minor signs + ANA

(NB: Requires a complete DX workup)

Question 16

List the Major signs of SLE.

Answer 16

• Polyarthritis
• Dermatologic lesions
• Glomerular nephritis
• Polymyositis
• Hemolytic anemia
• ITP
• Immue mediated leukopenia

Question 17

List the Minor signs of SLE.

Answer 17

• Fever
• CNS signs
• Oral ulceration
• Lymphadenopathy
• Pericarditis
• Pleuritis

Question 18

Which animals typically get Idiopathic IMPA-Type I?

Answer 18

• Sporting & large breed dogs
  
  • Rare in cats
• 2.5 - 4.5 years old common
  
  • (can be any age)

Question 19

C/S of IMPA?

Answer 19

• Cyclic fevers
• Stiffness
• Lameness (walks on eggshells)
• Multiple joints involved
• Palpable joint effusion
• Cervical, vertebral pain
• Hyperglobulinemia
• Hypoalbuminemia

Question 20

Which joints are most commonly affected by IMPA?

Answer 20

Small, distal joints

Question 21

TX for IMPA?

Answer 21

1. Prednisone
2. Azathioprine
3. Cyclosporine