Polyarthritis - Green Flashcards
What are the 3 classifications of Polyarthritis?
- Infectious
- Non-erosive Immune mediated
- Erosive Immune mediated
What is the most common type of polyarthritis in dogs & cats?
Inflammatory
(Non-erosive)
What is often the cause of Infectious Polyarthritis?
Bacterial
Which form of septic arthritis is more common?
Direct inoculation of joint
via bite, puncture wound, trauma or SX
C/S of Septic Arthritis?
- Systemically ill ⇒ febrile, depressed
- Painful joint(s)
- Swollen joint(s)
- Large, proximal joints (hematogenous)
What should “normal” joint fluid look like?
What should the normal nucleated cell count be?
Will neutrophils dominante?
- Clear to straw yellow & “sticky”
- < 3,000 nucleated cells
- < 10% neutrophils present
What tissues should you culture if you suspect septic arthritis?
- Synovial fluid
- Blood
- Urine
What should you do if you suspect hematogenous infection?
-
Search for the septic site!
- Thoracic & Abdominal Rads
- Abdominal U/S
- Spinal radiographs
- ECG
- Culture!
How do you TX Septic Arthritis?
-
Long term Abs. (4-6 wks) based on culture
-
Broad spectrum, Beta-lactamase resistent
- Cephalexin
- Clavamox
- Gram (-) ⇒ Fluoroquinolones
- Anaerobic bacT ⇒ Metronidazole
-
Broad spectrum, Beta-lactamase resistent
What is a common side effect of septic arthritis?
Secondary DJD
How common is Immune Mediated Erosive Polyarthritis?
VERY RARE
< 1% of polyarthritis cases
What is the most common form of Immune Mediated Polyarthritis in the DOG?
Non-erosive Idiopathic Polyarthritis
Be weary of _____ drugs in Dobies, as it can cause non erosive IMPA.
Sulfa drugs
(SMZ-TMP)
What other drugs can cause Non-erosive IMPA?
- Phenobarbital
- Penicillin
- Cephalexin
- Vaccines
How can you DX Systemic Lupus Erythematosus (SLE)?
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)
List the Major signs of SLE.
- Polyarthritis
- Dermatologic lesions
- Glomerular nephritis
- Polymyositis
- Hemolytic anemia
- ITP
- Immue mediated leukopenia
List the Minor signs of SLE.
- Fever
- CNS signs
- Oral ulceration
- Lymphadenopathy
- Pericarditis
- Pleuritis
Which animals typically get Idiopathic IMPA-Type I?
- Sporting & large breed dogs
- Rare in cats
- 2.5 - 4.5 years old common
- (can be any age)
C/S of IMPA?
- Cyclic fevers
- Stiffness
- Lameness (walks on eggshells)
- Multiple joints involved
- Palpable joint effusion
- Cervical, vertebral pain
- Hyperglobulinemia
- Hypoalbuminemia
Which joints are most commonly affected by IMPA?
Small, distal joints
TX for IMPA?
- Prednisone
- Azathioprine
- Cyclosporine
