young dog with suspected polyarthropathy

[rita]

I was hoping to get an opinion on a dog that I have yet to examine. Buck is a 13 month old Shep X who has been "lame" since the fall of 2020. He is reportedly a bit worse at this time. Colleagues have tried to examine him and he is hesitant at best. He can be aggressive and is very tense when touched. This is the reason that I would like to get my feet on the ground before seeing him. I am considering a CHILL protocol so that I can touch him but that will lessen any response from him.

Given the lack of opportunity for a proper physical exam, he was sedated, palpated, radiographed and, in a separate visit, had joint taps done. He was 4Dx neg on July 22nd of this year. They tell me that he did not have a cranial drawer or tibial thrust (which I acknowledge is not foolproof), no appreciable laxities or effusions. He was put on a trial of meloxicam with no response.

The Interpretation and Comments from his joint taps (from the R and L elbow, R and L stifle, L carpus) came back as follows:
" Overall there is increased cellularity with an increase in synovial cells and synovial cell hyperplasia indicating chronic degenerative arthropathy. Did the dog have prior infectious disease, viral diseases or nutritional deficiencies as a puppy? Congenital and poor joint conformations may also play a role in joint abnormalities." (the other joints came back as non-diagnostic)

A radiologist was suspicious of bilateral stifle effusion. When I watch him walk, he doesn't strike me as a dog with cruciate disease, nor the way he gets up after resting.

I am having difficulties uploading 2 videos, one after rest and the other once he has been up and moving. I will try to forward them in a separate email. In the videos, he seems to be hesitant in his front end as well as his obvious hind end lameness when first rising from rest. Given his signalment, I am concerned about some form of polyarthropathy but not sure where to go from here in terms of further diagnostics or appropriate therapeutics. Any opinions or advice would be welcomed.

[lehughes]

Firstly, I'm uploading the links to the videos that Rita shared with me via email:

https://youtu.be/8QpI9D5CfQc

https://youtu.be/tLqtTMcPf_4

PS (right click on the links and select open in a new window - OR cut and paste them into a new window)

[lehughes]

Hey Rita,

Okay, so I am not great at reading x-rays, but nothing jumps out at me with these... at least not in the stifles, hips, tarsi. The SIJ's look odd to me - so I'dd check those.

Now the gait at the beach doesn't look very problematic to me. I would agree - doesn't look cruciate-ish.

How he looks getting up is the more interesting video. My first thought was back... maybe lumbosacral, but then he does a little stretch into extension - which is not lumbosacral. Could be SIJ... if I'm still on track with 'back pain' thinking.

However, the joint pain / polyarthropathy suspicion is high on the list of potential diagnoses as well... however, I would think you / someone should be able to appreciate some joint swelling (at least in previous dogs I've seen with such diagnoses, you could pick up some joint swelling.)

In my mind, you go through your eval as best you can (I'd want to get my hands on the SIJ and Lumbar spine), PLUS have a discussion about diet and supplements with a thought process on reducing inflammation via dietary means.

That's off the top of my head anyways!

Best of luck with this case!

Cheers,

Laurie