Nonerosive immune-mediated polyarthritis is an immune-mediated inflammatory disease of the diarthroidal joints (movable joints: shoulder, knee, etc.), which occurs in multiple joints, and in which the cartilage of the joint (articular cartilage) is not eroded away. A type III hypersensitivity reaction, which causes antibodies to be bound to an antigen, in this case joint tissue, causes this condition.
These antibody-antigen complexes are called immune complexes, and they are deposited within the synovial membrane (where the fluid that lubricates the joints is held). There, the immune complexes trigger an abnormal immune response to the joint cartilage. What this means is that, in effect, the body is fighting against itself. This leads to an inflammatory response, and complement protein activation by the tissue surrounding the cartilage, in response to the immunity displaying cells, leading to the clinical signs of arthritis.
You will need to give your veterinarian a thorough history of your dog's health leading up to the onset of symptoms. Your veterinarian will perform a thorough physical exam on your dog, taking note of signs of pain, decreased range of motion, and any lameness. A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, a urinalysis, and an electrolyte panel. In dogs suspected to have lupus erythematosus, a lupus erythematosus preparation or an antinuclear antibody test can be performed. Joint fluid aspirate will be taken for lab analysis, and submitted for bacterial culture and sensitivity. A biopsy (tissue sample) of synovial tissue will also help to make a definitive diagnosis.
X-ray images can also be used as a diagnostic tool. If a nonerosive, immune-mediated polyarthritis condition is present, it will be visible on the radiograph image.
Physical therapy, including range-of-motion exercises, massage and swimming can help treat severe disease. For dogs that have a lot of difficulty walking, bandages and/or splints may be put around the joint to prevent it from further degrading. Weight loss will also help to decrease pressure on the joints if your dog is overweight. If your dog is on antibiotics your veterinarian will attempt to rule out a reaction to the antibiotics.
Surgery is only recommended to remove infection if your dog has a concurrent infection when diagnosed with the nonerosive polyarthritis.
Your veterinarian will schedule frequent follow-up appointments with your dog, but if its condition worsens, contact your veterinarian immediately. Remission is usually achieved in 2-16 weeks, but the recurrence rate jumps to 30-50 percent when therapy is discontinued.
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