Rheumatoid arthritis

From Dog
Jump to: navigation, search
Rheumatoid arthritis in the forelimb of a dog[1]

Rheumatoid arthritis is an uncommon immune-mediated disease of dogs characterized by progressive arthritis.

Causes include:

- predisposition in the Nova Scotia Duck Tolling Retriever with SLE-related disease complex including immune-mediated rheumatic disease and steroid-responsive meningitis-arteritis[3]
- Canine distemper[4]

This condition mainly occurs in small and toy breed dogs of any age, with the most common occurrence being 2 to 6 years of age. Rheumatoid arthritis is a chronic problem that can result in joint deformity[5].

It has been speculated that in immune-mediated disease, type II collagen serves as an autoantigen and that some type of altered host immunoglobulin (IgG) is the inciting antigen that stimulates the immune response[6][7].

Clinically affected dogs often present with shifting lameness and joint pain on manipulation. Affected joints may be swollen. Anorexia, depression and fever may also be evident. Splenomegaly and muscle wasting also have been reported.

A presumptive diagnosis can be established on presenting clinical signs and supportive radiographic and CT imaging studies.

Blood tests may reveal leukocytosis, neutrophilia and/or hyperfibrinogenemia.

Synovial fluid analysis may show increased protein concentration and the presence of nucleated cells. Biochemical analysis usually reveals marked increases in inflammatory cytokines[8] and metalloproteinases[9].

A differential diagnosis would include juvenile polyarthritis[10], nutritional secondary hyperparathyroidism (usually young dogs), hypertrophic osteodystrophy and rickets.

Treatment can involve immunosuppressive drugs, gold salts, and/or nonsteroidal anti-inflammatory drugs. Aspirin has been used for palliative treatment.

Immunosuppressive treatment usually involves the administration of prednisolone and/or azathioprine or cyclophosphamide.

References

  1. University of Pennysylvania
  2. Ollier WE et al (2001) Dog MHC alleles containing the human RA shared epitope confer susceptibility to canine rheumatoid arthritis. Immunogenetics 53(8):669-673
  3. Wilbe M et al (2009) MHC class II polymorphism is associated with a canine SLE-related disease complex. Immunogenetics 61(8):557-564
  4. Tizard, IR (2004) Veterinary Immunology, An Introduction, 7th ed. Philadelphia, W. B. Saunders Co., pp:405-408
  5. Ettinger SJ, Feldman EC (2000) Textbook of Veterinary Internal Medicine, Diseases of the Dog and Cat, 5th ed. Philadelphia, W.B. Saunders Co., pp:78, 1879-1880, 1885
  6. Nelson RW, Couto CG (1998) Small Animal Internal Medicine, 2nd ed. St. Louis, Mosby, Inc., pp:1085-1087
  7. Khatlani TS et al (2013) Autoantibodies against T-Cell costimulatory molecules are produced in canine autoimmune diseases. J Immunother 26(1):12-20
  8. Carter SD et al (1999) Canine rheumatoid arthritis and inflammatory cytokines. Vet Immunol Immunopathol 69(2-4):201-214
  9. Hegemann N et al (2003) Synovial MMP-3 and TIMP-1 levels and their correlation with cytokine expression in canine rheumatoid arthritis. Vet Immunol Immunopathol 91(3-4):199-204
  10. Peace TA et al (2001) What's your diagnosis? Fever and leukocytosis in a young beagle. Canine juvenile polyarteritis syndrome (beagle pain syndrome). Lab Anim (NY) 30(5):23-26