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Polyarthritis 1441

Polyarthritis
VetBooks.ir Suspect polyarthritis (reluctant to move; “walking on

eggshells” gait, warm, swollen joints, ±fever)

Point-of-care testing for VBD (Lyme disease,
ehrlichiosis, anaplasmosis)

Appropriate treatment (e.g., Yes Are season/geography/signs
10 mg/kg/d doxycycline) suggestive of VBD?
and short course of analgesia
No

Resolution No improvement within 48-72 hours Arthrocentesis

Inflammatory, Inflammatory, septic
nonseptic (degenerate PMN, bacteria) Noninflammatory
VBD, Vector-borne disease; ANA, antinuclear antibody
test; SLE, systemic lupus erythematosus; IMPA,
immune-mediated polyarthritis; TMS, trimethoprim-
sulfa drugs; GI, gastrointestinal; K9, canine Radiograph affected joint Septic joints: Degenerative joint
• Joint culture disease:
• Urine culture • Radiographic
• Blood culture confirmation
Nonerosive Joint erosion • Echocardiogram

CBC, biochemistry, urinalysis, Consider:
retroviral testing (cats) • K9 erosive arthritis
• Feline progressive
polyarthritis
Yes Other evidence of SLE (e.g., • Rheumatoid arthritis
Consider: SLE Perform ANA
anemia, proteinuria)?

No
Consider:
• Idiopathic IMPA
• Reactive IMPA (distant infection/inflammation)
• Enteropathic IMPA (GI or hepatic disease)
• Neoplasia-associated
• Vaccine-associated
• Drug-associated (e.g., TMS, penicillins)
• Breed associated
AUTHOR & EDITOR: Leah A. Cohn, DVM, PhD, DACVIM

Clinical Algorithms

www.ExpertConsult.com