Page 1277 - Veterinary Immunology, 10th Edition

38.2. Most signs should have been present for at least 6 weeks. In
VetBooks.ir addition, steps should be taken to exclude SLE (by testing for ANA)

and to exclude an infectious cause for the arthritis. In practice,
cytologic evaluation of synovial fluid with a protein concentration

of >3.0 g/dL and a nucleated cell count of >3,000 cells/mL consisting
of >12% neutrophils identifies an inflammatory arthritis, especially
when supported by radiographic evidence of erosion.

Box 38.2

Diagnostic Criteria for Canine

Rheumatoid Arthritis

• Stiffness or joint pain, especially after periods of inactivity

• Symmetrical joint swelling, especially if multiple joints are
involved

• Sterile synovial fluid containing inflammatory cells, especially

neutrophils

• Positive rheumatoid factor test

• Erosive polyarthritis with characteristic histology

Treatment.

Treatment of canine rheumatoid arthritis tends to be unsatisfactory,
and the long-term prognosis of the disease is poor. Nonsteroidal
antiinflammatory drugs, such as aspirin, carprofen, or etodolac,

have been the first choice in treating early, uncomplicated cases of
rheumatoid arthritis, although their efficacy is unclear.
Corticosteroids such as prednisolone should be reserved for late,
severe cases in which salicylates have proved inadequate. Local

steroid injections into affected joints will produce rapid relief and
clinical remission. However, the joints are still subjected to stress,
disease progression is not slowed, and the corticosteroids delay
healing and promote articular degeneration. Their use may

therefore permit articular damage to proceed unabated. Recently,

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