Diagnostic tests performed and prescribed prednisolone dose for a dog with immune-mediated polyarthritis vary across veterinary specialties.

Abstract

Objective To compare the investigation, management, and outcome, including medication adverse effects, of nonassociative immune-mediated polyarthritis cases when referred to different specialist disciplines. Methods A retrospective observational review of medical records from 4 United Kingdom referral centers (2018 through 2022) was conducted. Dogs were included if they had nondegenerative neutrophilic inflammation in synovial fluid from > 2 joints and associated disease was not evident. Data on clinical signs, diagnostic tests, treatment, and adverse effects were collected. Remission at 12 months and relapse were recorded. Results 83 dogs met the inclusion data. Cases referred to internal medicine underwent more diagnostic procedures, received lower initial prednisolone doses, and were more commonly prescribed adjunctive immunosuppressives compared to neurology (effect size, 0.35; 95% CI, 0.1 to 0.57:OR, 4.7; 95% CI, 0.6 to 216) and orthopedics (effect size, 0.26; 95% CI, 0.02 to 0.53:OR, 4.0; 95% CI, 0.5 to 185). There was no significant difference in the frequency of adverse effects with prednisolone dose, referral service, or adjunct immunosuppressant use. Remission at 12 months was not significantly associated with referral service, corticosteroid dose, or adjunctive immunosuppressant use. Conclusions The management of nonassociative immune-mediated polyarthritis varies significantly across specialist disciplines. Despite differences in treatment strategies, adverse effects were common and not significantly associated with corticosteroid dose or adjunct use. Clinical Relevance Further controlled prospective studies should focus on optimizing treatment protocols to improve outcomes and minimize complications in this challenging disease.