Arthritis: borrelial

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr John Innes BVSc PhD CertVR DSAS(orth) MRCVS
Dr Kyle Braund BVSc MVSc PhD FRCVS DipACVIM
Synonyms Lyme disease

Introduction

  • Cause : a multisystemic inflammatory disease associated with infection by the tick-borne spirochaete Borrelia burgdorferi Borrelia burgdorferi , primarily transmitted by ticks of the Ixodes genus.
  • Mono-articular or pauco-articular inflammatory arthritis, seen in Lyme disease, occurring weeks or months after exposure to ticks (see Borreliosis Borreliosis ).
  • Immune mediated joint disease (Type 2 idiopathic polyarthritis).
  • Signs : may be concurrent systemic illness, acute lameness.
  • Diagnosis : serology, synovial fluid examination, cytopathology.
  • Treatment : doxycycline Doxycycline , amoxicillin Amoxicillin.
  • Prognosis : good in most cases.
  • Seasonal incidence consistent with seasonal changes in tick activity.

Diagnosis

Clinical signs

  • Pyrexia.
  • Lymphadenopathy.
  • Inflammatory arthropathy.
  • Musculoskeletal pain.
  • Cardiac arrhythmia (heart block due to myocarditis).
  • Renal failure/glomerulonephritis Glomerulonephritis.
  • Neurological signs (aggression, seizures).

Diagnosis

Differential diagnosis

  • Causes of pyrexia of unknown origin.
  • Causes of polyarthritis:
    • Immune-mediated arthritides Arthritis: immune-mediated.
    • Canine idiopathic polyarthritides Arthritis: polyarthritis - idiopathic.
    • Degenerative arthropathy.
    • Crystal-induced arthritis.
    • Other infective arthritis, eg bacterial, fungal, viral.

Sequelae

Prognosis

  • Good if prompt antibiotic therapy and for long enough.
  • Recurrent polyarthritis is possible and may require repeated courses of antibiotics and NSAIDs.

Expected response to treatment

  • Rapid response to antibiotics (often within a few days).

Reasons for treatment failure

  • Antibiotics started too late or not continued for long enough.
  • Incorrect diagnosis.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Speck S, Reiner B & Wittenbrink M M (2001) Isolation of Borrelia afzelii from a dog. Vet Rec 149 , 19-20.
  • Harter L et al(1999) Upregulation of inducible nitric oxide synthase mRNA in dogs experimentally infected with Borrelia burgdorferi. Vet Immunol Immunopathol 67 (3), 271-284.
  • Boon G D (1997) Synovial fluid analysis - a guide for general practitioners. Vet Med 92 , 443-451.
  • Magnarelli L A et al(1997) Serologic diagnosis of canine and equine Borreliosis - use of recombinant antigens in enzyme-linked immunosorbent assays. J Clin Microbiol 35 (1), 169-173.
  • May C et al(1990) Lyme disease in the dog. Vet Rec 126 , 293.
  • Roush J K, Manley P A & Dueland R T (1989) Rheumatoid arthritis subsequent to Borrelia Burgdorferi infection in 2 dogs. JAVMA 195 , 951-953.
  • Ellison R S (1988) The cytologic examination of synovial fluid. Semin Vet Surg 3 , 133-139.

Other sources of information

  • Bennett D et al(1992) Lyme disease in animals. Vet Annual, 32.
  • Appel M J G (1990) Lyme disease in dogs and cats. Comp Cont Ed Pract Vet 12 , 617-625.

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