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Arthritis - the differentials.

Once again, I am using the general term arthritis to cover all the various forms of arthritis. As mentioned last time, I will cover some of the conditions which might lead you to think that your pet has arthritis.

When your vet sees your pet with their condition (any condition) for the first time, they form a list of possibilities, which are narrowed down by discussing the clinical signs with you as the pet owner, and by examining the patient, your pet. This creates a list of differential diagnoses.

Arthritis' most predominant sign is that of lameness. So for any lame pet a vet sees, arthritis is usually in this list of differentials (and with the older patients, usually at the top). Other things they would consider might include:

(a) a sprain or strain

(b) pulled muscle

(c) a spasmed back

(d) a wound (bruising, traumatic, infected)

(e) a pulled or infected nail

(f) tumours of the muscle, joints or bones

(g) a peripheral or central nervous system disorder (and the list becomes really esoteric here)

The diagnosis
This early diagnosis of arthritis might not be100% conclusive so it is likely that further tests might be needed to confirm the diagnosis, and the severity of the condition. The tests outlined below help your vet recommend the most effective course of treatment.

X-rays
X-rays can show up most (but not all) conditions affecting the bony structures of the joints, limbs and spine, and some soft tissue structures as well. I am often asked why vets need to heavily sedate oranaesthetise an animal for this. For the X-ray to provide as much useful information as possible, your pet must be still during the process. Modern anaesthetics are very safe, and most practices now have a nurse monitoring the animal under anaesthetic constantly. Trying to interpret a poor x-ray can sometimes be just as dangerous as guesswork. So if your vet recommends anaesthetising your pet to x-ray him, there are good reasons why this is helpful in confirming a diagnosis.

Blood samples
Blood samples are useful for looking at for instance, increased white blood cell count for supurative arthritis, Rheumatoid factor, and anti nuclear antibody for auto-immune mediated arthritises.

Ultrasound
Ultrasound is of limited use as far as the bodies bony structures go, as ultrasound waves only penetrate the bone very shallowly.

Arthroscopy
Arthroscopy - a tiny camera inserted into the joint - a little more specialised, but becoming more prevalent these days. Can show changes in the cartilage which may not show up in x-rays, because cartilage is not mineralised with calcium.

Contrast radiography
Contrast radiography - a dye opaque to x-rays is injected into the joint, and an x-ray taken. This could show up particle of cartilage broken off from the joint surface- or joint mice as they are otherwise known.

This is not a comprehensive list of diagnostic techniques, but covers most of them currently used in modern veterinary medicine.

Next time, I'll start discussing the treatments currently used in conventional veterinary medicine

Notice:
Chris is not, and does not claim to be, an expert or specialist in the field of arthritis. He is a practising veterinary surgeon with an interest in alternative therapies. These articles are not intended to be definitive discussions on arthritis. While he is pleased to answer any general queries you may have about arthritis and joint diseases, it may be difficult to answer any specific questions about your pet or horse. Remember, the first port of call for assesment and diagnosis of any joint problems should be your own veterinary surgeon.

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