• 1. Dunn KJ, Dunn JK. Diagnostic investigations in 101 dogs with pyrexia of unknown origin. J Small Anim Pract 1998; 39: 574580.

  • 2. Rondeau MP, Walton RM, Bissett S, et al. Suppurative, nonseptic polyarthropathy in dogs. J Vet Intern Med 2005; 19: 654662.

  • 3. Goldstein RE. Swollen joints and lameness. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 7th ed. St Louis: Saunders Elsevier, 2010;130133.

    • Search Google Scholar
    • Export Citation
  • 4. Bennett D. Treatment of the immune-based inflammatory arthropathies of the dog and cat. In: Bonagura JD, ed. Kirk's current veterinary therapy XII. Philadelphia: WB Saunders Co, 1995;11881195.

    • Search Google Scholar
    • Export Citation
  • 5. Giger U, Werner LL, Millichamp NJ, et al. Sulfadiazine-induced allergy in six Doberman Pinschers. J Am Vet Med Assoc 1985; 186: 479484.

    • Search Google Scholar
    • Export Citation
  • 6. Bennett D. Immune-mediated and infective arthritis. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 7th ed. St Louis: Saunders Elsevier, 2010;743749.

    • Search Google Scholar
    • Export Citation
  • 7. Appel MJ, Allan S, Jacobson RH, et al. Experimental Lyme disease in dogs produces arthritis and persistent infection. J Infect Dis 1993; 167: 651664.

    • Search Google Scholar
    • Export Citation
  • 8. Kornblatt AN, Urband PH, Steere AC. Arthritis caused by Borrelia burgdorferi in dogs. J Am Vet Med Assoc 1985; 186: 960964.

  • 9. Foley J, Drazenovich N, Leutenegger CM, et al. Association between polyarthritis and thrombocytopenia and increased prevalence of vectorborne pathogens in Californian dogs. Vet Rec 2007; 160: 159162.

    • Search Google Scholar
    • Export Citation
  • 10. Goodman RA, Hawkins EC, Olby NJ, et al. Molecular identification of Ehrlichia ewingii infection in dogs: 15 cases (1997–2001). J Am Vet Med Assoc 2003; 222: 11021107.

    • Search Google Scholar
    • Export Citation
  • 11. Santos M, Marcos R, Assuncao M, et al. Polyarthritis associated with visceral leishmaniasis in a juvenile dog. Vet Parasitol 2006; 141: 340344.

    • Search Google Scholar
    • Export Citation
  • 12. Goodman RA, Breitschwerdt EB. Clinicopathologic findings in dogs seroreactive to Bartonella henselae antigens. Am J Vet Res 2005; 66: 20602064.

    • Search Google Scholar
    • Export Citation
  • 13. Henn JB, Liu CH, Kasten RW, et al. Seroprevalence of antibodies against Bartonella species and evaluation of risk factors and clinical signs associated with seropositivity in dogs. Am J Vet Res 2005; 66: 688694.

    • Search Google Scholar
    • Export Citation
  • 14. Sykes JE, Kittleson MD, Pesavento PA, et al. Evaluation of the relationship between causative organisms and clinical characteristics of infective endocarditis in dogs: 71 cases (1992–2005). J Am Vet Med Assoc 2006; 228: 17231734.

    • Search Google Scholar
    • Export Citation
  • 15. Clements DN, Gear RN, Tattersall J, et al. Type I immune-mediated polyarthritis in dogs: 39 cases (1997–2002). J Am Vet Med Assoc 2004; 224: 13231327.

    • Search Google Scholar
    • Export Citation
  • 16. Colopy SA, Baker TA, Muir P. Efficacy of leflunomide for treatment of immune-mediated polyarthritis in dogs: 14 cases (2006–2008). J Am Vet Med Assoc 2010; 236: 312318.

    • Search Google Scholar
    • Export Citation
  • 17. Johnson KC, Mackin A. Canine immune-mediated polyarthritis: part 2: diagnosis and treatment. J Am Anim Hosp Assoc 2012; 48: 7182.

    • Search Google Scholar
    • Export Citation
  • 18. Miller E. Immunosuppressive therapy in the treatment of immune-mediated disease. J Vet Intern Med 1992; 6: 206213.

  • 19. Johnson KC, Mackin A. Canine immune-mediated polyarthritis: part 1: pathophysiology. J Am Anim Hosp Assoc 2012; 48: 1217.

  • 20. Cohn LA. Glucocorticoid therapy. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 7th ed. St Louis: Saunders Elsevier, 2010;602608.

    • Search Google Scholar
    • Export Citation
  • 21. Archer TM, Boothe DM, Langston VC, et al. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med 2014; 28: 120.

    • Search Google Scholar
    • Export Citation
  • 22. Palmeiro BS. Cyclosporine in veterinary dermatology. Vet Clin North Am Small Anim Pract 2013; 43: 153171.

  • 23. Berg RI, Sykes JE, Kass PH, et al. Effect of repeated arthrocentesis on cytologic analysis of synovial fluid in dogs. J Vet Intern Med 2009; 23: 814817.

    • Search Google Scholar
    • Export Citation
  • 24. Singer LM, Cohn LA, Reinero CR, et al. Leflunomide pharmacokinetics after single oral administration to dogs. J Vet Pharmacol Ther 2011; 34: 609611.

    • Search Google Scholar
    • Export Citation
  • 25. Brown DC, Boston RC, Coyne JC, et al. Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res 2007; 68: 631637.

    • Search Google Scholar
    • Export Citation
  • 26. Brown DC, Boston RC, Coyne JC, et al. Ability of the canine brief pain inventory to detect response to treatment in dogs with osteoarthritis. J Am Vet Med Assoc 2008; 233: 12781283.

    • Search Google Scholar
    • Export Citation
  • 27. Foster JD, Sample S, Kohler R, et al. Serum biomarkers of clinical and cytologic response in dogs with idiopathic immune-mediated polyarthropathy. J Vet Intern Med 2014; 28: 905911.

    • Search Google Scholar
    • Export Citation
  • 28. Viviano KR. Update on immununosuppressive therapies for dogs and cats. Vet Clin North Am Small Anim Pract 2013; 43: 11491170.

Comparison of the efficacy of prednisone and cyclosporine for treatment of dogs with primary immune-mediated polyarthritis

Amy C. Rhoades DVM1, William Vernau BVMS, DVSC, PhD2, Philip H. Kass DVM, MPVM, PhD3, Melissa A. Herrera DVM4, and Jane E. Sykes BVSC, PhD5
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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 4 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 5 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

OBJECTIVE To compare efficacy between cyclosporine and prednisone for treatment of primary immune-mediated polyarthritis (IMPA) in dogs.

DESIGN Randomized controlled clinical trial.

ANIMALS 20 client-owned dogs with primary IMPA.

PROCEDURES Dogs were randomly assigned to receive prednisone (starting at 1 mg/kg [0.45 mg/lb], PO, q 12 h; n = 10) or cyclosporine (5 mg/kg [2.3 mg/lb], PO, q 12 h; 10) for 90 days. Cyclosporine-treated dogs also received carprofen, tramadol, or both for the first 7 days for analgesia. Data collection, physical examination, and cytologic analysis of synovial fluid samples were performed on days 0, 14, 45, and 90. Trough whole blood cyclosporine concentrations were determined on days 7 to 17 for cyclosporine-treated dogs. Treatment failure was defined as lack of clinical improvement by day 14, lack of cytologic improvement by day 45, or need to change treatment because of adverse effects.

RESULTS Treatment was successful for 7 prednisone-treated dogs and 7 cyclosporine-treated dogs. Absence of synovial fluid cytologic abnormalities on day 45 was identified for 5 prednisone-treated dogs and 8 cyclosporine-treated dogs. Prednisone-treated dogs were more likely to develop polyuria, polydipsia, and polyphagia than were cyclosporine-treated dogs. Opportunistic infections (ie, demodicosis or Erysipelothrix bacteremia) were identified in 2 cyclosporine-treated dogs and 0 prednisone-treated dogs, and diarrhea developed in 1 cyclosporine-treated dog, requiring treatment discontinuation.

CONCLUSIONS AND CLINICAL RELEVANCE Although the number of dogs evaluated was small, limiting generalizability, results of this study suggested that cyclosporine offers promise as a suitable alternative to prednisone for treatment of IMPA in dogs.

Abstract

OBJECTIVE To compare efficacy between cyclosporine and prednisone for treatment of primary immune-mediated polyarthritis (IMPA) in dogs.

DESIGN Randomized controlled clinical trial.

ANIMALS 20 client-owned dogs with primary IMPA.

PROCEDURES Dogs were randomly assigned to receive prednisone (starting at 1 mg/kg [0.45 mg/lb], PO, q 12 h; n = 10) or cyclosporine (5 mg/kg [2.3 mg/lb], PO, q 12 h; 10) for 90 days. Cyclosporine-treated dogs also received carprofen, tramadol, or both for the first 7 days for analgesia. Data collection, physical examination, and cytologic analysis of synovial fluid samples were performed on days 0, 14, 45, and 90. Trough whole blood cyclosporine concentrations were determined on days 7 to 17 for cyclosporine-treated dogs. Treatment failure was defined as lack of clinical improvement by day 14, lack of cytologic improvement by day 45, or need to change treatment because of adverse effects.

RESULTS Treatment was successful for 7 prednisone-treated dogs and 7 cyclosporine-treated dogs. Absence of synovial fluid cytologic abnormalities on day 45 was identified for 5 prednisone-treated dogs and 8 cyclosporine-treated dogs. Prednisone-treated dogs were more likely to develop polyuria, polydipsia, and polyphagia than were cyclosporine-treated dogs. Opportunistic infections (ie, demodicosis or Erysipelothrix bacteremia) were identified in 2 cyclosporine-treated dogs and 0 prednisone-treated dogs, and diarrhea developed in 1 cyclosporine-treated dog, requiring treatment discontinuation.

CONCLUSIONS AND CLINICAL RELEVANCE Although the number of dogs evaluated was small, limiting generalizability, results of this study suggested that cyclosporine offers promise as a suitable alternative to prednisone for treatment of IMPA in dogs.

Contributor Notes

Drs. Rhoades and Herrera's present address is Veterinary Medical and Surgical Group, 2199 Sperry Ave, Ventura, CA 93003.

Address correspondence to Dr. Sykes (jesykes@ucdavis.edu).