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In this episode, host Alyssa Watson, DVM, welcomes back John M. Thomason, DVM, MS, DACVIM (SAIM), to talk about his recent Clinician’s Brief article, “Top 4 Primary Immune-Mediated Disorders in Dogs.” In part 2 of this 2-part conversation, Dr. Thomason focuses on immune-mediated polyarthritis (IMPA) and pemphigus foliaceus. He covers some diverse presentations for IMPA and makes joint taps sound highly doable. You’ll also be reminded about those fabled “fried egg cells.”
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Key Takeaways
Immune-mediated polyarthritis (IMPA) classically causes joint effusion and marked lameness, but it also causes fever of unknown origin and, in some dogs, may not cause lameness at all.
Joint taps are the way to definitively diagnose IMPA and are highly doable, with the carpi, stifles, and tarsi being the most amenable to sampling.
Pemphigus foliaceus is an autoimmune skin disease that involves the breakdown of connections between skin cells (desmosomes); the disconnected skin cells take on a big, round appearance and are known as acantholytic keratinocytes, “fried egg cells.”
Start treating the pyoderma (almost always present, too) before moving forward with skin biopsy, if you can, because bacterial skin infection (along with dermatophytosis and demodicosis) can also cause acantholysis.
Steroids remain the mainstay and initial therapy for IMPA and pemphigus foliaceus, with drugs like mycophenolate, modified cyclosporine, and azathioprine as steroid-sparing agents.
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The Team:
Alyssa Watson, DVM - Host
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