Septic Arthritis?

[SheilaHolder]

Hi, any help and advise will be most greatly appreciated, thank you x

9 year old Beardie male

Past History;
Hip Dysplasia
Immune Mediated Periodontitis - 18 teeth removed
Stomatitis
Sub Mandibular Sialocele (drained whenever having teeth done, became infected last time it was drained 4yrs ago and didn't return)
Perianal Adenoma

Puppy vacs only
No chemicals ever
Raw Fed

Has now developed sudden onset severe swelling and lameness right wrist joint, no trauma, ongoing for 10 days

Started on anti inflammatory (Rimadyl), antibiotics (Noroclav) & paracetamol

Bloods - red blood cells ok, white cell count raised
XRay - shows nothing significant, slight arthritic changes to be expected with age
Joint Fluid - abnormal volume, cloudy with reduced viscosity
Lyme Disease test - Negative
Synovial Fluid show marked neutrophilic inflammation
Still waiting for Synovial Fluid cultures to come back

I asked is this IMPA, vet said no definitely not. He said its Septic Arthritis but not sure where infection coming from. 

2 choices now;
6 week course of antibiotics and test fluid again or

Flush joint now, long course of antibiotics and test fluid again in 6 weeks.

Joint is extremely swollen and painful, it's 4cm bigger than good leg. Vet has recommended Physio to keep joint moving and hot and cold therapy to increase blood flow.

Could infection in joint be coming from oral issues? vet hasn't suggested this, could they be missing something?

Still waiting for synovial cultures.

Sheila
Very worried beardie mum 

[Catherine]

I  do not have any experience of IMPA so hopefully Jo will be along soon with some advice. Other than the swelling and lameness does your Beardie have any other symptoms?What I will say is that vets do not know everything and it has been my experience and that of others that some of them are still in the dark concerning autoimmune diseases in dogs. So it is good that you are querying things.

I am quite surprised to see he is being given paracetomol as I understood it was toxic for dogs. It must be so demoralising to have all this happen with your dog when you have tried to keep things as natural as possible. However you have to remember that medication and operations will involve chemicals. Obviously some medication is needed at times, but it does help to try and reduce the medication given if possible. Some vets seem to prescribe antibiotics and   painkillers as a matter of course when not necessarily needed.

[Jo CIMDA]

Hi Sheila and welcome

I am sorry your beardie has a joint problem.  It sounds particularly painful - poor lad - and on top of having all those teeth removed!   As it is confined to one joint in one leg it is very unlikely, at this stage anyway, to be an immune mediated disease. 

This isn't my area but I wonder if his joint became infected through a bite, say from a horse-fly or mosquito or puncture wound etc? 

  Your vet seems to have done lots of tests to rule out possible causes, which is good.  As you are waiting for the synovial fluid results to come back I presume your vet has put your boy on two different antibiotics. This is usually done when the bacteria hasn't been identified and speculative treatment with two different antibiotics is given in the hope that one of them will be correct. Two different antibiotics will cover most, but not all, bacterium.   When the culture results come back I hope the specific bacteria has been identified and the appropriate antibiotic can be prescribed.

I don't know for sure, but I would have thought oral bacteria is unlikely to travel to a joint, but I could be wrong.  How about putting hot and  cold compress on the joint in the hope that it will reduce the swelling and increase blood flow to the area?  I am sure a cold compress will be fine but check if you can give hot and cold with your vet.

I presume they will want to sedate him to flush the joint so unless you feel you have no choice, I think I would be inclined to just go with the speculative antibiotics for now until you get the results back and the appropriate antibiotic can be given.  Sometimes these nasty  infections need intravenous antibiotics, so this might also be an option.

I do hope you start to see an improvement very soon.

Jo

[SheilaHolder]

Hi Jo, thank you for your reply, it is aprreciated.  He's only on one type of antibiotics and as he is responding I'll be taking the less invasive option of long term antibiotics.  I'm already doing the hot and cold therapy and this seems to be helping, we're just unsure as to where the infection has come from.  Hopefully results from the cultures will tell us. Thank you again, Sheila