Murphy• “Murphy” is a male Labrador Retriever, DOB March 3,

2005• Referred from community veterinarian to your E.R. for

evaluation of “failure to rise.”

• History• Previously healthy working dog, with recent travel to B.C.

and Saskatchewan. Drank stagnant water yesterday, OK last night. This morning Murphy had trouble rising and walking in the back legs. With support of client, he could bear weight on left hindlimb, not on right side.

• What else might you ask the client?• What organ systems do you think are involved?

• Physical Exam• BW = 37.0 kg• T=38.4C• P=140/min• R=panting• Capillary refill test (CRT) ~1 sec• Mucous membranes: pink and moist• Eyes: normal• Ears: normal• Heart & lungs: normal auscultation• Abdomen: soft, non-painful• Neck and back: no pain• Cranial nerves: WNL• Oral exam: WNL• Basewide (sawhorse) stance and goose-stepping (exaggerated

hypermetria)• Hopping response slightly decreased• Knuckling WNL• Withdrawal WNL• Vocalization with manipulation, particularly hyperflexion of

carpi, and flexion-extension of stifles and hocks.• Mild effusion of carpi and tarsi noted, no appreciable effusion of

stifles.

• Your Assessment• What do you need to know about the MSK system to

improve your diagnostic investigation?

• Recommendations/Options Offered to Client• What tests might you recommend?• What do you need to know before you predict the

natural history of this patient’s problem?

• Dx tests–follow-up• X-ray• Cytology• Microbiology

Synovial Fluid Cytology

Provisional Diagnosis

• Acute Polyarthritis• Rx: Meloxicam

• Antibiotics or Corticosteroids based on Culture & Sensitivity

Two weeks after Prednisone begunTwo weeks after Prednisone begunVery few cells seen in joint fluidVery few cells seen in joint fluid