Recommendations for rheumatoid/polyarthritis case

[Guest guest]

Greetings all --

Cue Ball is an approximately 4 year old female spayed chihuahua.

Here is her gait video on YouTube:

I will try to post the radiographs as well.

Client rescued her 1 year ago off the streets. Spayed her. Says her gait was

essentially normal when he rescued her. A few months prior to presentation, she

had an episode of pain that they could not localize. After the pain subsided,

she started to show abnormalities in the carpi, metacarpi and digits, and it was

not long before she looked as she currently does.

On examination, she has mild to moderate crepitus in the front limb digits,

metacarpal and carpal joints. Her left carpus is medially displaced and the

right is laterally displaced. It appears that there is no liagmentous support

from the distal radii to the digits. She essentially walks on her distal radii.

Her rear limb digits are starting to splay, and have mild crepitus. The tarsi

both are lax, especially medial/lateral.

Amazingly, she allowed full examination and did not seem painful (protested the

most when I tried to lift her gums and look at her teeth!). Most chihuahuas I

handle tend to scream at the slightest perceived infraction, and the client

reported that when she was painful, she was difficult to handle.

Surgery and radiology depts said that this is rheumatoid/erosive poly-arthritis.

I agree from what I know about the disease (which is n=2 now).

Their recommendations were to see rehab (me) for recommendations, otherwise do

nothing until she has another flare up, and start immunosuppressive drugs at

that time.

Any ideas/input? Custom orthotics? Fore-limb/quad cart? Any supplements?

I advised to consider a stroller or doggie carrier, since she likes to go out,

but to minimize walking as much as possible. Is that the right advice?

Ok - I am going to attempt to post her radiographs after I post this message

(last time I did this I lost the message...argh)

Bridget