1
|
Spear DJ, Crouse ZJ, Kearns SA. Retrospective evaluation of leflunomide as an adjunctive therapy in dogs with non-associative immune-mediated thrombocytopenia: 20 cases (2008-2021). J Small Anim Pract 2024; 65:261-269. [PMID: 38433454 DOI: 10.1111/jsap.13715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/22/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To describe leflunomide as an adjunctive therapy in the treatment of non-associative immune-mediated thrombocytopenia. MATERIALS AND METHODS A retrospective study of dogs with a diagnosis of non-associative immune-mediated thrombocytopenia treated with leflunomide March 2008 to September 2021 was conducted. Data collected included signalment, clinical signs, physical examination findings and diagnostic testing performed. Medications administered, duration of hospital stay, time to platelet concentration >150×109/L and adverse events during leflunomide therapy were recorded. Relapses within a year of diagnosis were reported. RESULTS A total of 20 client-owned dogs met inclusion criteria. Nineteen of 20 dogs (95%) achieved a platelet concentration >150×109/L with leflunomide and prednisone combination therapy and four dogs (21.1%) relapsed during treatment or shortly after treatment. Adverse effects included diarrhoea (n=5), mild lymphopenia (n=9) and mild intermittent anaemia (n=1). A single dog developed hepatotoxicity presumed to be secondary to leflunomide therapy that resolved after drug discontinuation. One dog was treated for aspiration pneumonia during treatment. Two dogs were euthanased while receiving leflunomide. CLINICAL SIGNIFICANCE Length of hospitalisation, time to platelet recovery, treatment response and relapse rate were comparable with alternative treatment protocols. Most adverse effects did not require leflunomide dose adjustment; however, two dogs died while undergoing leflunomide treatment and there is compelling evidence that one of these dogs experienced fatal infection secondary to immune-suppression. Hepatotoxicity remains a known complication of leflunomide treatment and serial biochemistry testing is recommended.
Collapse
Affiliation(s)
- D J Spear
- Department of Internal Medicine, Massachusetts Veterinary Referral Hospital, Woburn, MA, 01801, USA
- Department of Internal Medicine, Angell Animal Medical Center, Boston, MA, 02130, USA
| | - Z J Crouse
- Department of Internal Medicine, Angell Animal Medical Center, Boston, MA, 02130, USA
| | - S A Kearns
- Department of Internal Medicine, Angell Animal Medical Center, Boston, MA, 02130, USA
| |
Collapse
|
2
|
Klußmann S, Meyer-Lindenberg A, Brühschwein A. Arthrographic description of the canine carpal joint cavities and its recesses. Anat Histol Embryol 2024; 53:e13026. [PMID: 38462761 DOI: 10.1111/ahe.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 03/12/2024]
Abstract
Joint effusion is diagnostically important. The canine carpal joint effusion, which is sometimes difficult to detect clinically, has received less attention in diagnostic ultrasound (US) studies. The aim of the present study was to provide a description of the morphological appearance of the canine carpal joint cavities and recesses using US, radiography, helical computed tomography (CT) and three-dimensional volume rendering technique (3D-VRT) images and to prove the applicability of musculoskeletal US for the detection of artificial carpal joint effusion in dogs. The understanding of the characteristics of these structures in normal patients is essential in the diagnosis. Twenty-eight clinically and radiologically unremarkable canine carpal cadavers of different breeds were examined, representative images were selected and anatomical structures were labelled. The canine carpal joint cavities and in particular its recesses had a complex appearance with a basic structure found in all dogs: Antebrachiocarpal joint: dorsoproximal antebrachiocarpal recess, dorsodistal antebrachiocarpal recess, medial antebrachiocarpal recess, lateral antebrachiocarpal recess and five palmar antebrachiocarpal recesses. Middle carpal joint: two dorsal middle carpal recesses, medial common middle carpal and carpometacarpal recess, lateral common middle carpal and carpometacarpal recess, four palmar middle carpal recesses. The carpometacarpal joint had dorsal and palmar funnel-shaped and irregular, finely tubular extensions, the most prominent ran dorsal to metacarpal III, the maximum distal end represented the proximal metacarpal diaphysis. All recesses presented ultrasonographically as a generalized anechogenic to hypoechoic filled continuation of the articular capsule with an indistinct peripheral hypoechogenic to isoechogenic fine capsule, the synovial-connective tissue interface was difficult to identify. The novel results of this study provide the first morphological description of the ultrasonographic, radiographic and computed tomographic arthrographic appearance of the canine carpal joint cavities and recesses with different injection volumes. The canine carpal joint cavities and in particular its recesses had a complex appearance with a basic structure found in all dogs. The applicability of musculoskeletal US to visualize an artificial carpal effusion has been demonstrated. The results of this study, and in particular US, give the practitioner an advantage in visualizing joint effusion and assist in the decision to perform arthrocentesis.
Collapse
Affiliation(s)
- Sven Klußmann
- Clinic for Small Animal Surgery and Reproduction, LMU Munich, Munich, Germany
- Equine Clinic, LMU Munich, Munich, Germany
| | | | - Andreas Brühschwein
- Clinic for Small Animal Surgery and Reproduction, LMU Munich, Munich, Germany
| |
Collapse
|
3
|
Tang JWY, Saiz A, Vulpe A, Ribas Latre A, Furtado R, Seth M, Valls Sanchez F. Diagnostic Utility of Thoracic Radiography and Abdominal Ultrasonography in Canine Immune-Mediated Polyarthritis: 77 Cases. Animals (Basel) 2024; 14:534. [PMID: 38396501 PMCID: PMC10885912 DOI: 10.3390/ani14040534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Thoracic radiography and abdominal ultrasonography are part of standard diagnostic investigations in cases of canine immune-mediated polyarthritis (IMPA). However, the clinical importance of thoracic and abdominal imaging towards the management of canine IMPA currently remains unknown. The primary aim of this study was to describe the findings documented on thoracic radiography and abdominal ultrasonography in dogs diagnosed with IMPA, and to evaluate the diagnostic utility of thoracic radiography and abdominal ultrasonography in the initial approach and management of these cases. Seventy-seven dogs diagnosed with IMPA who underwent thoracic radiography and abdominal ultrasonography at a single referral hospital between 2008 and 2022 were included. The diagnostic imaging studies of these 77 dogs were reviewed by one blinded board-certified diagnostic imaging specialist for quality assurance. The medical records, including the diagnostic imaging reports of these dogs, were then reviewed by three blinded board-certified internal medicine specialists. Using a modified version of a previous question and scoring system, the three internal medicine specialists then generated an answer for the overall diagnostic utility and a diagnostic utility score for thoracic radiography and abdominal ultrasonography for each case. The abnormal findings identified in radiography and ultrasonography were described. In the cases where the findings were considered significant enough to immediately affect the case management, the results of the further investigations that were subsequently performed were also described. No abnormalities were detected in thoracic radiography for 30 cases, and none were detected in abdominal ultrasound for 6. The majority of the internists considered thoracic radiography to be not useful in the overall case management at the time of IMPA diagnosis in 70 cases, and considered abdominal ultrasonography to be not useful in the overall case management in 57 cases. The majority of the internists agreed on the utility of thoracic radiography in 95% of the cases, and in 61% of the cases for abdominal ultrasonography. The most common finding in the thoracic radiography was a mild bronchial pulmonary pattern, and the most common in the abdominal ultrasonography was mild lymphadenomegaly. Therefore, although thoracic radiography and abdominal ultrasonography identified numerous abnormal findings in this population of dogs, in the majority of the cases, the findings were deemed not useful towards the overall case management at the time of the initial diagnosis of IMPA. Thus, the use of thoracic radiography and abdominal ultrasonography should be taken into careful consideration when considering initial diagnostic investigations for canine IMPA.
Collapse
Affiliation(s)
- Julia W. Y. Tang
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | - Anna Saiz
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | - Alina Vulpe
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | | | - Rita Furtado
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | - Mayank Seth
- KGS Veterinary Services Limited, Saffron Walden, Essex CB11 3GP, UK;
| | | |
Collapse
|
4
|
Ravicini S, Kent A, Dunning M, Baines S, Clarke S, Allerton F. Description and outcome of dogs with primary immune-mediated polyarthritis: 73 cases (2012-2017). J Small Anim Pract 2023; 64:142-148. [PMID: 36321528 DOI: 10.1111/jsap.13565] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/18/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To provide a description of primary idiopathic immune-mediated polyarthritis, including long-term outcome and relapse rates, for dogs starting treatment with corticosteroids alone or corticosteroids with a second immunosuppressant. MATERIALS AND METHODS Medical records were reviewed between January 2012 and December 2017 to identify dogs diagnosed with primary immune-mediated polyarthritis. Data including signalment, clinicopathological findings, type and duration of treatment, relapse and outcome were recorded. RESULTS Seventy-three dogs were included. Fifty-four dogs were started on corticosteroid monotherapy (an additional immunosuppressant was introduced later in 27/54 dogs) and 19 dogs were treated with multi-modal immunosuppression from the outset. Ninety-five percent (69/73) of dogs responded favourably to therapy although death was attributed to immune-mediated polyarthritis in 19% (14/73) of dogs. Relapse of clinical signs was reported in 53% (39/73) dogs (31/39 while on treatment), with multiple relapses observed in 17 dogs. Complete cure (permanent withdrawal of immunosuppressive medication) was achieved in 46 dogs (63%). Overall, 81% of dogs had a well-managed disease for an extended timeframe (≥1131 days). Fourteen of 19 (74%) dogs that started treatment with multi-modal immunosuppression and 32 of 54 (59%) started on corticosteroids alone achieved a complete cure. CLINICAL SIGNIFICANCE This study provides extended follow-up information for a large cohort of dogs with primary immune-mediated polyarthritis. Immunosuppressive therapy was discontinued in the majority of dogs but disease-associated mortality remains high.
Collapse
Affiliation(s)
- S Ravicini
- Washington State University, College of Veterinary Medicine, Pullman, WA, USA
| | - A Kent
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - M Dunning
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK.,School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - S Baines
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - S Clarke
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| |
Collapse
|
5
|
Mechanisms of Systemic Osteoporosis in Rheumatoid Arthritis. Int J Mol Sci 2022; 23:ijms23158740. [PMID: 35955873 PMCID: PMC9368786 DOI: 10.3390/ijms23158740] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
Rheumatoid arthritis (RA), an autoimmune disease, is characterized by the presence of symmetric polyarthritis predominantly of the small joints that leads to severe cartilage and bone destruction. Based on animal and human data, the pathophysiology of osteoporosis, a frequent comorbidity in conjunction with RA, was delineated. Autoimmune inflammatory processes, which lead to a systemic upregulation of inflammatory and osteoclastogenic cytokines, the production of autoantibodies, and Th cell senescence with a presumed disability to control the systemic immune system's and osteoclastogenic status, may play important roles in the pathophysiology of osteoporosis in RA. Consequently, osteoclast activity increases, osteoblast function decreases and bone metabolic and mechanical properties deteriorate. Although a number of disease-modifying drugs to treat joint inflammation are available, data on the ability of these drugs to prevent fragility fractures are limited. Thus, specific treatment of osteoporosis should be considered in patients with RA and an associated increased risk of fragility fractures.
Collapse
|
6
|
Treeful AE, Coffey EL, Friedenberg SG. A scoping review of autoantibodies as biomarkers for canine autoimmune disease. J Vet Intern Med 2022; 36:363-378. [PMID: 35192227 PMCID: PMC8965235 DOI: 10.1111/jvim.16392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/06/2022] [Accepted: 02/09/2022] [Indexed: 11/27/2022] Open
Abstract
Background Autoantibody biomarkers are valuable tools used to diagnose and manage autoimmune diseases in dogs. However, prior publications have raised concerns over a lack of standardization and sufficient validation for the use of biomarkers in veterinary medicine. Objectives Systematically compile primary research on autoantibody biomarkers for autoimmune disease in dogs, summarize their methodological features, and evaluate their quality; synthesize data supporting their use into a resource for veterinarians and researchers. Animals Not used. Methods Five indices were searched to identify studies for evaluation: PubMed, CAB Abstracts, Web of Science, Agricola, and SCOPUS. Two independent reviewers (AET and ELC) screened titles and abstracts for exclusion criteria followed by full‐text review of remaining articles. Relevant studies were classified based on study objectives (biomarker, epitope, technique). Data on study characteristics and outcomes were synthesized in independent data tables for each classification. Results Ninety‐two studies qualified for final analysis (n = 49 biomarker, n = 9 epitope, and n = 34 technique studies). A high degree of heterogeneity in study characteristics and outcomes reporting was observed. Opportunities to strengthen future studies could include: (1) routine use of negative controls, (2) power analyses to inform sample sizes, (3) statistical analyses when appropriate, and (4) multiple detection techniques to confirm results. Conclusions These findings provide a resource that will allow veterinary clinicians to efficiently evaluate the evidence supporting the use of autoantibody biomarkers, along with the varied methodological approaches used in their development.
Collapse
Affiliation(s)
- Amy E Treeful
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Emily L Coffey
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Steven G Friedenberg
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| |
Collapse
|
7
|
Hajizadeh A, Abtahi Froushani SM, Tehrani AA, Azizi S, Bani Hashemi SR. Effects of Naringenin on Experimentally Induced Rheumatoid Arthritis in Wistar Rats. ARCHIVES OF RAZI INSTITUTE 2021; 76:903-912. [PMID: 35096326 DOI: 10.22092/ari.2020.351612.1527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/06/2020] [Indexed: 12/18/2022]
Abstract
Naringenin is one of the most important and abundant known flavonoids found in grapefruit and other citrus fruits. This experimental study aimed to assess the clinical effects and immune responses of naringenin in the animal model of rheumatoid arthritis (RA) according to various reports on its anti-inflammatory effects and modulation of the immune system. To this end, 40 Wistar rats in the weight range of 160-180g were randomly assigned to four groups (n=10) including healthy, control, naringenin, and methotrexate orally treated groups. To induce RA disease, a compound of 200 μl of Freund's adjuvant and collagen type II was injected subcutaneously into the rear footpads of rats. The severity of RA clinical signs was assessed based on a standard scoring method. The treatment lasted for three weeks (days7-28 after induction). The obtained data pointed out that the levels of C-reactive protein (CRP), myeloperoxidase, nitric oxide, IL-17, and IFN-γ cytokines significantly increased in the RA rats, while the level of their serum antioxidants significantly reduced, compared to the healthy rats. The inflammation of the paws and the level of CRP decreased similarly in both methotrexate and naringenin-treated groups. In the naringenin-treated group, a further decrease was detected in serum myeloperoxidase, nitric oxide, and the total antioxidant capacity occurred, as compared to the methotrexate-treated rats. Nonetheless, IL-17 and IFN-γ cytokines levels were further decreased in the methotrexate-treated group. Accordingly, it can be concluded that naringenin can be effectively used for the reduction of inflammatory effects and control of RA disease.
Collapse
Affiliation(s)
- A Hajizadeh
- Department of Microbiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - S M Abtahi Froushani
- Department of Microbiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - A A Tehrani
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - S Azizi
- Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - S R Bani Hashemi
- Department of Immunology, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| |
Collapse
|
8
|
Whitworth F, Adamantos S, Frowde P, Whitelock R, Black VL. Ligament Laxity in Nonerosive Immune-Mediated Polyarthritis in Dogs: Five Cases (2009-2017). J Am Anim Hosp Assoc 2019; 55:210-214. [PMID: 31099600 DOI: 10.5326/jaaha-ms-6920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ligament laxity is a known complication of erosive immune-mediated polyarthritis (IMPA) in dogs. The purpose of this study was to describe the occurrence and clinical features of carpal or tarsal ligament laxity in cases of nonerosive IMPA in dogs for the first time. Five client-owned dogs with a diagnosis of nonerosive IMPA and carpal or tarsal ligament laxity in which the influence of corticosteroids was excluded were identified. Medical records were reviewed, and data including signalment, investigative findings, and treatment regimen (e.g., surgical management) was extracted. Primary care practices were contacted to obtain follow-up, and the data was descriptively analyzed. The affected joints were either carpi and tarsi (n = 3) or carpi only (n = 2). In three cases, surgical arthrodesis was performed. Three dogs were euthanized (1 mo, 12 mo, and 5 yr) as a result of the severity of clinical signs and poor control. In the four dogs surviving >6 mo, multiple episodes of relapse were recorded, and multimodal immunosuppression was needed. The prognosis for the dogs described was poor, with none achieving control of the disease without ongoing immunosuppressive therapy. Damage to soft-tissue periarticular structures may be related to prolonged clinical disease or a more severe presentation. Jaccoud's arthropathy in humans with systemic lupus erythematosus may represent a homologous presentation.
Collapse
Affiliation(s)
- Fiona Whitworth
- From Langford Vets, University of Bristol, Bristol, United Kingdom (V.L.B., F.W.); Paragon Veterinary Referrals, Wakefield, United Kingdom (S.A.); Davies Veterinary Specialists, Hitchin, United Kingdom (P.F.); and The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom (R.W.)
| | - Sophie Adamantos
- From Langford Vets, University of Bristol, Bristol, United Kingdom (V.L.B., F.W.); Paragon Veterinary Referrals, Wakefield, United Kingdom (S.A.); Davies Veterinary Specialists, Hitchin, United Kingdom (P.F.); and The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom (R.W.)
| | - Polly Frowde
- From Langford Vets, University of Bristol, Bristol, United Kingdom (V.L.B., F.W.); Paragon Veterinary Referrals, Wakefield, United Kingdom (S.A.); Davies Veterinary Specialists, Hitchin, United Kingdom (P.F.); and The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom (R.W.)
| | - Richard Whitelock
- From Langford Vets, University of Bristol, Bristol, United Kingdom (V.L.B., F.W.); Paragon Veterinary Referrals, Wakefield, United Kingdom (S.A.); Davies Veterinary Specialists, Hitchin, United Kingdom (P.F.); and The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom (R.W.)
| | - Vicki L Black
- From Langford Vets, University of Bristol, Bristol, United Kingdom (V.L.B., F.W.); Paragon Veterinary Referrals, Wakefield, United Kingdom (S.A.); Davies Veterinary Specialists, Hitchin, United Kingdom (P.F.); and The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom (R.W.)
| |
Collapse
|
9
|
Oliveira L, Tudury E, Lucena D, Costa L, Araújo B, Cardoso P, Olivier N, Baraúna Júnior D. Estudo biomecânico comparando a utilização de placas bloqueadas híbridas na artrodese dorsal e medial do carpo de cães. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-10245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivou-se com este trabalho comparar biomecanicamente os posicionamentos dorsal e medial da placa bloqueada na artrodese do carpo em cães. Para isso, foram utilizados sete pares de membros torácicos de cães eutanasiados por razões não relacionadas ao estudo, em que sete membros foram estabilizados com placa dorsal, e seus respectivos pares com placa em posicionamento medial. Os membros com as articulações radiocarpometacarpianas estabilizadas cirurgicamente foram submetidos a ensaio de compressão axial em máquina universal de ensaios de materiais, e os dados de limite de elasticidade, rigidez estrutural, carga máxima e carga no momento da fratura dos posicionamentos foram comparados por meio do teste de Student-Newman-Keuls, a um nível de significância de 5%. Todos os membros foram fraturados no terço distal do terceiro metacarpo; nos membros com placa dorsal, a fratura ocorreu distal ao orifício distal e, nos membros com placa medial, a fratura ocorreu no último orifício dos metacarpos dois e três. Não houve dobra ou quebra de placas e parafusos e não houve diferença significativa entre os posicionamentos dorsal e medial dos implantes quanto aos parâmetros avaliados.
Collapse
Affiliation(s)
- L.M. Oliveira
- Universidade Estadual da Região Tocantina do Maranhão, Brazil
| | - E.A. Tudury
- Universidade Federal Rural de Pernambuco, Brazil
| | | | | | | | | | - N.C. Olivier
- Universidade Federal do Vale do São Francisco, Brazil
| | | |
Collapse
|
10
|
Idowu OA, Heading KL. Type 1 immune-mediated polyarthritis in dogs and lack of a temporal relationship to vaccination. J Small Anim Pract 2017; 59:183-187. [DOI: 10.1111/jsap.12774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 11/27/2022]
Affiliation(s)
- O. A. Idowu
- Melbourne Veterinary Specialist Centre, 70 Blackburn Road, Glen Waverley; Melbourne 3150 Australia
| | - K. L. Heading
- Melbourne Veterinary Specialist Centre, 70 Blackburn Road, Glen Waverley; Melbourne 3150 Australia
| |
Collapse
|