Descriptive Analysis and Factors Associated With Relapse in Dogs With Presumptive Idiopathic Immune-Mediated Polyarthritis.

Abstract

BACKGROUND: Immune-mediated polyarthritis (IMPA) is a joint disease common in dogs. Although its prognosis is generally favorable, relapses are frequent, and predictive factors for relapse remain poorly characterized. OBJECTIVES: To evaluate the outcome of medical management of IMPA in dogs and identify predictive factors for relapse. ANIMALS: Client-owned dogs diagnosed with non-associative IMPA between 2010 and 2022 across four veterinary referral centers. METHODS: This was a retrospective multicentric study. The data collected at the time of diagnosis, including signalment, clinical presentation, imaging, and laboratory findings, and treatments, were analyzed. Relapse was defined as the recurrence of clinical signs, CRP levels above the reference range, or both after remission. Associations with time from remission to relapse were assessed using univariate and multivariable Cox models. RESULTS: Among 119 dogs, 114 (95.8%) achieved remission. Among the 85 dogs with relapse data, the median time to relapse was 6.5&#x2009;months, with relapse rates of 43% at 6&#x2009;months, 61% at 12&#x2009;months, and 65% at 24&#x2009;months. In the multivariable analysis, thrombocytosis (adjusted hazard ratio [aHR]&#x2009;=&#x2009;5.5 [2.0-15.0], p&#x2009;<&#x2009;0.001), lymphadenomegaly (aHR&#x2009;=&#x2009;4.0 [1.5-11], p&#x2009;=&#x2009;0.006) and lameness (aHR&#x2009;=&#x2009;3.9 [1.2-12.2], p&#x2009;=&#x2009;0.02) at initial admission were independently and significantly associated with time from remission to relapse. CONCLUSION: This study highlights a favorable clinical outcome for dogs with non-associative IMPA with high remission rates but substantial relapse risks. Lameness, lymphadenomegaly, and thrombocytosis are associated with a greater risk of relapse.