1. 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?

2. 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.

3. 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

4. Synovial Fluid Cytology

10. Provisional Diagnosis Acute Polyarthritis Rx: Meloxicam Antibiotics or Corticosteroids based on Culture & Sensitivity

11. Two weeks after Prednisone begun Very few cells seen in joint fluid