immune mediated poly arthritis IMPA

Discussion in 'Labrador Health' started by Kmw3006, Sep 14, 2018.

  1. Kmw3006

    Kmw3006 Registered Users

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    Spent the last day and a half going thru 37 pages of thread titles and didn't see this topic so hopefully this will be a little new. Has anyone had to deal with immune mediated poly arthritis (IMPA). If so how long did it take to recover fully, if the dog recovered fully? What sort of therepies did you use? Been dealing with it since January with only partially success and I want my yellow tornado all the way back.
     
  2. Stacia

    Stacia Registered Users

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    Welcome. Sorry I have no experience of IMPA but just wanted to say hello and I am sure someone who does have some knowledge/experience of IMPA will be along soon.
     
  3. tom@labforumHQ

    tom@labforumHQ Administrator Staff Member

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    Hi and welcome to the forum! Hope you find the answers you need
     
  4. Aisling Labs

    Aisling Labs Registered Users

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    Hi,

    I'm so sorry to hear that your yellow tornado is suffering. I had never heard of it before so did a bit of quick reading; what I came away with is that there a many different causes of the disease from vaccine or drug treatment to underlying disorders in the intestines or kidneys and several other diseases mentioned.

    From this limited bit of information, it seems that treatment would depend upon what caused it's onset. What treatments has your Vet been using?
     
  5. Kmw3006

    Kmw3006 Registered Users

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    Yea, bunch of causes. All tests from, tic born to fungal, bacterial, viral, and organ functions came back normal. So my dog falls into the largest catagory called idiopathic. I think that stands for "the idiot can't figure out whats wrong". Even the vets got a laugh out of that. Started with a course of antibiotic incase it was bacterial or tic born along with high dose of prednisone. Prednisone seemed to help but the side effects suck. Started weaning off pred. and added mycophenolate. Now totally off pred. and just on myco. and low dose codine for pain. Going to vet tomorrow for another joint tap. Depending on what that shows, and what my bank account can handle, will probable change drugs. Next drug that has proven effective is called leflunomide, the cheapest I've seen it is about 140$ for a 30 day supply.
     
  6. mandyb

    mandyb Registered Users

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    Good luck.
     
  7. Beanwood

    Beanwood Registered Users

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    The cause of immune-mediated diseases can be tricky to identify. It is not unusual for them to be classed as "idiopathic", indeed some of these are self-limiting, meaning they just sort themselves out naturally over a period of time. The caveat here is that I am not vet, nor have experience with IMPA, but do have some understanding of immunology.

    From what I can gather, the vet is treating the symptoms through a step-wise process which is fairly logical, certainly the same in humans...so pain relief initially then steroids. A diagnosis based on certain blood tests checking for things like CRP levels..basically indicating whether the problem is immune-mediated, meaning a fault in the inflammatory cascade resulting in pain and inflammation of certain joints. I think your vet is simply ruling out possible underlying treatable causes such as infection or tick-borne diseases.

    The next stage is DMARDs (disease-modifying drugs) of which I can see your dog has been prescribed. Now these do take a fair amount of time to take effect, I think around 8 weeks or so. This is why your vet is weaning your dog of steroids and waiting for the for the DMARDs to have an effect, while still using meds to help with the joint discomfort.

    Is this the first joint tap? I am presuming X-rays have been taken of the affected joints? Examining the cells from a joint tap can give the vet a better idea of what is happening, so they can treat the problem more effectively.

    I am sorry your dog is suffering, IMPA looks like a painful and frustrating disease for both dog and owner. I was wondering whether you have a referral process where you are to vets who specialise..hmm...maybe orthopaedics or immunology? It looks like though it will take some time to get under control.
     
  8. Kmw3006

    Kmw3006 Registered Users

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    This is the second joint tap. First stet done back in Jan. Doing this one to compare chemistry and neutriphil cell counts before trying new drug therapy. As far as vets, she has a regular vet and a vet we were refered to. To go any higher on the vet scale would mean a trip to one of the Vet schools, K-State or Iowa St.
     
  9. Kmw3006

    Kmw3006 Registered Users

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    Been a long while since I've been here. This is the update. New joint taps came back as 50-60%neutrophil ( special white cell)count . Only need 10-12% to confirm IMPA. Increased the mycophenalate and restarted the pednisone. One of the issues with IMPA is it can also affect internal organs, which started happening. At that point it became a vicious circle, as the drugs to help improve the IMPA also can hurt internal organs. She went down hill fast, and had to put her down. Thanks to those who sent opinions and worries. If any one wants more info about my experience with this don't hesitate to reach me via PM if this site has such a feature.
     
  10. Bud Light/Dilly Dilly

    Bud Light/Dilly Dilly Registered Users

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    Geez.... I am so so sorry to hear that.
     
  11. Beanwood

    Beanwood Registered Users

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    I am so sorry to hear this, my heart goes to you at this sad time:hug:
     
  12. mandyb

    mandyb Registered Users

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    So sorry to hear this, must have been awful for you. x
     
  13. Capn Jeff

    Capn Jeff Registered Users

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    You seem pretty knowledgeable. Thanks for your post. My dog was just diagnosed with IMPA after 2 blood draws, X-rays, urinalysis and a joint tap. This condition came on like a lightening bolt.
    It first presented like temporary paralysis in all limbs. He recovered within a few minutes but since then was greatly limited in his mobility. Within 2 weeks he was barely able to stand and walk.
    A course of prednisone and antibiotics ( just in case they missed something) along with Gabapentin for pain is, so far, working wonders.
    Before this he was an active 8 yr old lab cross. Very fit for his age.
    I’m wondering if anyone has had experience with such a rapid onset of IMPA (immune moderated poly arthritis)
     

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