Dr. Erika DePapp
Complete blood count (CBC). The CBC evaluates the red and white blood cells as well as the platelets. Many dogs with shar-pei fever will have elevations of the white blood cell count.
A history and physical exam are always important to obtain an accurate clinical picture and choose appropriate diagnostic tests. Owners may report previous episodes of illness and fever, since this is a disease that recurs.
Additional tests that may be recommended include:
Biochemical profile. The biochemical profile helps to evaluate liver and kidney function as well as assessing blood sugar, protein and electrolyte levels (sodium and potassium are examples of electrolytes). Affected dogs may show elevated globulin levels. Globulins are proteins that become elevated in the face of inflammation. Dogs with early disease do not show other abnormalities on the biochemical profile. Dogs suffering from kidney and/or liver damage have elevations of kidney and liver parameters. This blood test is an important marker for indicating disease status and progression.
Urinalysis and culture. Analysis of the urine provides further information about kidney function. Dogs with significantly impaired kidney function have dilute urine and may have excessive protein in the urine. Bacterial culture of a urine sample is warranted to rule out a urinary tract infection.
Urine protein/creatinine ratio. This test is used to quantify the amount of protein in the urine and is an important indicator of a certain type of kidney damage that may be seen secondary to amyloid deposition in the kidneys.
Blood culture. Bacterial culture of the blood during a high fever helps to rule out the likelihood of an infection within the bloodstream.
Chest and abdominal x-rays. These tests are often normal in dogs with shar-pei fever. They are nevertheless important tests to rule out other diseases, such as pneumonia and other infections.
X-rays of joints. Dogs that present with swollen hocks show evidence of soft tissue swelling on x-rays, but no bony abnormalities.
Joint taps. Small amounts of fluid can be obtained from the affected joints. Characterization of cell types within the fluid may rule out certain diseases. Culture of the fluid is recommended to rule out bacterial infection. This test is not used as a specific indicator of shar-pei fever because joint inflammation due to various causes may have similar cell types in the joint fluid. Some dogs with shar-pei fever have normal fluid analyses.
Blood tests for tick-borne disease. Antibodies in the blood can be measured to test for the possibility of the aforementioned infectious diseases that are spread by ticks.
Immune system tests. If SLE or rheumatoid arthritis is suspected, special blood tests can be performed to help confirm the diagnosis. These are called the Antinuclear Antibody Test (ANA), and Rheumatoid Factor.
Kidney or liver biopsy. In dogs showing evidence of kidney or liver dysfunction, biopsies of these organs may be considered to confirm a diagnosis of amyloid deposition. In many cases the dogs have had a history of shar-pei fever, and the subsequent development of kidney or liver disease is presumed to be due to amyloid, even without biopsy confirmation.
The main goal of therapy in dogs with shar-pei fever is to reduce the risk of secondary kidney or liver disease in patients suffering from the signs of recurring fever and lameness. In most cases the fever episodes are short-lived and do not cause prolonged illness. Sometimes however, the fevers can be quite high, and may require hospitalization.
In dogs with temperatures greater than 106 degrees Fahrenheit, there is a risk of cell damage secondary to the excess body heat. These patients need to be hospitalized and treated with IV fluids. If there is any indication of concurrent bacterial infection, antibiotic therapy is also warranted. In most cases there are no infections, and antibiotics do not help.
Non-steroidal anti-inflammatory drugs may be used to relieve pain and lameness associated with the episodes of fever and joint swelling. They may also reduce the fever. This class of drugs must be used carefully in veterinary patients to avoid undesired side effects. They should only be used under the direct supervision of your veterinarian.
Colchicine is a special drug used in humans with a similar disorder. When used early in the course of the disease, this drug helps reduce the frequency of fever episodes, as well as reducing the likelihood of amyloid deposition and secondary kidney or liver failure. Use of colchicine in patients with established kidney failure may or may not be helpful, and may increase risk of drug toxicity. This drug is not approved for use in dogs and may cause severe side effects including vomiting and diarrhea, as well as bone marrow suppression. This is another drug that should only be used under direct supervision of your veterinarian, and must be handled carefully by humans.
A low protein diet may be helpful in slowing down development of kidney disease in dogs with recurrent fever episodes.
Supportive therapy should be provided for dogs already showing signs of kidney failure. This may include fluid therapy, use of anti-ulcer medication, strict dietary regimens, use of anti-nausea drugs, blood pressure monitoring, and use of a drug to reduce protein loss through the kidneys (not all dogs have protein-losing kidney disease).