Erosive Sacroiliitis in a Puppy? A Rare Diagnosis With Complete Resolution

Case Report: Presumed non-septic erosive sacroiliitis in a juvenile Bernese Mountain Dog: a 1.5-year follow-up

Johanna Mäkitaipale; Nele Eley

Background

Sacroiliac joint (SIJ) disease is an underrecognized cause of lower back pain, gait abnormalities, and hindlimb lameness in dogs. While septic sacroiliitis and degenerative SIJ changes have been reported, clinically significant non-septic erosive sacroiliitis has not previously been well described in dogs, particularly in juveniles. This case report documents the clinical course, imaging findings, and long-term outcome of presumed non-septic erosive sacroiliitis in a young Bernese Mountain Dog.

Methods

A four-month-old intact male Bernese Mountain Dog presenting with hindlimb gait abnormalities, tarsal hyperextension, and lumbosacral pain underwent orthopedic examination, radiography, and computed tomography (CT). Imaging focused on the sacroiliac joints and hips. The dog was managed conservatively with non-steroidal anti-inflammatory medication (carprofen), physiotherapy, joint nutraceuticals, and exercise restriction. Follow-up orthopedic examinations and imaging were performed at 3 weeks, 6 weeks, and 1.5 years after diagnosis.

Results

Initial radiographs and CT revealed bilateral erosive lesions of the sacroiliac joints, more severe on the left side, characterized by multiple articular bone erosions, peripheral sclerosis, and joint space widening. Clinical signs resolved rapidly within weeks of conservative treatment. Follow-up radiographs at 6 weeks showed partial resolution of erosive changes, and by 1.5 years, both radiography and CT demonstrated complete resolution of SIJ lesions. The dog remained clinically normal throughout long-term follow-up despite concurrent moderate hip dysplasia.

Limitations

Definitive exclusion of septic sacroiliitis was not possible, as sacroiliac joint aspiration and microbiological culture were not performed. MRI and contrast-enhanced imaging were not used, potentially limiting detection of early inflammatory or soft tissue changes. As a single case report, findings cannot be generalized to the broader canine population.

Conclusions

This case supports the existence of a presumptive non-septic erosive sacroiliitis in dogs and demonstrates that conservative management can result in complete clinical and imaging resolution, even in juvenile patients. Sacroiliac joint pathology should be considered in the differential diagnosis for young dogs presenting with hindlimb gait abnormalities and lumbosacral pain, and advanced imaging such as CT can be valuable for diagnosis and monitoring.

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