How do I diagnose and manage Shar-Pei fever and the associated risk of renal amyloidosis?

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Shar-Pei fever (SPAID) is diagnosed clinically by compatible signs in a Shar-Pei or crossbreed after ruling out other causes of fever, and the primary management goal is reducing the chronic autoinflammatory state that drives progression to renal amyloidosis. 3 Diagnosis of Shar-Pei fever is clinical. No pathognomonic laboratory test is described. The diagnosis rests on the presence of compatible clinical signs — episodic fever and swollen hocks — in a Shar-Pei or cross, with other causes of fever excluded. 3 Serum amyloid A measurement may be used as a supportive tool when amyloidosis is suspected, though a definitive diagnosis of renal amyloidosis requires intravital renal biopsy with histopathological confirmation of amyloid deposits. 1 The episodic inflammatory episodes of Shar-Pei fever are postulated to create a subclinical, chronic autoinflammatory state that predisposes affected dogs to amyloid-associated (AA) amyloidosis. 2 Amyloidosis in Chinese Shar-Pei occurs secondary to immune dysregulation and a subsequent autoinflammatory disorder, with genetic analysis identifying one primary risk locus and a suggested modifier locus. 7 Hepatic amyloidosis can also occur in affected Shar-Pei, in addition to the more common renal involvement. 4 Renal amyloidosis in Shar-Pei has a distinct clinicopathologic profile compared to other breeds. Shar-Pei with renal amyloidosis are significantly younger at presentation than non-Shar-Pei dogs (median 4.8 years vs. median 9.0 years). 5 Median serum creatinine at presentation across all dogs with renal amyloidosis is 5.5 mg/dL, and Shar-Pei present with creatinine concentrations approximately 3-fold higher than non-Shar-Pei dogs. 5 Hypoalbuminemia is present in 64.7% of Shar-Pei with renal amyloidosis (vs. 100% of non-Shar-Pei). 5 An elevated urine protein:creatinine ratio is present in 96% of all dogs with renal amyloidosis. 5 Nephrotic syndrome occurs in 10% of non-Shar-Pei dogs but is not reported in Shar-Pei with this dise