Lemetayer Julie, Taylor Susan
Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N5B4, Canada
Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N5B4, Canada.
J Feline Med Surg. 2014 Jul;16(7):547-62. doi: 10.1177/1098612X14539086.
Osteoarthritis, a degenerative non-inflammatory joint disease, is common in cats, usually causing gradual changes in behavior and lifestyle rather than severe lameness. Inflammatory arthritis occurs much less frequently and is nearly always associated with debilitating lameness. It may have an infectious or immune-mediated cause - but, unlike the canine disease, is much more likely to be infectious in origin.
Cats with inflammatory joint disease are presented for evaluation of lethargy, anorexia, reluctance to walk or fever. Synovial fluid collection and analysis is required to confirm joint inflammation, but this is a procedure many veterinarians are not comfortable performing in cats. Once inflammatory arthritis is confirmed, extensive testing is required to diagnose infectious causes and determine appropriate treatment. Immune-mediated polyarthritis can be treated with immunosuppressive drugs only after all infectious possibilities are eliminated. Radiographs are used to characterize the arthritis as erosive or nonerosive, but radiographic changes in cats are often subtle compared with those described in canine rheumatoid-like arthritis.
This review, aimed at all veterinarians who treat cats, describes the general clinical approach to feline joint disease, the collection and analysis of synovial fluid, and the diagnosis and management of inflammatory joint diseases affecting cats. The diagnostic approach to an unusual case of erosive polyarthritis is discussed in the Case Notes.
To date, the veterinary literature on inflammatory joint disease in cats has been limited to older reviews of immune-mediated disorders and multiple single case reports or small case series describing infectious disorders. This article offers a current comprehensive review of these disorders.
骨关节炎是一种退行性非炎性关节疾病，在猫中很常见，通常会导致行为和生活方式逐渐改变，而非严重跛行。炎性关节炎的发生频率要低得多，几乎总是与使人衰弱的跛行有关。它可能由感染或免疫介导引起——但与犬类疾病不同，其起源更可能是感染性的。
患有炎性关节疾病的猫会因嗜睡、厌食、不愿行走或发烧前来接受评估。需要采集和分析滑液以确认关节炎症，但这是许多兽医不太愿意在猫身上进行的操作。一旦确诊为炎性关节炎，就需要进行广泛的检查以诊断感染原因并确定适当的治疗方法。只有在排除所有感染可能性后，免疫介导的多关节炎才能用免疫抑制药物治疗。X光片用于将关节炎特征化为侵蚀性或非侵蚀性，但与犬类类风湿样关节炎中描述的情况相比，猫的X光片变化通常很细微。
这篇综述面向所有治疗猫的兽医，描述了猫关节疾病的一般临床方法、滑液的采集和分析，以及影响猫的炎性关节疾病诊断和管理。病例记录中讨论了侵蚀性多关节炎罕见病例的诊断方法。
迄今为止，关于猫炎性关节疾病的兽医文献仅限于对免疫介导疾病的旧综述以及多个描述感染性疾病的单病例报告或小病例系列。本文对这些疾病进行了当前的全面综述。
