Thom Leonie K, Pool Roy R, Malik Richard
1 Wilston Vet, Brisbane, Queensland, Australia.
2 Osteopathology and Dental Services, Texas A&M University, College Station, Texas, USA.
J Feline Med Surg. 2017 Mar;19(3):304-310. doi: 10.1177/1098612X17693503.
Clinical summary: A 13-year-old, spayed Devon Rex with unilateral digital flexor musculotendinous contracture of the forelimb was treated by surgical tenotomy. The condition improved transiently, but recurred rapidly and became bilateral. Histopathologic analysis of necropsy tissues resulted in a morphologic diagnosis of fibromyositis of the antebrachial muscles causing contracture and flexural deformity of the carpi and phalanges of both thoracic limbs. A search for similar cases yielded the clinical notes of a second cat, a 10-year-old, spayed Devon Rex, also with bilateral disease. This second case responded well to surgical tenotomy but tissue biopsies were not obtained to permit microscopic assessment of the underlying pathologic process. Relevance and novel information: Acquired and permanent contracture of the digital flexor muscles and/or tendons of the forelimbs is a rare and poorly described condition of cats. The very limited number of documented cases describing disease affecting one or more digits (but not the carpus) infers a causal link with onychectomy, but reported histopathologic changes have been limited to the tendons. The two cases described in this report suffered contracture of the carpus and all digits bilaterally, one without previous onychectomy and the other 9 years after onychectomy. There were novel histopathologic findings in the muscles of the one case for which biopsy material was available. Information gained from these two cases provides a new perspective for the investigation and treatment of future cases. Specifically, consideration should be given to an underlying immune-mediated myopathic process and a possible genetic predisposition in the Devon Rex breed. Currently, the poorly understood etiopathogenesis hinders our ability to definitively recommend treatment options, which might include corticosteroids and other forms of immunosuppressive therapy.
一只13岁已绝育的德文卷毛猫,前肢单侧指屈肌肌腱挛缩,接受了手术切断术治疗。病情短暂改善,但很快复发并发展为双侧病变。尸检组织的组织病理学分析得出形态学诊断,即前臂肌肉纤维肌炎导致双侧胸肢腕关节和指骨挛缩及屈曲畸形。检索类似病例得到了第二只猫的临床记录,这是一只10岁已绝育的德文卷毛猫,同样患有双侧疾病。第二例对手术切断术反应良好,但未获取组织活检以进行潜在病理过程的显微镜评估。相关性和新信息:猫前肢指屈肌和/或肌腱的后天性永久性挛缩是一种罕见且描述较少的病症。记录在案的描述影响一个或多个趾(但不包括腕关节)疾病的病例数量非常有限,这暗示与拔甲术存在因果关系,但报告的组织病理学变化仅限于肌腱。本报告中描述的两例均出现双侧腕关节和所有趾挛缩,一例之前未进行过拔甲术,另一例在拔甲术后9年出现。对于有活检材料的一例,在肌肉中发现了新的组织病理学发现。从这两例中获得的信息为未来病例的研究和治疗提供了新视角。具体而言,应考虑潜在的免疫介导性肌病过程以及德文卷毛猫品种可能存在的遗传易感性。目前,病因发病机制尚不清楚,这阻碍了我们明确推荐治疗方案的能力,治疗方案可能包括皮质类固醇和其他形式的免疫抑制疗法。