Whitworth Fiona, Adamantos Sophie, Frowde Polly, Whitelock Richard, Black Vicki L
From Langford Vets, University of Bristol, Bristol, United Kingdom (V.L.B., F.W.); Paragon Veterinary Referrals, Wakefield, United Kingdom (S.A.); Davies Veterinary Specialists, Hitchin, United Kingdom (P.F.); and The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom (R.W.).
J Am Anim Hosp Assoc. 2019 Jul/Aug;55(4):210-214. doi: 10.5326/JAAHA-MS-6920. Epub 2019 May 17.
Ligament laxity is a known complication of erosive immune-mediated polyarthritis (IMPA) in dogs. The purpose of this study was to describe the occurrence and clinical features of carpal or tarsal ligament laxity in cases of nonerosive IMPA in dogs for the first time. Five client-owned dogs with a diagnosis of nonerosive IMPA and carpal or tarsal ligament laxity in which the influence of corticosteroids was excluded were identified. Medical records were reviewed, and data including signalment, investigative findings, and treatment regimen (e.g., surgical management) was extracted. Primary care practices were contacted to obtain follow-up, and the data was descriptively analyzed. The affected joints were either carpi and tarsi (n = 3) or carpi only (n = 2). In three cases, surgical arthrodesis was performed. Three dogs were euthanized (1 mo, 12 mo, and 5 yr) as a result of the severity of clinical signs and poor control. In the four dogs surviving >6 mo, multiple episodes of relapse were recorded, and multimodal immunosuppression was needed. The prognosis for the dogs described was poor, with none achieving control of the disease without ongoing immunosuppressive therapy. Damage to soft-tissue periarticular structures may be related to prolonged clinical disease or a more severe presentation. Jaccoud's arthropathy in humans with systemic lupus erythematosus may represent a homologous presentation.
韧带松弛是犬类侵蚀性免疫介导性多关节炎（IMPA）的一种已知并发症。本研究的目的是首次描述犬类非侵蚀性IMPA病例中腕关节或跗关节韧带松弛的发生率及临床特征。确定了5只确诊为非侵蚀性IMPA且存在腕关节或跗关节韧带松弛的客户拥有犬，排除了皮质类固醇的影响。查阅了病历，并提取了包括特征、检查结果和治疗方案（如手术管理）等数据。联系初级保健机构以获取随访信息，并对数据进行描述性分析。受影响的关节为腕关节和跗关节（n = 3）或仅腕关节（n = 2）。3例进行了手术关节固定术。3只犬因临床症状严重且控制不佳而实施安乐死（分别为1个月、12个月和5年）。在存活超过6个月的4只犬中，记录到多次复发情况，需要采用多模式免疫抑制治疗。所述犬的预后较差，若无持续的免疫抑制治疗，无一例能控制疾病。软组织关节周围结构的损伤可能与临床疾病持续时间延长或表现更为严重有关。人类系统性红斑狼疮中的雅各布关节病可能代表一种同源表现。
