Hernon Tom, Langley-Hobbs Sorrel J
Langford Veterinary Services, Small Animal Hospital, University of Bristol, Langford, Bristol, UK.
JFMS Open Rep. 2020 Feb 27;6(1):2055116920907417. doi: 10.1177/2055116920907417. eCollection 2020 Jan-Jun.
A 9-year-old neutered male domestic shorthair cat was referred for assessment of a chronic non-weightbearing left forelimb lameness that had an acute onset following a suspected cat bite to the distal limb 4 weeks previously. There was minimal improvement following conservative management. On examination there was discomfort on palpation of the left palmar metacarpal region. An orthopaedic examination performed under sedation identified a moderate effusion of the left fourth metacarpophalangeal joint. A CT scan was performed, which identified fragmentation of the medial palmar sesamoid of the fourth digit (sesamoid V). Arthrocentesis of the fourth metacarpophalangeal joint identified septic inflammation. Surgical removal of the fragmented palmar sesamoid was performed and was submitted for histopathology and bacteriology analysis. Postoperative CT confirmed the removal of all fragments. species were isolated from the sesamoid fragments. Histopathology revealed osteomyelitis, neutrophilic inflammation and multifocal necrosis, with evidence of fibrosis present. The cat was re-examined 3 months postoperatively, at which point there was no evidence of lameness and orthopaedic examination of the limb was unremarkable.
To our knowledge, this is the first reported case of fragmentation of a palmar sesamoid in a cat. This case study describes the diagnosis and the successful management of a cat with fragmentation of a palmar sesamoid, following an altercation with another cat.
一只9岁已绝育的雄性家猫因慢性非负重性左前肢跛行前来就诊。4周前该猫的远端肢体疑似被猫咬伤后急性发病。保守治疗后改善甚微。检查时，左掌侧掌骨区域触诊有压痛。在镇静状态下进行的骨科检查发现左第四掌指关节有中度积液。进行了CT扫描，发现第四指内侧掌籽骨（籽骨V）碎裂。对第四掌指关节进行关节穿刺，发现有脓性炎症。手术切除了碎裂的掌籽骨，并送去做组织病理学和细菌学分析。术后CT证实所有碎片均已切除。从籽骨碎片中分离出了多种细菌。组织病理学显示为骨髓炎、嗜中性粒细胞炎症和多灶性坏死，并有纤维化迹象。术后3个月对该猫进行复查，此时没有跛行迹象，对该肢体的骨科检查也未发现异常。
据我们所知，这是第一例报道的猫掌籽骨碎裂病例。本病例研究描述了一只猫在与另一只猫发生争斗后掌籽骨碎裂的诊断和成功治疗情况。
