Langford Small Animal Hospital, Langford House, University of Bristol, Bristol, UK.
Specialty Oral Pathology for Animals, Geneseo, IL, USA.
J Feline Med Surg. 2021 Dec;23(12):1200-1212. doi: 10.1177/1098612X21998612. Epub 2021 Mar 24.
The aim of this case series was to describe the clinical features and treatment of paronychia in cats diagnosed with patellar fracture and dental anomaly syndrome (PADS). Clinical records, photographs, microbiology, cytology and histopathology reports were collected, and follow-up was obtained. Five cats with paronychia were included. All five cats had multiple digits of multiple limbs affected and eventually underwent amputation of the third phalanx of one or multiple digits. A total of 36 digits were affected, 17% (n = 6/36) resolved with medical management and 83% (n = 30/36) were eventually treated successfully by amputation. The cats had treatment with numerous courses of antibiotics (range 7-20; mean 11 courses) over periods of time ranging from 10 to 67 months (mean 32 months).
Chronic paronychia may be an additional clinical feature of PADS and the probable mechanism involves poor integrity of osteopetrotic bone, loss of normal nailbed anatomy and secondary osteomyelitis of the distal phalanx. Medical management with antibiotics, anti-inflammatory therapy and steroid treatment may improve the clinical signs in the short term; however, in severe instances, amputation of the third phalanx of the affected digit seems to be necessary to resolve repeated recurrences and discomfort. Additional information on the long-term outcome is required. In any cat with atraumatic patellar fractures and/or retained deciduous teeth, paronychia may require surgical management if medical management is unsuccessful.
本病例系列的目的是描述诊断为髌骨骨折和牙异常综合征(PADS)的猫的甲沟炎的临床特征和治疗方法。收集了临床记录、照片、微生物学、细胞学和组织病理学报告,并进行了随访。纳入了 5 例患有甲沟炎的猫。这 5 只猫均有多根多肢的多个指(趾)受累,最终对一个或多个指(趾)的第三指(趾)骨进行了截肢。共有 36 个指(趾)受累,36%(n=6/36)经药物治疗后痊愈,83%(n=30/36)最终通过截肢成功治疗。这些猫接受了多种疗程的抗生素治疗(范围 7-20;平均 11 个疗程),时间从 10 至 67 个月不等(平均 32 个月)。
慢性甲沟炎可能是 PADS 的另一个临床特征,其可能的发病机制涉及到骨硬化骨完整性受损、正常甲床解剖结构丧失以及末节指骨的继发性骨髓炎。短期使用抗生素、抗炎治疗和皮质类固醇治疗可能会改善临床症状;然而,在严重情况下,可能需要对受影响指的第三指(趾)骨进行截肢,以解决反复发作和不适的问题。需要更多关于长期预后的信息。对于任何无创伤性髌骨骨折和/或滞留乳牙的猫,如果药物治疗无效,甲沟炎可能需要手术治疗。