Queen Mother Hospital for Animals, Department of Clinical Science and Services, Royal Veterinary College, North Mymms, UK.
Langford Veterinary Services, University of Bristol, Bristol, UK.
J Feline Med Surg. 2022 Oct;24(10):e401-e410. doi: 10.1177/1098612X221107783. Epub 2022 Jun 28.
Cats with non-erosive immune-mediated polyarthritis (IMPA) were identified from seven referral hospitals between 2009 and 2020 for a multicentre retrospective case series. Data were obtained from hospital records and referring veterinarians were contacted for follow-up. Twenty cases were identified: 12 castrated males (60%), one entire male (5%) and seven spayed females (35%). Common clinical signs included lameness (n = 20/20) and pyrexia (n = 10/18). Three cats presented with and two cats developed ligament laxity during treatment. Thirteen cats (65%) were diagnosed with non-associative IMPA and seven (35%) with associative IMPA. Comorbidities identified included chronic enteropathy (n = x/7), feline immunodeficiency virus (n = x/7) feline herpesvirus (n = x/7), bronchopneumonia (n = x/7) and discospondylitis (n = x/7). Sampling of the tarsal joints most frequently identified an increased proportion of neutrophils, consistent with IMPA. Eighteen cats (90%) received immunosuppressants. Eleven cats were started on prednisolone; eight had a poor response resulting in the addition of a second agent, euthanasia or acceptance of the persisting signs. One cat received ciclosporin and required an alternative second agent owing to adverse effects. Five cats were started on prednisolone and ciclosporin; three had a poor response and required an alternative second agent. One cat received prednisolone and chlorambucil and had a good response. Two cats (10%) received meloxicam and had a good response, although the clinical signs recurred when medication was tapered. A good outcome was achieved in 14/20 cats (70%) with IMPA. In the cats with a poor outcome 4/6 were euthanased and 2/6 had chronic lameness.
Prognosis for feline IMPA can be good. Multimodal immunosuppression was often required. IMPA should be considered in lame cats, with or without pyrexia, when there is no evidence of trauma or infection. The tarsal joints should be included in the multiple joints chosen for sampling. Ligament laxity can occur in non-erosive feline IMPA.
2009 年至 2020 年间，从七家转诊医院中确定了患有非侵蚀性免疫介导性多关节炎（IMPA）的猫，以进行多中心回顾性病例系列研究。从医院记录中获得数据，并联系转诊兽医进行随访。共确定了 20 例病例：12 例去势雄性（60%），1 例完整雄性（5%）和 7 例去势雌性（35%）。常见的临床症状包括跛行（20/20）和发热（18/18）。3 只猫在治疗过程中出现并 2 只猫发展为韧带松弛。13 只猫（65%）被诊断为非关联性 IMPA，7 只（35%）为关联性 IMPA。确定的合并症包括慢性肠炎（7/7）、猫免疫缺陷病毒（7/7）、猫疱疹病毒（7/7）、支气管肺炎（7/7）和椎间盘炎（7/7）。跗关节的采样最常发现中性粒细胞比例增加，与 IMPA 一致。18 只猫（90%）接受了免疫抑制剂治疗。11 只猫开始使用泼尼松龙；8 只猫反应不佳，导致添加第二种药物、安乐死或接受持续存在的症状。1 只猫接受环孢素治疗，由于不良反应需要替代第二种药物。5 只猫开始使用泼尼松龙和环孢素；3 只猫反应不佳，需要替代第二种药物。1 只猫接受泼尼松龙和氯苯丁酸治疗，反应良好。2 只猫（10%）接受美洛昔康治疗，反应良好，尽管在药物减量时症状复发。14/20 只（70%）患有 IMPA 的猫预后良好。在预后不良的猫中，6 只中有 4 只被安乐死，6 只中有 2 只患有慢性跛行。
猫的 IMPA 预后良好。通常需要多模式免疫抑制。当没有创伤或感染证据时，对于有或没有发热的跛行猫，应考虑 IMPA。应选择跗关节进行采样的多个关节。非侵蚀性猫的 IMPA 可出现韧带松弛。
