1,454
edits
Changes
Jump to navigation
Jump to search
Periosteal Proliferative Polyarthritis (view source)
Revision as of 07:38, 8 September 2011
, 07:38, 8 September 2011Created page with "==Introduction== Periosteal proliferative polyarthritis is a form of '''idiopathic inflammatory arthritis''' rare in dogs but recognised relatively commonly in '''cats'''. The a..."
==Introduction==
Periosteal proliferative polyarthritis is a form of '''idiopathic inflammatory arthritis''' rare in dogs but recognised relatively commonly in '''cats'''.
The aetiology is uncertain, but links have been made with infections with '''[[FeLV]], [[FIV]] and FeSFV''' (feline syncytium forming virus). It has been suggested that infection with FeLV or FIV-induced immunosuppression allows FeSFV to multiply in the joints of predisposed individuals. However there isn't an increased incidence of FeLV or FIV in affected cats.
All affected cats are infected with FeSFV, but this virus can be cultured from the joints of many normal cats too, and so the finding may be just '''incidental'''.
It occurs more commonly in '''young, entire or castrated, male cats less than 5 years of age'''.
==Clinical Signs==
There is an acute onset '''pyrexia and malaise''' with a '''stiff gait, joint effusion and joint pain'''.
There may be generalised '''muscle atrophy''' and '''lymphadenopathy'''.
During the more chronic phase, there is marked periosteal new bone formation, especially around the hocks and carpi, which leads to '''joint ankylosis''' in 2-8 weeks.
==Diagnosis==
All affected joints should be '''radiographed'''. Findings include:
:periarticular soft tissue swelling
:distension of the joint capsule
:loss of intraarticular fat shadows
:periarticular '''periosteal new bone formation'''
:joint ankyolsis
:'''osteophyte''' bridging of joints
:coarsening of the trabecular pattern
:'''enthesiopathies'''
Serioal radiographs are useful to monitor the '''progression''' of the disease.
'''Immunological tests''' such as the Rheumatoid factors or the anti-nuclear antibody are negative.
'''Haematology and biochemistry''' reveal: leukocytosis, increased fibrinogen, and 50-70% of cats are FeLV positive.
'''Synovial fluid analysis''' reveals: increased volume, increased turbidity, increased white blood cell count (non-degenerate polymorphonuclear cells).
Synovial membrane biopsies can be submitted for histopathology, however the changes are not specific for the condition.
==Treatment==
'''Prednisolone''' is the mainstay of therapy and should be administered initially at immunosuppressive doses. The dose can be reduced to a minimal level once signs are controlled.
Additional immunosuppressive drugs can be added if the response to prednisolone alone is poor, most commonly '''cyclophosphamide'''.
Repeated '''synovial fluid cytology''' can be performed to monitor the response to treatment. A low white blood cell count indicates that treatment should be continued.
Animals should be monitored for '''secondary infections''' which can occur during treatment, and treated promptly.
Even if the drugs can be stopped, relapses often occur which require repeated treatments.
The overall prognosis is '''guarded to poor''', as the condition can produce such severe joint deformity that '''euthanasia''' is indicated on humane grounds.
{{Learning
|flashcards = [[Small Animal Orthopaedics Q&A 17]]
}}
==References==
Pasquini, C. (1999) '''Tshauner's Guide to Small Animal Clinics''' ''Sudz Publishing''
Scott, H. (2007) '''Feline Orthopaedics''' ''Manson Publishing''
Dunn, J. (1999) '''Textbook of small animal medicine''' ''Elsevier Health Sciences''
[[Category:To Do - Helen]]
[[Category:To Do - Review]]
Periosteal proliferative polyarthritis is a form of '''idiopathic inflammatory arthritis''' rare in dogs but recognised relatively commonly in '''cats'''.
The aetiology is uncertain, but links have been made with infections with '''[[FeLV]], [[FIV]] and FeSFV''' (feline syncytium forming virus). It has been suggested that infection with FeLV or FIV-induced immunosuppression allows FeSFV to multiply in the joints of predisposed individuals. However there isn't an increased incidence of FeLV or FIV in affected cats.
All affected cats are infected with FeSFV, but this virus can be cultured from the joints of many normal cats too, and so the finding may be just '''incidental'''.
It occurs more commonly in '''young, entire or castrated, male cats less than 5 years of age'''.
==Clinical Signs==
There is an acute onset '''pyrexia and malaise''' with a '''stiff gait, joint effusion and joint pain'''.
There may be generalised '''muscle atrophy''' and '''lymphadenopathy'''.
During the more chronic phase, there is marked periosteal new bone formation, especially around the hocks and carpi, which leads to '''joint ankylosis''' in 2-8 weeks.
==Diagnosis==
All affected joints should be '''radiographed'''. Findings include:
:periarticular soft tissue swelling
:distension of the joint capsule
:loss of intraarticular fat shadows
:periarticular '''periosteal new bone formation'''
:joint ankyolsis
:'''osteophyte''' bridging of joints
:coarsening of the trabecular pattern
:'''enthesiopathies'''
Serioal radiographs are useful to monitor the '''progression''' of the disease.
'''Immunological tests''' such as the Rheumatoid factors or the anti-nuclear antibody are negative.
'''Haematology and biochemistry''' reveal: leukocytosis, increased fibrinogen, and 50-70% of cats are FeLV positive.
'''Synovial fluid analysis''' reveals: increased volume, increased turbidity, increased white blood cell count (non-degenerate polymorphonuclear cells).
Synovial membrane biopsies can be submitted for histopathology, however the changes are not specific for the condition.
==Treatment==
'''Prednisolone''' is the mainstay of therapy and should be administered initially at immunosuppressive doses. The dose can be reduced to a minimal level once signs are controlled.
Additional immunosuppressive drugs can be added if the response to prednisolone alone is poor, most commonly '''cyclophosphamide'''.
Repeated '''synovial fluid cytology''' can be performed to monitor the response to treatment. A low white blood cell count indicates that treatment should be continued.
Animals should be monitored for '''secondary infections''' which can occur during treatment, and treated promptly.
Even if the drugs can be stopped, relapses often occur which require repeated treatments.
The overall prognosis is '''guarded to poor''', as the condition can produce such severe joint deformity that '''euthanasia''' is indicated on humane grounds.
{{Learning
|flashcards = [[Small Animal Orthopaedics Q&A 17]]
}}
==References==
Pasquini, C. (1999) '''Tshauner's Guide to Small Animal Clinics''' ''Sudz Publishing''
Scott, H. (2007) '''Feline Orthopaedics''' ''Manson Publishing''
Dunn, J. (1999) '''Textbook of small animal medicine''' ''Elsevier Health Sciences''
[[Category:To Do - Helen]]
[[Category:To Do - Review]]