#Feline pica syndrome series#
2 Another series of 191 cats with various fractures reported that 48% had dental anomalies possibly related to knees and teeth syndrome. Persistence of deciduous cheek teeth was reported in 40 of 60 cats with patellar fractures in one case series. 2,4įailure of deciduous tooth exfoliation in cats is rare and most often the result of an altered eruption path of the permanent tooth (see Take-Home Messages). In some cases, lameness and quadricep swelling precede visible radiographic fractures. 2,4 Intraoral and whole-body orthopedic radiography, with particular attention given to the pelvic limbs, should be performed for evaluation.
5 Physical examination findings typically reveal persistent deciduous teeth, pelvic limb lameness, and swelling of the distal quadriceps muscle concurrent paronychia has also been reported. 2,12 The mean age of onset of pelvic limb lameness or radiographic diagnosis is 28 months (range, 4 months-8 years). 2,4,11įeline knees and teeth syndrome is typically recognized in young cats, with male cats more frequently affected than female cats. 8-10 Patellar sclerosis has similarly been observed in some cats with knees and teeth syndrome. 8-10 In addition, fractures of the patella and other bones have been associated with generalized osteopetrosis. 8 In humans, osteomyelitis of the jaw associated with osteopetrosis and dental pathology has been reported. 2,5 This syndrome was believed to be a manifestation of osteogenesis imperfecta, but another mechanism is currently supported, 6,7 as patellar fractures showing radiographic evidence of sclerosis and generalized osteosclerosis have been seen in both humans and cats. 2įeline knees and teeth syndrome was first identified in the United States, but affected cats have since been identified in South America and the United Kingdom. 3,4 Pathologic fractures of the tibia and fibula can occur up to 10 years after diagnosis. 1,2 Other fractures, including in the long bones and pelvis, and spinal abnormalities have also been reported. This pathologic syndrome may include persistence of deciduous teeth, unerupted permanent teeth, and insufficiency fractures of the patella.
Lateral and craniocaudal pelvic limb radiographs revealed a displaced left patellar fracture and a nondisplaced right patellar fracture ( Figure 2).įeline knees and teeth syndrome is an association of nontraumatic patellar fractures and persistent deciduous teeth. Dental radiographs revealed persistent deciduous teeth and impacted permanent teeth. The patient received buprenorphine (15 µg/kg IV) for analgesia, followed by an induction with alfaxalone (0.5 mg/kg IV) and general anesthesia with isoflurane to facilitate dental and orthopedic radiography. Hypothyroidism was considered less likely due to the patient’s normal conformation and weight, as well as the absence of lethargy and anorexia. Patellar insufficiency fracture (ie, stress fracture) remained a likely differential due to the presence of persistent deciduous teeth and the possibility of osteogenic disease. Inflammatory and neoplastic processes were considered less likely due to the patient’s age and absence of other clinical abnormalities. Differential diagnoses for the patient’s stifle swelling, lameness, and pain included patellar luxation, atraumatic stress fracture of the patella, long bone fracture, soft-tissue or musculoskeletal injury (eg, cranial cruciate ligament injury), viral polyarthritis, and slipped capital femoral epiphysis.
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