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Physeal Dysplasia with Slipped Capital Femoral Epiphysis in Cats

Physeal Dysplasia with Slipped Capital Femoral Epiphysis in Cats. James Montgomery, DVM September 22, 2008. Femoral capital physeal fractures. Trauma is the most common cause Most frequently in cats between 4 and 11 months Highest incidence in cats 6 to 9 months Treatment Conservative

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Physeal Dysplasia with Slipped Capital Femoral Epiphysis in Cats

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  1. Physeal Dysplasia with Slipped Capital Femoral Epiphysis in Cats James Montgomery, DVM September 22, 2008

  2. Femoral capital physeal fractures • Trauma is the most common cause • Most frequently in cats between 4 and 11 months • Highest incidence in cats 6 to 9 months • Treatment • Conservative • Surgical • Femoral head excision • Surgical reduction and stabilization with multiple pins • Physis typically closes between 30 and 40 weeks of age in cats

  3. Spontaneous capital physeal fractures • No history of trauma • Common presenting complaints • Lameness • Weakness • Decreased ability to jump • Common physical exam findings • Pain • Crepitus during flexion and extension of the hip • Muscle atrophy (less common)

  4. Spontaneous capital physeal fractures • Diagnosis may be challenging • Acute fractures • Minimal displacement • Chronic fractures with substantial metaphyseal osteolysis and sclerosis • Serial radiographs may be required • In children, ultrasonography can be used to diagnose acute slippage of the capital femoral epiphysis • Open leg lateral and frog leg views beneficial

  5. Spontaneous capital physeal fractures • More likely to be overweight, neutered males with delayed physeal closure • Radiographic abnormalities: • Salter Harris Type I • Variable degrees of fragment displacement • Osteolysis • Sclerosis • More severe changes in cats with more chronic fractures • Many cats are affected bilaterally (5 of 13 in Craig study) McNicholas, et al. JAVMA, 2002

  6. Histology • Growth plate thicker than normal • Loss of characteristic zonal stratification • Chondrocytes lack normal columnar arrangement • Grouped in clusters • Randomly interspersed within the physis • Also a feature of normally closing physes • Normal metaphyseal bone interspersed with fibrous tissue and necrotic tissue • More prominent in cats with chronic fractures McNicholas, et al. JAVMA, 2002

  7. Risk factors • Sex • Reproductive status • Delayed physeal closure • Abnormally high body weight

  8. Risk factors • McNicholas study (JAVMA 2002): • 25 of 26 cats male • All 26 neutered • 14 of 16 cats (those for which neutering age was recorded) were neutered at < 6 months of age • All had at least 1 radiographically open physis • Mean age of cats in study was 94.5 weeks • Hypothesize hypotestosteronism leads to delayed closure of the capital physeal growth plate • Increased exposure to cyclic shear forces

  9. Risk factors • Craig study -13 cats (Vet Pathol 2001) • 85% male • Average age 16.3 months (range 4.5 – 24 months) • 9 of 10 cats (for which weights were available) were overweight or obese • 23% were Siamese • Significantly greater than the percentage of Siamese in the control population (5%; 662/13,250)

  10. Slipped capital femoral epiphysis (SCFE) • Well-described entity in humans • Pathogenesis poorly understood • Primarily affects overweight adolescent boys • 13 years old on average • Male to female ratio ranges from 2:1 to 4:1 • Onset is atraumatic and often insidious • 21% to 80% of reported cases are bilateral • Undiagnosed cases are thought to be a frequent cause of DJD in later life

  11. Slipped capital femoral epiphysis (SCFE) • Good correlation between human syndrome and feline syndrome • A genetic etiology is supported • Male predominance • Siamese cats (Craig) • Endocrine disorders possibly contribute • Unclear if obesity is a symptom of underlying endocrine disorder or related to gonadectomy • Hypothyroidism and growth hormone deficiency diagnosed most commonly in humans with SCFE • No cats had signs of endocrine imbalance other than obesity (Craig)

  12. References Craig LE. Physeal dysplasia with slipped capital femoral epiphysis in 13 cats. Vet Pathol 2001;38:92-7. Fischer HR, Norton J, Kobluk CN, et al. Surgical reduction and stabilization for repair of femoral capital physeal fractures in cats: 13 cases (1998-2002). J Am Vet Med Assoc 2004;224:1478-82. McNicholas WT Jr, Wilkens BE, Blevins WE, et al. Spontaneous femoral capital physeal fractures in adult cats: 26 cases (1996-2001). J Am Vet Med Assoc 2002;221:1731-6.

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