ISSN 2398-2950      

Patellar fracture and dental anomaly syndrome (PADS)

ffelis

Synonym(s): Knees and teeth syndrome, KATS, Patellar fracture and retained, persistent deciduous teeth

Podcast: Patellar fracture and dental anomaly syndrome


Introduction

  • Cause: unknown, hereditary cause suspected. Affected cats prone to pathological fractures.
  • Signs: lameness, discharging sinuses around the mouth and chin, mandibular (and maxillary) osteomyelitis, persistent nail bed infections.
  • Diagnosis: radiographic changes showing typical fractures, presence of persistent deciduous teeth or absence of adult teeth with presence of unerupted teeth on CT scans.
  • Treatment:  unknown for the syndrome. Individual fractures can be treated appropriately. Patellar fractures usually do well with conservative management. Persistent and unerupted teeth should be removed.
  • Prognosis: guarded, in over a third of cats they will develop fractures in other bones.

Pathogenesis

Etiology

  • Unknown, siblings can be affected.

Predisposing factors

General

  • None.

Pathophysiology

  • Unknown but some cats will have increased bone density, either generalized and small areas of increased bone density. The fractures are stress insufficiency fractures occurring consistently in similar bone and similar levels and fractures lines in these bones. Bones are often sclerotic prior to fracture or at the fracture site.

Timecourse

  • The first fractures occur when cats are usually 1-3 years of age. Preceding fractures of other bones reported, eg pelvis and calcaneus. Subsequent fractures occur with the tibia fracturing at an average age of 8 years.

Epidemiology

  • Reported all other the world.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Howes C, Longley M, Reyes N et al (2018) Skull pathology in 10 cats with patellar fracture and dental anomaly syndrome. J Feline Med Surg 1098612X18797368 PubMed.
  • Langley-Hobbs S (2016) Patella fractures in cats with persistent deciduous teeth - Knees and Teeth Syndrome (KaTS). Companion Animal 21 (11), 620-625 VetMedResource.
  • Langley-Hobbs S J, Ball S, McKee W M (2009) Transverse stress fractures of the proximal tibia in 10 cats with non-union patellar fractures. Vet Rec 164 (14), 425-430 PubMed.
  • Langley-Hobbs S J (2009) Survey of 52 fractures of the patella in 34 cats. Vet Rec 164 (3), 80-86 PubMed.

Other sources of information

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