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Equine Collagenolytic Granuloma (view source)
Revision as of 09:41, 8 August 2011
, 09:41, 8 August 2011Created page with "Also Known As: '''''Equine Eosinophilic Granuloma with collagen degeneration — Nodular Necrobiosis of Collagen''''' ==Aetiology== '''Equine Collagenolytic Granuloma's''' are t..."
Also Known As: '''''Equine Eosinophilic Granuloma with collagen degeneration — Nodular Necrobiosis of Collagen'''''
==Aetiology==
'''Equine Collagenolytic Granuloma's''' are the second most '''common''' '''nodular''' disease in the horse. The underlying cause of the disease is not fully understood but theories include '''insect hypersensitivity''' (especially mosquitoes), '''embedded hairs''' and '''trauma'''. In reality it is likely to be '''multifactorial'''. A similar disease can be seen in dogs and [[Feline Eosinophilic Granuloma|cats]].
==Clinical Signs==
The presence of one or more '''firm, non-pruritic, non-painful nodules'''. They are normally found on the '''neck''' and '''saddle area''' but may occur anywhere. Size varies from as small as '''half a centimeter''' in diameter to '''very large nodules'''. There may be a '''necrotic plug''' which appears whitish in colour, but overlying skin can be completely normal. The lesions may become [[Mineralisation - Pathology|'''mineralised''']] over time.
==Diagnosis==
'''Cytological''' analysis of '''FNA's''' may provide a diagnosis. Smears should show a '''chronic, active, sterile eosinophilic [[Chronic Inflammation - Introduction|inflammation]]'''. Eosinophils, neutrophils, macrophages and mast cells may all be present. This is common for a non-specific inflammatory response.
Diagnosis can be confirmed by '''biopsy'''. '''Histopathological''' examination should show a '''granulomatous eosinophilic inflammation surrounding multifocal areas of collagen degeneration'''.
==Differentials==
Any nodular disease may be considered a differential diagnosis. [[Hypoderma spp.|Hypoderma]] should be considered, but in these cases a breathing pore is normally present.
==Therapy==
* '''Surgery''' — complete surgical excision. Normally only appropriate for single lesions. This is the only effective treatment for mineralised lesions.
* [[Steroids|'''Glucacorticoids''']] — administered systemically or intralesional.
'''Systemic glucacorticoids''' are appropriate if there are multiple nodules. Treatment is normally with prednisolone. The other therapies mentioned may be used as adjuncts.
'''[[Steroids|Glucacorticoid]] administration intralesionally/perilesionally/sublesionally''' may be effective. Treatment is normally with either triamcinolone acetonide or methylprednisolone acetate. A total dose should be calculated prior to administration to prevent the development of [[Laminitis|'''laminitis''']] from exogenous steroids.
If the granulomas are recurrent it may be worth investigating underlying causes such as insect hypersenstivity. This can be achieved by intradermal allergy testing, and management of this using insect control measures and hyposensitisation may be enough to prevent recurrence in the future.
==References==
Bond, Hendricks, Loeffler (2009) '''Veterinary Dermatology''' RVC Intergrated BVetMed Course, ''Royal Veterinary College''
Freeman, KP (2007) '''Self-Assessment Colour Review of Veterinary Cytology - Dog, Cat, Horse and Cow''' ''Manson''
Merck & Co (2009) '''The Merck Veterinary Manual''' (Ninth Edition), ''Merial''
[[Category: To Do - Siobhan Brade]]
[[Category:To Do - Manson review]]
==Aetiology==
'''Equine Collagenolytic Granuloma's''' are the second most '''common''' '''nodular''' disease in the horse. The underlying cause of the disease is not fully understood but theories include '''insect hypersensitivity''' (especially mosquitoes), '''embedded hairs''' and '''trauma'''. In reality it is likely to be '''multifactorial'''. A similar disease can be seen in dogs and [[Feline Eosinophilic Granuloma|cats]].
==Clinical Signs==
The presence of one or more '''firm, non-pruritic, non-painful nodules'''. They are normally found on the '''neck''' and '''saddle area''' but may occur anywhere. Size varies from as small as '''half a centimeter''' in diameter to '''very large nodules'''. There may be a '''necrotic plug''' which appears whitish in colour, but overlying skin can be completely normal. The lesions may become [[Mineralisation - Pathology|'''mineralised''']] over time.
==Diagnosis==
'''Cytological''' analysis of '''FNA's''' may provide a diagnosis. Smears should show a '''chronic, active, sterile eosinophilic [[Chronic Inflammation - Introduction|inflammation]]'''. Eosinophils, neutrophils, macrophages and mast cells may all be present. This is common for a non-specific inflammatory response.
Diagnosis can be confirmed by '''biopsy'''. '''Histopathological''' examination should show a '''granulomatous eosinophilic inflammation surrounding multifocal areas of collagen degeneration'''.
==Differentials==
Any nodular disease may be considered a differential diagnosis. [[Hypoderma spp.|Hypoderma]] should be considered, but in these cases a breathing pore is normally present.
==Therapy==
* '''Surgery''' — complete surgical excision. Normally only appropriate for single lesions. This is the only effective treatment for mineralised lesions.
* [[Steroids|'''Glucacorticoids''']] — administered systemically or intralesional.
'''Systemic glucacorticoids''' are appropriate if there are multiple nodules. Treatment is normally with prednisolone. The other therapies mentioned may be used as adjuncts.
'''[[Steroids|Glucacorticoid]] administration intralesionally/perilesionally/sublesionally''' may be effective. Treatment is normally with either triamcinolone acetonide or methylprednisolone acetate. A total dose should be calculated prior to administration to prevent the development of [[Laminitis|'''laminitis''']] from exogenous steroids.
If the granulomas are recurrent it may be worth investigating underlying causes such as insect hypersenstivity. This can be achieved by intradermal allergy testing, and management of this using insect control measures and hyposensitisation may be enough to prevent recurrence in the future.
==References==
Bond, Hendricks, Loeffler (2009) '''Veterinary Dermatology''' RVC Intergrated BVetMed Course, ''Royal Veterinary College''
Freeman, KP (2007) '''Self-Assessment Colour Review of Veterinary Cytology - Dog, Cat, Horse and Cow''' ''Manson''
Merck & Co (2009) '''The Merck Veterinary Manual''' (Ninth Edition), ''Merial''
[[Category: To Do - Siobhan Brade]]
[[Category:To Do - Manson review]]