Feline Eosinophilic Granuloma

Description

Feline eosinophilic granuloma complex includes three lesions: 1)Eosinophilic ulcer which present on the lip or oral mucosa of middle-aged cats. 2)Eosinophilic plaque which present on the skin of the medial thighs and abdomen. or 3)Eosinophilic granuloma which present on the posterior aspect of the rear legs of young cats and also found on the tongue, palate and oral mucosa.

Eosinophilic granulomas of the oral cavity appear as yellow/pink raised linear lesions. They can occur on the oral mucosa, hard palate mucosa, soft palate, or the base of the tongue. Cats with eosinophilic lesions of the mouth often have concurrent skin lesions.

The cause of feline eosinophilic granuloma is unknown but it has been associated with food and insect bite allergies, atopy, immunosuppression, bacteral and viral infections.

Signalment

More commonly found in young cats (2-6 years) More common in females than males

Diagnosis

An ulcerated mass may be found at the base of the tongue or on the hard palate, the glossopalatine arches or anywhere else in the mouth.

Clinical Signs

• dysphagia
• halitosis
• +/- anorexia

Laboratory tests

• Peripheral blood eosinophilia may be present.

Biopsy

• A deep biopsy specimen of the mass is required for a definitive diagnosis
• Histology reveals an eosinophilic tissue infiltrate

Treatment

• Medical
  • Control ectoparasites
  • Diet trial and skin testing may be carried out to rule out food allergy and atopy
  • Antibiotics if there is evidence of a bacterial infection
  • Corticosteroid therapy if the patient is refractory to the above. Treatment should be tapered gradually once a response is seen then discontinued once signs have completely disappeared.
  • Chlorambucil may be useful in resistent cases

• Surgical
  • Surgical excision is required for large lesions that interfere with breathing or swallowing.

Prognosis

• Good but the lesion can recur.

References

• Tutt, C., Deeprose, J. and Crossley, D. (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) BSAVA

• Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier

From Pathology

This is a complex of diseases affecting skin and oral cavity mainly of cat, which include:

1. Oral eosinophilic granuloma
2. Linear granuloma of skin
3. Eosinophilic plaque of skin

Clinical

• Any age, but usually young adults.
• Mainly affects lips, may also occasionally affect frenulum of tongue.
• Sometimes called "rodent ulcer "
• Not neoplastic - it is an inflammatory disease but is progressive and destructive.

• May see small plaque or becomes very infiltrative.
• In worst cases may erode away whole nose.

Pathogenesis

• Histologically lots of eosinophils, polymorphs.
• Exaggerated eosinophilic response.