When steroids quit workingfor eosinophilic granuloma complex in cats

When steroids quit workingfor eosinophilic granuloma complex in cats

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Aug 01, 2003
12Next Q. I have a cat with a rodent ulcer that used to respond to steroid injections. Is there anything new for this? A. I am faced with this question at least once weekly from referring veterinarians. My response is: I wish it were that simple! Photo 1: Eosinophilic plaque lesions on ventral abdomen. Note the red, raised, almost "glistening" quality to the lesions.Unfortunately, there is no standard therapy for eosinophilic granuloma complex (EGC) lesions in cats that doesn't involve finding out the etiology of the likely underlying allergy ... and that takes some detective work. Formerly, most of us treated EGC lesions with methylprednisolone acetate injections every two weeks for a total of three injections. Now that we are more cognizant of steroids inciting diabetes in cats or reports of even one dose of methylprednisolone acetate weakening cardiac muscle, a more concerted effort must be made to determine the underlying reason for the EGC lesion(s). Underlying allergy (ectoparasite, food allergy, food storage mite allergy, contact allergy or atopy), bacterial infection, or inheritability seem to be at the underlying etiology of most cases of EGC lesions. Photo 2: Severe eosinophilic plaque lesions on the ventral abdomen of a cat with flea allergy dermatitis.EGC lesionsEGC lesions consist of feline indolent ulcer (rodent ulcer), eosinophilic plaque and eosinophilic granuloma (Photos 1 and 2). A patient may have one or a combination of lesions at the same time. Indolent ulcers involve the upper lip and sometimes the oral cavity. Usually accompanying eosinophilia is not present. Occasionally indolent ulcers can undergo a malignant transformation. Feline eosinophilic plaques are usually seen on the ventral abdomen or medial thighs. The owner reports constant licking of the area and the lesions reflect this attention-erythemic, raised, weeping and usually multiple. Systemic eosinophilia is often present. Cytology of a lesion reveals eosinophils and neutrophils. Linear granuloma is usually seen on the caudal thighs and consists of yellow-to-pink raised non pruritic plaques arranged in a linear fashion. Of the three types of lesions, linear granulomas are most often seen in young cats