(06) - Feline Eosinophilic Granuloma Complex

Question 1

1. The eosinophilic granuloma complex includes a group of lesions that affect the skin, mucocutaneous junctions and oral cavity of cats.
2. Depending on the type of lesion and body location, the disease can have a variable history and clinical presentation.
3. What Three lesions have been recognized?
4. The etiology is unknown but, some cases are associated with allergic conditions, genetic factors and rarely bacterial infection.

Answer 1

3. the eosinophilic ulcer, the eosinophilic plaque and the eosinophilic granuloma.

Question 2

1. Indolent ulcer, also called eosinophilic ulcer or rodent ulcer, is a common cutaneous,
   mucocutaneous, and oral mucosal lesion of cats.
2. What is the etiology?
3. However, some cases may be associated with what?

Answer 2

2. unknown

3. allergies or genetic factors

Question 3

1. There is no age or breed predilection, but what may be predisposed?
2. The lesions have variable sizes and are well-demarcated with raised margins and a central granular and glistening ulcerated area.
3. Most indolent ulcers occur where?.
4. Lesions recur frequently and, occasionally they will be refractory to treatment
5. Rarely, an indolent ulcer will transform into what?

Answer 3

1. females
2. unilaterally on the upper lip (However, lesions can be bilateral and also occur in the oral cavity or in other areas of the skin.)
3. a squamous cell carcinoma.

Question 4

1. The history and clinical signs are usually diagnostic of indolent ulcers.
2. It is important to try to identify any underlying conditions such as food allergy and atopy while also maintaining a good flea control.
3. What may be necessary to rule out neoplasia and infectious granulomas?

Answer 4

3. Biopsies

Question 5

1. Look for an underlying condition and try to resolve it if feasible, or to control it.
2. What are often needed to control the lesions?
3. Lesions often recur and animals may need to be maintained on long-term alternate schedule of oral
   glucocorticoids or periodic injectable glucocorticoids
4. What has been also shown to be efficacious and it is a good alternative to glucocorticoids?
5. What is an option for cases that do not respond to glucocorticoids or gold salts?
6. Treat secondary infections!

Answer 5

2. Injectable or oral glucocorticoids
3. Oral cyclosporine
4. Chlorambucil or gold salts

Question 6

1. The etiology of eosinophilic plaque is unknown. However, the eosinophilic plaque is thought to be a hypersensitivity reaction to what?

Answer 6

1. fleas, food, or environmental allergens

Question 7

1. Most eosinophilic plaques occur where?
2. Lesions may be single or multiple, and they may occur on mucocutaneous junctions or in other areas of the skin.
3. Lesions often will have an eroded or ulcerated surface and have variable sizes.
4. Pruritis present?
5. Most plaques occur in allergic patients.

Answer 7

1. on the ventral abdomen and medial thighs

4. yes - often severe

Question 8

1. Diagnosis is based on history and clinical signs.
2. Skin biopsy is important to rule out what and what?
3. It is necessary to try to identify an underlying allergic condition (food elimination trial, and /or
   intradermal testing, flea control).

Answer 8

2. infectious granulomas (bacterial, fungal) and neoplasia (mast cell tumor, lymphoma).

Question 9

1. Treat appropriately any identified underlying allergic condition
2. All aspects of treatment are similar to the ones already described for indolent ulcer

Answer 9

d

Question 10

1. Feline eosinophilic granuloma is a common cutaneous, mucocutaneous and oral mucosal lesion of cats.
2. The pathogenesis and etiology of eosinophilic granulomas are unknown but, in some cases an allergic etiology has been reported.
3. Genetic factors may also play a role in the pathogenesis of this condition.

Answer 10

d

Question 11

1. The clinical presentation varies according to the location of the lesion.
2. Lesions are raised, alopecic, yellow or pink in color.
3. Depending on the location, the lesions may ulcerate and may have a linear or nodular configuration.
4. Linear lesions are more frequently seen where?
5. Lesions on the feet and oral cavity are what?
6. Eosinophilic granuloma is the most common cause of lower lip swelling (pouting) and nodules and asymptomatic swollen chins (fat-chinned cats) in the cat.
7. Some cats with severe eosinophilic granuloma lesions have peripheral eosinophilia and eosinophilic lymphadenopathy

Answer 11

4. on the caudal or medial aspects of the thighs (and they are asymptomatic and can spontaneously regress)
5. nodular (usually ulcerated and will cause discomfort to the animals to walk or eat.)

Question 12

1. The history and clinical signs are very suggestive of eosinophilic granuloma.
2. All allergic causes, including food, atopy and fleas should be ruled out.
3. What are indicated to rule out the various differential diagnoses?

Answer 12

3. biopsies

Question 13

1. Any specific hypersensitivity reaction should be identified and controlled (food, atopy, flea,).
2. Linear granulomas are usually asymptomatic and do not need to be treated. Most cases have
   spontaneous resolution.
3. All other aspects of therapy are as described for indolent ulcer

Answer 13

d