Feline eosinophillic granuloma complexes

Question 1

Most likely underlying causes for EGC lesions are:

Ectoparasites

Allergies (flea, dietary, environmental)

But also?

Answer 1

Evidence of bacterial pyoderma found in 86% biopsies of eosinophilic plaques and lip ulcers

Potentiated amoxycillin 3 weeks

E/plaques: 4/8 cases with >70% reduction in lesion size

Lip ulcers: 2/8 cases with >70% reduction in lesion size

Question 2

The EGC does not represent a specific dermatological diagnosis and numerous aetiological that have been proposed as potential causes. The lesions are thought to represent a group of cutaneous reaction patterns to primary, underlying disease processes, mot commonly hypersensitivity disorders. The lesions included in the EGC include?

Answer 2

• Indolent (or eosinophillic) ulcers
• eosinophillic plaques
• eosinophillic granulomas

Question 3

What is the practical relevance of EGC?

Answer 3

The feline EGC comprises a group of clinically well recognised but poorly understood dermatoses that are common in cats.

In many cases lesions are severe and can be accompanied by varying degrees of pain/pruritis.

Lesions can become chronic and recurrent.

Therefore prompt diagnoses and treatment is very important.

Question 4

What are the possible aetiological agents of EGC?

Answer 4

Question 5

What are indolent ulcers and their differential diagnoses?

Answer 5

Question 6

What are eosinophillic plaques and what are d/dx?

Answer 6

Question 7

What are eosinophillic granulomas and what are the d/dxs?

Answer 7

Question 8

What is the diagnositc approach to EGC?

Answer 8

Question 9

Cats presenting with EGC lesions should be systemically well. Those showing signs of systemic illness should be?

Answer 9

Should be investigated for other problems as appropriate before treatment.

Question 10

What should you be concerned about when using ciclosporin to treat EGC?

Answer 10

Toxoplasmosis appears to be rare at standard doses of ciclosporin (7-7.5mg/kg), but could be more of a concern at higher doses.

Toxoplasmosis-naive cats may be at slightly higher risk of developing toxoplasmosis following treatment; preventative measures should be taken to avoid this including: avoiding raw meat, keeping cats indoors, fitting two bells to collar (to prevent successful hunting).

Toxoplasmosis positive cats however don’t appear to be at risk of recrudescence of latent disease.