The Cat with Lesions of the Eosinophilic Granuloma Complex

Key Questions

> How old was this patient when clinical signs were first recognized?
> Is the disease seasonal?
> Are there other clinical signs such as sneezing, coughing, or diarrhea?
> What do you feed the animal? Was a special diet used in the past?
> Was the disease treated before? If so, which drugs were used and how successful was treatment?
> What is used for flea control now?
> When was the last medication given?

Differential Diagnoses

All subsets of the eosinophilic granuloma are mucocutaneous reaction patterns in the cat.

> Indolent (or eosinophilic or rodent) ulcer commonly affects the upper lip unilaterally or bilaterally (Fig. 2-53), but may occur in the oral cavity or elsewhere on the body (Fig. 2-54). The well-circumscribed ulcers with raised borders are rarely painful or pruritic; frequently the owner is more bothered by the lesions than the cat. The differential diagnoses of the feline eosinophilic ulcer are neoplastic diseases such as squamous cell carcinoma and infectious ulcers (eosinophilic ulcers are often secondarily infected as well). Diagnosis is confirmed by biopsy. Prior antimicrobial treatment is recommended if cytology is indicative of infection.

> Eosinophilic plaques occur typically on the abdomen or medial thighs, are well-circumscribed, and severely pruritic (Fig. 2-55).

> Eosinophilic (linear) granulomas are nonpruritic, raised, firm, yellowish, and clearly linear plaques and occur most commonly on the caudal thighs (Fig. 2-56).

Differential diagnoses of both eosinophilic plaques and granulomas include neoplasias and bacterial and fungal granulomas (Table 2-10). Diagnostic procedures of choice are cytology and biopsy. After the diagnosis has been confirmed, the underlying cause needs to be identified, if possible, and treated.

Figure 2-53. Indolent ulcer in a 2-year-old female Domestic ShortHair (DSH).

Figure 2-54. Indolent ulcer of the nipple in a 4-year-old female DSH.

Figure 2-55. Eosinophilic plaques in the inguinal area of a DSH. (Courtesy of Dr. Sonya Bettenay).

Figure 2-56. Linear granuloma in a male 8-year-old DSH.

Figure 2-57. The cat lesions of the eosinophilic granuloma complex.