Feline Eosinophilic Complex

Although most people have never heard of it, feline eosinophilic complex is actually a relatively common skin disease that afflicts cats. Technically, eosinophilic granuloma complex refers to three related dermatological diseases: indolent ulcer, feline eosinophilic plaque, and feline eosinophilic granuloma. While each of these has a unique clinical appearance, they all share a characteristic microscopic appearance, as they are made up of eosinophils. In addition, all of these are common skin diseases seen in cats.

Feline eosinophilic complex can occur in all cats, of all breeds, all ages and both sexes.

Symptoms of feline eosinophilic complex
Since all of these conditions have their own presentations, I will discuss the symptoms and characteristics of each individually:

• Feline eosinophilic plaque: These appear as single or multiple lesions that are raised, red and may be ulcerated as well. While they can occur anywhere on the body, they are most often seen on the belly and back portion of cats’ thighs. The lesions are usually very itchy and cats will often lick them incessantly.
• Feline eosinophilic granuloma: There are two forms of eosinophilic granulomas in cats: cutaneous (meaning skin) and oral. The cutaneous form typically occurs as an isolated lesion that is raised, red, firm, linear and may be ulcerated. People often notice a hairless area and upon further inspection see a raised red lesion. Lesions can occur anywhere on the body but are most frequently found on the back of the thigh, the chin or the lip. When they occur on the lip, it appears swollen. The oral form of eosinophilic granulomas present as well-circumscribed firm masses or plaque like lesions on the tongue or roof of the mouth (palate).
• Indolent ulcer: Indolent ulcers most commonly occur on the upper lips of cats. The lesion starts as a small crater-like, erosive lesion that often enlarges without treatment. Cats with indolent ulcers can have small, barely noticeable lesions to large ulcerated lesions that disfigure the lips. Despite their often-angry looking appearance, indolent ulcers are usually not itchy or painful.

Causes of feline eosinophilic complex
All three variations of feline eosinophilic complex are believed to be caused by a hypersensitivity reaction, also known as an allergic reaction. This can be an allergy to fleas, food ingredients, pollen, dust, house mites or other environmental allergens (atopy).

Diagnosis of feline eosinophilic complex
Feline eosinophilic lesions are diagnosed based on physical examination findings and medical history. In addition, your veterinarian may recommend more testing to confirm the diagnosis and rule out other diseases like fungal infections or tumors. This may include getting cytology or a biopsy of a lesion. If your cat has a skin or oral lesion, don’t assume it is a feline eosinophilic granuloma or plaque. It is important to have your veterinarian examine your cat and make sure that it is not something else. For example, squamous cell carcinomas are common ulcerative tumors seen in the mouth of cats.

Treatment of feline eosinophilic complex
Treatment is aimed at causing the lesion to regress and at the same time addressing the underlying cause. For example, if your cat’s feline eosinophilic plaque is thought to be caused by flea allergies it’s imperative that your cat be treated for fleas and remains on year round flea protection. Failure to address and treat the underlying cause will typically lead to reoccurrence of lesions at some point in your cat’s life. Steroids are the most common treatment used to make the lesion disappear. If the lesions are infected, systemic antibiotics may also be needed.

Questions to ask your veterinarian:

• How long does it typically take for the lesions to go away after treatment?
• Are there any side effects of the treatment? What are they?
• When should I come in for a recheck?

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

EGC: Not So Easy as 1-2-3 Eosinophilic Granuloma Complex in Cats

Eosinophilic Granuloma Complex in Cats

Eosinophilic granuloma complex, or EGC for short, is a complicated and incompletely understood condition that affects cats. EGC is a skin condition and lesions can vary in size and location. What’s an eosinophil? Eosinophils are white blood cells that are often activated when the body is exposed to allergens or parasites.

There are several presentations of EGC: The first is thickening and ulceration of the upper lip known as a “rodent” ulcer. Despite looking rather painful, these lesions are not usually sore or itchy, but they can cause a rather dramatic physical change to the upper lip. The second is a thickened linear plaque that can be pink or yellowish in appearance and often occurs on the inside or back of the hind leg or on the abdomen. Eosinophilic plaques are sometimes itchy. The third is the granuloma which is often more of a raised, round lesion on the skin or sometimes inside the mouth on the tongue or palate. Sometimes, EGC also causes puffiness or swelling of the chin or lower lip. Lesions within the mouth can be quite painful and they sometimes look like tumors, so, biopsy is often recommended for these cases.

EGC is not contagious to other cats. It is an inflammatory condition caused by an inappropriate response by the cat’s immune system to some type of allergen (fleas or mosquitos, pollen, plastics, or foods/proteins) though in some cases, the underlying trigger cannot be identified.

EGC lesions are usually treated with steroids like prednisolone. Some cases may also require antibiotics. Lesions that are unresponsive to steroids or that continue to recur frequently are sometimes treated with other immune-suppressing drugs such as cyclosporine (one common brand is feline Atopica). If the underlying allergen can be identified such as with a food allergy, changing the diet to a hypoallergenic food or otherwise eliminating the allergen can aid in preventing lesions from re-occurring.

EGC lesions are not fatal, but they can sometimes impact a cat’s quality of life and they should always be evaluated to make sure they are EGC lesions and not a more serious type of tumor. Most cats have recurrent lesions, but they can often be controlled with medications and cats can live a relatively normal life with EGC.

If your cat displays any of these signs: swollen upper or lower lip, thickened pink skin on the hind legs or belly or your cat is having trouble eating or swallowing and/or you see an ulcerated area inside the mouth, have her seen by your vet to confirm that the lesions are EGC lesions and to get proper treatment for your cat with steroids or other medications.

This blog brought to you by the Patton Veterinary Hospital serving Red Lion, York and the surrounding communities.

Eosinophilic Granuloma Complex

Overview

Eosinophilic granuloma complex refers to a characteristic allergic skin reaction in cats and can manifest as different types of skin lesions referred to as eosinophilic plaques, eosinophilic granumolas or indolent ulcers. Flea allergy is thought to be the most common cause. Allergic reactions to food components, which are allergens that are inhaled into the respiratory system (atopy), and allergic reactions to other insects such as mosquitoes also can result in eosinophilic skin lesions. In unusual cases, an allergic cause cannot be found and a hereditary disorder is suspected. This complex is more common in female cats.

Eosinophilic plaques usually are found on the abdomen or the inner thighs. They are raised, red lesions that may be glistening in appearance or oozing serum. Eosinophilic plaque lesions are extremely itchy and often are surrounded by broken hairs from constant licking of the area.

Eosinophilic granulomas often are found on the backs of the legs, on the roof of the mouth or on the tongue, and on the lower lip. Lesions on the back of the legs usually are raised, round, and pink or yellow in color. More than one lesion may be present and they tend to occur in a linear distribution along the leg.

Indolent ulcers, also called rodent ulcers, almost always are found on the upper lip and usually are confined to one side. The lesions most often are raised and ulcerated.

Diagnosis and Treatment Notes:

• Eosinophilic granuloma complex is generally diagnosed with a thorough history, physical examination and skin biopsy.

• Treatment depends on the severity of the disease, your individual pet, and your veterinarian. Pets with eosinophilic granuloma complex are treated with flea control medication, corticosteroids, antibiotics, fatty acid supplements, hormonal drugs and possibly a special diet. Discuss treatment details when your pet is diagnosed with this condition.

What to Watch for*:

• Raised red skin lesions
• Ulcers on the lips, tongue or inside the mouth
• Excessive itching
• Hair loss

*Please notify us if you notice any of the above signs or if you have any questions!

Introduction

Feline eosinophilic granuloma complex (EGC) is a common finding in veterinary dermatology. 1 It comprises a group of reaction patterns that affects the skin, oral cavity and mucocutaneous junctions of cats. 1,2 EGC can be caused by a variety of factors but is most commonly thought to be the cutaneous manifestation of feline allergic disease. The three primary clinical lesions of EGC include indolent (also referred to as eosinophilic or rodent) ulcer, eosinophilic plaque and eosinophilic granuloma. All three lesion types share an inflammatory etiology and a pathogenesis involving an influx of eosinophils into dermal tissues. 3 This case describes an unusually severe clinical presentation of EGC that does not fit into one of the aforementioned clinical entities. Despite the novel appearance, the lesions responded to the therapies traditionally used to treat EGC.