Eosinophilic granuloma

[Chris]

Hi Gesine, if you can provide some more info about the granuloma and some therapy approaches so far, that could help me provide you with some more information.

However, you can find some good general information with our article Eosinophilic Granuloma Complex in Cats.

Essentially, an eosinophilic granuloma is related to some kind of allergy response. The allergy itself can be a number of things from something environmental to being connected to a food allergy. Some eosinophilic granulomas pop up because of a single isolated allergy response while others are due to chronic recurrence.

Usually we treat these initially with a steroid like prednisolone combined with an antibiotic. A lot of times the lesions have secondary infection present that makes them more irritating.

Sometimes if they’re from an isolated cause, a course of steroids will resolve them. The allergy cause is still present and the granuloma returns, one approach is with long-term medication like cyclosporine (Atopica) to suppress the immune response.

Allergy testing is sometimes helpful, although you can’t always intervene against the allergen if it’s a common one like dust or storage mites in the home. Elimination or prescription diet trials can also help to determine if a food allergy is related.

cats.com

Eosinophilic Granuloma Complex in Cats - Cats.com

In this guide, JoAnna Pendergrass, DVM explains the symptoms, diagnosis, and treatment of eosinophilic granuloma complex in cats.

[Gesine]

Chris, thank you soooo much for your reply, although I am aware of everything you speak of. My cat Louie seems to be getting worse each year. It also seems to be seasonal. I live in Southern California (Temecula, more inland than coastal). He was a free-roaming cat in his previous life, which I didn’t know about when I adopted him. During our Winter, all the way to May, he is fine. But, I’m jumping ahead. Louie wants to be outside, so I provide him with a complete cat-safe backyard. He cannot be allowed to roam free because we have coyotes in this area. So, it’s in the house or in the backyard, where he is happy. He likes to lie under my bushes and sleep. As of May, all the way to when our temps get cooler (November), he is plagued with this disease. That’s almost 5 months when I can’t let him out. But, since he has me wrapped around his “Paws”, I let him out in the am for 15 min. Evidently, that’s enough to kick in the allergy. He is now getting depressed and screams to go out. He’s had some bad skin lesions and licks a certain part (i.e. his paw this time), until it’s raw. Vet prescribed steroids every 2 months, and they don’t seem to help him either, even with a stronger dose each time. Now, he’s on 25 mg of Trazodone just to relax him, and I have a Feliway plug-in under his cat post. I’m sorry for this long rant. I’m just so glad that I can speak with someone, as I am so unhappy that my beloved cat is so unhappy. Please let me know if I can provide anything further. I look forward to your reply! Gesi 🙂

[Chris]

Hi Gesi, that’s tough. I guess at least it’s seasonal and not a year-round problem. If you have difficulty controlling the flares with steroids, there may be few other options because they’re a hallmark of therapy and usually have good effect (unless there’s a secondary infection present requiring antimicrobials which is common). I’m not clear of course specifically why they wouldn’t be working well unless it’s just the persistent allergen exposure (or secondary infection not controlled, or flea exposure). Now since this is predominantly a skin issue, one thing you could consider would be environmental allergy testing (avaialble either as blood testing often through a general practice vet or skin testing with a dermatologist) to not only see what your cat is most allergic to, but also to develop an immunotherapy based on the worst ones. Immunotherapy is either in an oral drop form or an under the skin injection. There’s a certain schedule of frequency to follow depending on the company/product used. This in theory could help your cat develop immunity to the worst allergens. It can take several months, but perhaps if you were able to get testing completed and start immunotherapy right at the tail end of the bad season and continue during the colder months, immunity might be built up by the time spring rolls around. It might be worth asking your vet about if you have not yet.