Eosinophilic granuloma complex?

ldg

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Caution: Could seem disgusting!

Flowerbelle developed a small bump on the side of her neck early last week. We thought it was a scratch that got infected. She had to see the Vet a week ago today for her last lung worm shot. Doc said it seemed more like (I don't remember the name of it) - but basically it was fly larvae - that before that stage lived inside of her, worked its way up through her lungs and bronchial tubes and then worked its way out through her neck. It would finish developing into larval stage, then create a breathing hole. When it got to that point, we were to bring her in - they apply a little anesthetic, make incisions to make the hole a little larger and then just take out the thing.

Over the course of the week it grew to a pretty good size - like a quarter - then flattened out. No breathing hole ever developed.

We took her in to be spayed today, and the Vet said he'd take a look at it while she was sedated.

He called - and said it appeared to be EGC (Eosinophilic granuloma complex?) - but that they'd taken a biopsy and we'd have results (I think tomorrow?) - soon, anyway. He explained it as an allergic reaction to a parasite, and that it is not infectious (meaning it's not something our other cats can get from her).

Searching the Net.... it seems it's usually an allergic reaction to fleas (which she hasn't had for months now, since having been rescued), though sometimes identifying the source is impossible. However - from what I've read so far, it also seems that when this EGC manifests itself in the skin, it's usually on the lip, stomach, or inner thighs.

Anyone heard of this, and any ideas what the treatments might be?

Poor thing turned out to have a herpes virus in her left eye, and she's on antiviral drops 3 times a day, a cream to remove the excess liquid in the blisters on her eye (4 times a day), and 75mg of Lysine (to help improve the effectiveness of the antiviral) a day. And she HATES all of this. I'd hate to have her have to suffer through MORE medication (which I'm sure this means).

(If it's liquid, she laps anything up readily in a very small bit of cat milk. But pills are EXTREMELY difficult).

Poor thing!!!!

????????????????????

Thanks,

Laurie
 
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Poor Flowerbelle, and poor you. Of course I know nothing useful, so I'll just send you both hugs and well wishes
 

sandie

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There's like 3 forms of EGC. The biopsy will rule out anything else, and I am going to be anxious to see what it reveals. But the
Eosinophilic plaque can cause lesions can be found on the belly, inner thighs, or throat. A common cause is thought to be flea allergy, but atopy,triggered by allergens like pollens and dust, and food allergies also can cause EGC lesions in cats. An allergic response to mosquitoes is also possible.
Treatment is usually Corticosteroids.
 

cat-tech

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Assuming he did a cut biopsy, he pretty much ruled out cuterebra? (cuterebra is what he was first referring to, aka botfly larvae). While the biopsy should indeed rule in/out eosinophilic granuloma, I would still rule out concurrent infection of the original suspect :cuterebra infection, or, larvae yet infecting.

Adding to Sandie's post, any of the three forms of EGC (plaque, granuloma or indolent ulcer) are usually raised and visible lesions. It is the granuloma type that can occur anywhere on the body, including thighs, orally, foot pads. The plaque form usually occurs in the lower regions such as thighs, lower abdomen, etc. Rodent ulcers appear mainly on mouth and lip regions.

Determining the type will (help) determine the cause. Allergies to insects can include fleas, mosquitos and other insects...food allergies are also a common culprit. Some cases have been theorized as inheritable.

If the pathology comes back as any of the forms of EGC and your vet approaches corticosteroids (prednisone or prednisolone), please discuss with your vet about frequent monitoring of CBC, platelets and chemical screens while kitty is on this medication. Antibiotics may be another approach, as well as switching to a hypoallergenic diet as a process of elimination..................Traci
 
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ldg

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Tobycat, thanks for the hugs and good wishes!

Sandie and Traci, I can't thank you enough for the information. He did cut a biopsy, and my understanding is that he was able to already tell that it isn't cuterebra. (Thanks - I couldn't remember what he'd called it the first time, but that was it! I only remembered it being called "Acute something" by the time we got home. Must have been he was saying "she might have a cuterebra....")

I am SO GLAD we moved vets. This place is so professional, and this vet in particular (who has 20 years of experience) has totally thrown himself into Flowerbelle's case. He's done research on her conditions, he has independently called to say he found something, could we bring her in... he diagnosed the lung worm, has performed surgeries on her eye... then when the blisters didn't heal after the last surgery, he went searching for answers, and called us when he found them.

We'll see what the biopsy reports. We haven't had mosquitos around here for months. Unless it's like dustmites or a spider or something, I don't think it can be insect-related. She's an indoor-only cat and hasn't had a problem with external parasites for a long time.

But he definitely used the word "granuloma," and it is on her neck.

BTW - if this an allergy problem, could that also be the cause of her wheezing? We all originally thought the wheezing was from her lung worm & related scarring - and Sandie, you'll be happy to hear this - but last week when he gave her her last lung worm shot, they did a chest x-ray - and it was completely clear! He came in totally beaming and said he couldn't believe it - but there are NO SIGNS of any significant permanent scarring!!!!! I mean, he was really stunned, and said, "Kittens - go figure!!!!"

So we obviously asked about the wheezing and coughing - and he said that if she has cuterebra, as the thing made its way up through her system and out her neck that could account for it, and as soon as the thing developed and was removed and she healed up from that she should be OK.

But now that it appears that it is likely not cuterebra - could the EGC / allergies be responsible for her wheezing?

I know I'm going to get to ask him all these questions later today (or tomorrow, depending upon when he's willing to release her. They wanted to keep her there because of the multiple procedures and her small size).

Anway, thank you so, so much for helping me with this!
 

sandie

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I am so glad the lung worm is gone!!
To be honest, any of the research I have read on feline inhaled allergies don't cause wheezing. Someone else, or your vet may have more info. Since the chest x ray came back okay, the wheezing may not originate from the lungs. I know in my case, if you look at an x ray of her sinus cavity, you can see why it sounds like she's wheezing

At any rate, I am so glad she is getting the care she deserves. Make sure and let us know when you get the results and more info.
 

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I can't help you with the medical problems, but want to give you and Flowerbelle a big (((*hug*))). That girl's health problems just don't stop do they!?!?! She has gone thru more stuff than any kitten that I've ever heard of!! What a little trooper she is!
 

cat-tech

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Just to be on the safe side, did your vet ever do a heartworm test on her? If not, that would be one thing I would seriously consider, especially given your description of wheezing and coughing.

As for the lungworm, if the x-ray showed clear, I wouldn't think scarring would cause wheezing (nor EGC), but any number of things can, such as asthma, environmental allergens and pollutants, smoke, etc..................Traci
 

jcat

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You can find concise information about EGC at http:www.fabcats.org/is45.html
The pictures are of extreme cases, so don't let them upset you.
Our cat was diagnosed with it in July. He had a "rodent ulcer", cause unknown, on his upper lip, which disappeared after two cortisone shots two weeks apart. At the moment, he has a barely noticeable thickening of the upper lip in the same spot, and is getting one 500 mg. capsule of Omega 3 fatty acids in fish oil daily. He's been getting the oil on his food for one week, and if the thickening doesn't disappear in another two weeks, he's supposed to get another round of shots. He generally gets one capsule a week for "maintenance" between outbreaks.
It is possible for cats to have EGC internally, for instance in the lungs, stomach or bowels, but I'd assume that your vet would have spotted it on your cat's xrays if it were the cause of the wheezing.
EGC is very often a recurring problem, so you might want to see if there are English-language Yahoo groups (I participate in a German one), where you can exchange experiences and get helpful tips. Please discuss any "alternative treatments" with your vet before trying them, though.
 
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ldg

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Biopsy results: EGC. There was no sign of a cause. (Vet said they can determine if it's from a parasite or bug bite and it wasn't).

Also - her wheezing is almost gone, so now I'm thinking (and hoping) it was just the URI she had. Vet wants us to keep her on CEFA drops until she has the stitches out (Friday).

The Muro sodium chloride cream (4 times a day - Bausch & Lomb) and antiviral drops (3 times a day) are working wonders on her eye.
So far, we pretty much manage to sneak them in on her while she's asleep/napping, and it hasn't been too much of a problem for any of us (*phew*).

Re: EGC. Doc says that some kittens that develop EGC only have the condition as kittens, and that once they're a year - 1 1/2 years old it may not be a problem. However, should symptoms reappear, if they're on her neck again we should apply OTC corticosteriods for kids. (Didn't know human OTCS stuff was going to be the treatment, but wasn't surprised to hear treatment would be corticosteroids
). Obviously if that doesn't treat within a few days, we're to contact the vet. We can only pray that she grows out of it!!!

I didn't see the post re: heartworm before taking her to the vet. We'll ask them to test her on Friday when she's in to have her stitches out.

Thank you all sooooo much for your help, assistance, links, suggestions, good thoughts, etc. for this little girl!!!!!

Laurie
 
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