Dedham Veterinary Associates

DVA 326 Bridge Street * Dedham, MA 02026 * 781.326.2800

The large cell pictured above

is an eosinophil. This cell is

surrounded by normal red blood cells

and is a component of the blood stream as

Well as the culprit in EGC.

Feline Eosinophilic Granuloma Complex

What is feline eosinophilic granuloma complex?

Feline eosinophilic complex, or EGC, is a group of skin and mouth conditions in which the predominant inflammatory cell is the eosinophil. Eosinophils are white blood cells that normally circulate in the blood and show up at sites of various inflammation in small numbers. EGC is caused when a large number of the gather at one site and cause inflammation. They look distinctly different from other white blood cells under the microscope. It is not completely known why these huge clusters of eosinophils form but usually an allergy or local immune mediated disease is associated. These lesions can look very different from each other but are all itchy and painful.

EGC can occur in many places and take many forms. These are the most common:

Redness, swelling and even ulceration (“rodent ulcer”) of the lips
Bumps and rows of bumps or raised ridges along the front of the neck or back of the legs
Swellings in the mouth with or without gingivitis
Red and swollen paw pads, one foot or more can be affected at once
Ulcerated, red, raised plaque on the belly, inner thighs, flank or neck

How is EGC diagnosed?

A biopsy of the lesion is diagnostic. Sometime cytology by impression of the lesion or needle aspirate will yield the diagnosis. Usually blood work and urinalysis are needed to rule out causative or associated systemic disease. Skin scrapes for mites and a thorough check for fleas or even preventative flea treatment is done to rule out involvement of these parasites. Since allergies are often involved, your veterinarian may suggest allergy testing or a hypoallergenic food trial.

What is the treatment for EGC?

Most EGC lesions respond well to steroids. Some cats do better with oral prednisolone, others respond well to a long-acting injectable steroid called Depo-medrol, some cats need both. If infection is present, then a course of antibiotics is prescribed. If an offending allergen is found, then it is eliminated if possible. Many cats have problems with plastic. It is always a good idea to eliminate all contact between plastic or synthetic fibers and the site of the EGC if possible (food dishes, toys, litter pans, beds, etc.). If an EGC is severe or keeps coming back, laser therapy or even surgical removal of the lesion may be recommended. Supplementation with essential fatty acids is thought to be beneficial. A supplement called Dermcaps may be recommended. Severe or recurrent cases may be referred to a veterinary board-certified dermatologist.

What is the prognosis?

Some cats will have only one episode of EGC that never recurs. Other cats will have recurrent episodes, sometimes a different form each time. These recurrences may happen over a few months or years and then they suddenly stop. This is especially true in younger cats – it is almost as if they “grow out of” the problem. Most commonly, EGC will appear suddenly and periodically occur throughout the life of the cat. If these episodes are easily controlled by medication, then the cat can lead a pretty normal and happy life. Rarely, there is a severe form of ECG that is resistant to medical treatment. This type of EGC is considered to indicate a significant problem with the immune system or even can be a form of autoimmune disease. If medical management cannot make the cat comfortable, then euthanasia may be the only fair action for the suffering patients in these rare circumstances.

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