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Even a Kitten Can Have an Unusual, Terrible Problem

December 22, 2013

Or, When Eosinophilic Granuloma Rears It’s Ugly “Head” on a Paw

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Bombay sweetheart

Santana needed a miracle. The svelte, 4-,month-old, 5-pound golden-eyed Bombay cat sat, leg up, bits exposed, on a leather bench in Doc Truli’s examination room and fastidiously nibbled the underside of his right hind paw.

“Come here, little buddy,” said Doc Truli,” Let’s have a look at you.”

The Bombay charmer squeaked a grudging “urr” as Doc lifted him onto the exam table, careful now to brush up against his paws.

“Doc, the first doctor he saw tested for everything. But nothing has helped. As you can see, his pads look like they’re going to fall off and his poor paws bleed,” said Cyndee, Santana’s understandably worried human. “They tested for bacteria, fungus and viruses. We tried some cream and a spray and an antibiotic injection. None of it helped at all.”

Crusted, swollen, sore paws

Before treatment

Doc Truli gently pushed Santana’s inquisitive nose away from his foot, and turned the underside facing up. The devastation she saw looked painful to say the least. Crusted edges to the foot pads curled up and oozed blood mixed with clear serum from inside his paw. Plush fur at the margins gave way to grey, bald, dry flakey skin. Doc had seen paws like this before, never in a kitten so young.

“If I’m right, we need a biopsy and an analysis by a board-certified dermatopathologist (skin disease expert) in order to diagnose this problem,” said Doc Truli.

“Whatever he needs. It’s not getting better and we need to do something,” said Cyndee,” Is he going to be like this forever?”

Eosinophilic Granuloma

short-haired black cat with large yellow-gold eyes and a red sore on lip

This red, raw spot on a cat resembles ECG: feline eosinophilic granuloma complex

Commonly, eosinophilic granulomas (pronounced ee-owe-sin-owe-fill-ick) affect the mouth, sometimes sores on the back of the legs, or sores on the spine running along the top of a cat. The granulomas are thick areas of skin, very itchy, and filled with immune system cells called eosinophils. They are commonly called “rodent ulcers” when they appear on the edge of a lip.

They are diagnosed sometimes with cytology- taking a sample of cells from the surface of the sores and examining them under microscope enhancement. Sometimes they are obvious – like on the edge of a cat’s mouth. On the paws, however, there are many diseases that can make the paws look like Santana’s paws.

Differentials for Eosinophilic Granuloma on the Paws

  • Injury- chemical burns
  • Infection – bacterial, viral, fungal, parasitic
  • Autoimmune – eosinophilic, pemphigous
  • Toxic – liver disease

“We made sure we explored every possibility before we put the little cat under anesthesia and performed paw biopsies. While it looked like autoimmune disease – which logically would not respond to antibacterial and anti fungal treatments – many disease look identical and we need a careful analysis of a biopsy sample to be certain, especially since the treatments involve high doses of steroids,” says Doc Truli.

Santana’s biopsy procedure went well and he returned home the same night. Three days later, we had our diagnosis confirmed: eosinophilic granuloma complex. His treatment? High dose steroid injections every 2 weeks for 3 treatments. See the results for yourself:

crust between pads

crust on paw is better after 1 week

after treatment, paws are normal

almost healed 3 weeks later

After treatment, smooth, normal kitten pads

Bombay pads

To read more about eosinophilic granulomas: read VirtuaVet’s Eosinophilic Granuloma Complex in a Cat

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6 Comments leave one →
  1. Cayucos Jake permalink
    December 31, 2013 6:36 am

    I believe my cat has a Sebaceous Cyst on his tail. I was looking around to see if you have any information and/or pictures on the topic but couldn’t find anything specific. Can you point me in the right direction to find the info? The reason I believe he has this particular form of cyst comes from my dog having one several years ago. The one on my cats tail looks and feels the same as the one my dog had only a much smaller version. It’s perfectly round… well… maybe a little oval-ish, kind of spongy to the touch, is slightly warmer than the rest if his tail, moves freely when pushing it back and forth and is starting to ooze a substance that is white, greasy to the touch and has a sort of cream cheese consistency and look about it. Any info and/or advice would be greatly appreciated. By-the-way, I love your commitment to helping pet owners online and in the office. Thanks for your dedication and hard work.

    • January 1, 2014 10:37 am

      Boy, you are describing a cyst. The tail is a tough location because, if the cyst bothers him and keeps actively oozing, it might need to be surgically removed. And the tail is a small, cylindrical no-extra-skin kinda place for surgery. Sometimes I will remove benign lumps on a tail when they are small to head off a potential tail loss situation in the future.

      Good luck, a veterinarian who engages their mind to your situation would be helpful.

      -Doc Truli

      • Cayucos Jake permalink
        January 2, 2014 8:06 am

        Thanks Doc. Truli. I live in the country and the nearest town is quite small. We only have 1 veterinarian here. She’s very nice but also very busy. One time this very same cat had a lump under his chin that grew to a massive size by the end of the day. By that time the Doc’s office was closed and our kitty was going downhill fast. I have to use needles for medical reasons on a regular basis so I quickly made a tiny poke in the hopes if relieving the pressure enough to get him through the night. What came out was a green puss like liquid. It was obvious to me that he had an infection. So I quickly withdrew fluid into a syringe to bring to the Doc and then I took a clean bath towel and gently pushed as much if the fluid out as I could then I put 50/50 peroxide/water on his wound. When I brought him to the Doc the next day and showed her the fluid, she said I did well and may have saved his life which was a huge relief for us. Even though I’m a disabled Veteran, I don’t receive much compensation (barely over 700 US a month) and so I can’t afford to pay for things that I might be able to do on my own. So I asked the Doc if I could take care of it on my own and what should I do. She had me continue with peroxide for a couple days and trim back the dead tissue with scissors. It took quite a while for him to heal completely but he was a trooper and tolerated it all quite well. By-the-way, Doc said he had been bitten by a Recluse spider. As for this cyst though, if I take a sterile needle and made a hole, would it be wise to try to get some of the troublesome gunk out to relieve him of the pain? Should I leave it alone and hope it goes away on it’s own? It’s currently about the size of a large pea. Thank you so much for your help. I appreciate you.

  2. karen permalink
    December 23, 2013 1:00 pm

    Great story, a “miracle indeed. Thanks for sharing.

  3. December 22, 2013 10:07 pm

    So glad there was a happy outcome.

    • December 22, 2013 11:54 pm

      Thanks, Irene! The kitty runs and plays again. He’s pretty happy, too!

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