Even a Kitten Can Have an Unusual, Terrible Problem
Or, When Eosinophilic Granuloma Rears It’s Ugly “Head” on a Paw
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.”
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?”
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:
To read more about eosinophilic granulomas: read VirtuaVet’s Eosinophilic Granuloma Complex in a Cat