Eosinophilic granuloma in 5 month old cat

Re: Eosinophilic granuloma in 5 month old cat

Anthony Todd — Mon, 18 Jul 2011 16:32:10 GMT

[quote user="SteveOwen"]Any evidence for efficacy of antihistamines in either cats or dogs? I've never come across any. [/quote]

Makes 'em scratch slower, that's all.

Re: Eosinophilic granuloma in 5 month old cat

Martin Atkinson — Mon, 18 Jul 2011 09:07:45 GMT

[quote user="SteveOwen"]

But then maybe you know more than dermatology diploma holders Martin?

[/quote]

I've been around a lot longer than most of them Steve and have a lot more experience so perhaps that means I do.

Re: Eosinophilic granuloma in 5 month old cat

Anthony Todd — Sat, 16 Jul 2011 21:01:54 GMT

[quote user="SteveOwen"]But then maybe you know more than dermatology diploma holders Martin?[/quote]

Probably not, depending on how you measure"know".

If you measure the number of uncontrolled itchy pets coming out of academia on ineffective antihistamines and too- low- dose- continuous- steroids then I'll go with experience and less knowledge any day.

Re: Eosinophilic granuloma in 5 month old cat

SteveOwen — Sat, 16 Jul 2011 18:32:39 GMT

[quote user="Kate Richardson"]

[quote user="mariette asselbergs"]

Ovarid obsolete? I can testify that I have cured three cats with milliary eczema which had been for years and years under several unsuccessful treatments with numerous vets and are now gorgeous wuithout any skin blemishes on 1/2 a tablet twice weekly. When they stop they are back to lesions and itchiness within a few weeks. I see the cats all the time because they belong to a neighbour and to my brother in law. So I definitely believe in a place for it as a last resort.

[/quote]

Any evidence for efficacy of antihistamines in either cats or dogs? I've never come across any.

I don't think you have "cured" them- you are controlling the clinical signs. Eosinophilic ulcers/miliary dermatitis have an underlying allergic/hypersensitivity cause, so the key is to find the cause and control that if possible, with fleas and diet being being high up the list of possibilities. Nothing wrong with controlling the clinical signs if you cannot identify or eliminate the cause, so if nothing else worked (ie pred, anti-histamines, cyclosporin, hypoallergenic diet, stringent parasite control etc etc, then I guess Ovarid has its place, but I agree would be last resort treatment. But most definitely not a cure!

[/quote]

Re: Eosinophilic granuloma in 5 month old cat

SteveOwen — Sat, 16 Jul 2011 18:24:36 GMT

[quote user="Martin Atkinson"]

[quote user="Laura Henderson"]

Ovarid?

[/quote]

My God when were you born Laura? I thought the use of Ovarid for skin disease in cats died with the last of the old codgers. There is absolutely no inidcation for it, corticosteroids will do the job as well with a fraction of the potential side effects, indeed I think its use is almost tantamount to professional misconduct and the same almost applies to depomedrone except as a last resort - both are banned from my practice!. Rant over, I have seen several cases of eosinophilic granulomas in such young cats and so long as they are dormant I do nothing, they usually resolve spontaneously although some wax and wain. Halitosis is more likely due to teething. They are usuallly associated with stress and immune mediated problems, so resolve those: good parasite control, consider hypoallergenic diet and Feliway and mood modifiers if appropriate. If it is a progressive condition causing problems for the cat, use preds and titrate to minimum effective dose at most every alternate day.

[/quote]

Ovarid for skin disease certainly did not die out with the last of the old codgers. In fact, at a recent CPD event presented by Tim Nuttall of Liverpool University's dermatology department, he said it works better than anything else for feline skin disease and should always be used if nothing else works (obviously the likes of pred, cortavance, atopica should be tried first). And it is very safe if used appropriately - usually 2.5mg a week is sufficient, But then maybe you know more than dermatology diploma holders Martin?

Re: Eosinophilic granuloma in 5 month old cat

Anthony Todd — Fri, 15 Jul 2011 15:17:16 GMT

[quote user="Martin Atkinson"]a bit of bad press[/quote]

I welcome bad press, meself actually 'cos otherwise I will persist in my stupid beliefs for ever.

Any references or reviews for OvarId [megestrol, for the genericisti] ] and mammary tumours please, was not aware of that?

What's against a single, big, ie 5mg Ovarid, or 5-10mg of pred as necessary for, let's call it "itchy skin" in a cat, so we've got a diagnosis and can therefore treat immediately before we have an eosinophilic granuloma.

As a side benefit we relieve suffering for the animal even if the vet has to admit to no diagnosis, which is why I liked the job?

Usually these doses are only needed weekly or seasonally, at most, so side effects seemed absent to me. The main thing is to give enough in one hit and repeat as necessary.

Often used to give "atopic" dogs pred, say 2.5mg/Kg as necessary in one oral dosefor the uncontrolled itchy dogs. Never seen vaccines etc. stop the itch and antihistamines never, made 'em scratch slower though......

Never used continuous low doses.

Re: Eosinophilic granuloma in 5 month old cat

Martin Atkinson — Fri, 15 Jul 2011 11:09:45 GMT

I've only just come back to this thread and I see since I've been gone I've had a bit of bad press. I'm sorry if I upset/annoyed some people, I do have forthright views and dish out critisism but I am equally prepared to receive it back - there is no malice. I forget that almost by default those who frequent this forum are probably at the top end of the thinking veterinary profession, it is just that I have for several years had to pick up the crap from neighbouring vets who clearly are not, and who have treated miliary dermatitis and eosinophilic granulomaa in cats with ovarid and caused iatrogenic mammary carcinomas and diabetes, and dogs with undiagnosed skin disease with long term corticosteroid therapy that has caused iatrogenic cushings disease and one that was turned into a generalised demodex case with almost fatal consequences.

Re: Eosinophilic granuloma in 5 month old cat

Anthony Todd — Thu, 14 Jul 2011 20:46:11 GMT

[quote user="fluffygirl"]And make sure the owner doesn't have loads of squirty air fresheners around the house.[/quote]

The dinosaurs will remember the "Shake and Vac" carpet cleaning powder furore before flea allergic derm. was fashionable.

The girl in the ad ran off with our local butcher......

Can't remember if it was ever proved, I mean the allergy!!

Re: Eosinophilic granuloma in 5 month old cat

Anthony Todd — Thu, 14 Jul 2011 20:42:10 GMT

[quote user="Rachel Perry"]one more thought-[/quote]

And a few others.

I am very upset when vets say they won't use steroids until they've got a diagnosis, fat chance with most "allergies" once fleas are eliminated.

Surely the "diagnosis" can proceed concurrently with relief of these distressing symptoms!

I've had a few cats that had confirmed [by elimination and challenge] dietary allergies, with the classic FAD signs. one was the legendary fish allergy.

Food also can give an allergic stomatitis,at least in humans.

Sublesional depomed works better IMHO in discrete lesions than sub-cut or I/M.

Frontline, again IMHO, isn't as effective [or wasn't] as some of the others like Advantage, the main thing is owner compliance, every 28 days even if adhered to religiously may not be often enough in some cases. Instructions should be "every 28days religiously" not "monthly".

Img pred is a totally inadequate dose for FAD in the cat; 5-10mg once only, at the first sign of symptoms works much better IMHO.

[quote user="Rachel Perry"]contact hypersensitivity- make sure no plastic food bowls, only ceramic/saucers![/quote]

Certainly occurs in the dog, I remember, so something to eliminate with those strange swollen chins.

Re: Eosinophilic granuloma in 5 month old cat

fluffygirl — Thu, 14 Jul 2011 19:02:22 GMT

[quote user="Rachel Perry"]

one more thought- contact hypersensitivity- make sure no plastic food bowls, only ceramic/saucers!

[/quote]

And make sure the owner doesn't have loads of squirty air fresheners around the house. Saw a cat once with hideous scabby face and rodent ulcers which cleared up in 3 days once the client had removed the offending smelly things.

Re: Eosinophilic granuloma in 5 month old cat

Rachel Perry — Thu, 14 Jul 2011 18:25:33 GMT

one more thought- contact hypersensitivity- make sure no plastic food bowls, only ceramic/saucers!

Re: Eosinophilic granuloma in 5 month old cat

Evelyn Barbour-Hill — Thu, 30 Jun 2011 21:41:48 GMT

[quote user="Martin Atkinson"]My God[/quote]

I thought you said you were an atheist?

Re: Eosinophilic granuloma in 5 month old cat

Amanda Nicholls — Thu, 30 Jun 2011 17:17:38 GMT

[quote user="mariette asselbergs"]

a buster collar on an itchy cat seems like torture to me.

Mariette

[/quote]

A buster collar on a cat is torture, only very occassionally essential. I recently saw a cat for a second opinion with a nasty eosinophilic granuloma on the inner thigh, had been wearing a buster collar on and off for more than 6 months while the previous vet was treating it - excellent flea control but not given more than 1mg pred per day for risk of side effects, it was also underweight due to not eating the d/d food the owners were told to feed exclusively. Sometimes these cases are not easy to diagnose or treat but I have no hesitation reaching for the depo medrone (especially in a really skinny cat!) to give it a quality of life. The depo med only worked for 3 weeks and the cat is now doing great on atopica every 4th day and no buster collar!!!

Re: Eosinophilic granuloma in 5 month old cat

Evelyn Barbour-Hill — Thu, 30 Jun 2011 17:04:59 GMT

[quote user="mariette asselbergs"]And to be honest, a buster collar on an itchy cat seems like torture to me.[/quote]

Nicely put.

In the brave new world of the new Belgravia House Code, when Martin is the Supreme Commissar of the DC he will strike me off for sometimes using Depo-Medrone.

Ha! After the coup, I will be Number One Boss and President-for-Life and I will strike him off for using buster collars.

Re: Eosinophilic granuloma in 5 month old cat

Bob Russell — Thu, 30 Jun 2011 16:49:03 GMT

Short term side effects with ovarid (mostly from memory) are minimal. Boosted appetite most noticeable to clients. Longer term also less obvious than with pred for example. Not a product we have on our shelves any longer though!

Re: Eosinophilic granuloma in 5 month old cat

Noweia — Thu, 30 Jun 2011 16:19:08 GMT

[quote user="Martin Atkinson"]

[/quote]

I have seen far more steroid side effects than with Ovarid. So please don't jump down my throat, thanks. It this kind of post that puts a lot of people off posting here.

Re: Eosinophilic granuloma in 5 month old cat

Martin Atkinson — Thu, 30 Jun 2011 15:37:28 GMT

[quote user="bob lehner"]

Just curious - how does this tally with your comment on another post (19/1/11) ' no it hasn't had any corticosteroids - my practice is a steroid free zone!'

[/quote]

Blimey Bob you clearly have a better memory than me or a bee in your bonnet. Nothing like taking things out of context and remember I'm often playing Devils'advocate but I'm sure what I said or at least meant to say was, 'my practice is a steroid free zone...until a diagnosis has been made and other options have been considered and eliminated. It is certainly a depot-steroid zone - except every 2nd blue moon. I hope you haven't been storing other examples of my pontification on the use or not thereof or I might think you're a stalker.

Re: Eosinophilic granuloma in 5 month old cat

mariette asselbergs — Thu, 30 Jun 2011 15:13:00 GMT

Martin,

I do agree wholeheartedly with you that diagnostics must be done completely and treatments aimed at the established cause in the first place. But these are three cases which I have followed for years going from vet to vet and getting more and more desperate. I have made sure that their flea control was perfect and tried if a cycle could be broken with some short acting cortico's. Nothing worked, and the ovarid, tried in despair as a last result gave complete recovery within weeks, and then we tried the lowest possible dose and this works perfectly.

These cats were not just a bit itchy, they licked their complete skin off, unless given a huge cortico shot which their other vets did, which only controlled it for a little while, until when it started relentlessly again. These cats never grew normal fur. All work up and feliways and everything had been tried. What they are now on is what in my dinosaur days female cats (among them my own) took every week as birth control for 10, 15 years, without mammary tumours or diabetes, so I am really not that worried. And to be honest, a buster collar on an itchy cat seems like torture to me.

Mariette

Re: Eosinophilic granuloma in 5 month old cat

bob lehner — Thu, 30 Jun 2011 14:51:59 GMT

[quote user="Martin Atkinson"] I might try a quick shot of dexamethasone just to break the cycle and follow the above treatment plans and 90% of these cats with even severe dermatitis will respond satisfactorily. Of the remainder alternate dose preds will be effective, Cortavance and a buster collar for a few days also works, [/quote]

Just curious - how does this tally with your comment on another post (19/1/11) ' no it hasn't had any corticosteroids - my practice is a steroid free zone!'

Re: Eosinophilic granuloma in 5 month old cat

Martin Atkinson — Thu, 30 Jun 2011 14:36:39 GMT

For sure some of these cases can be a challenge. You need to differentiate between miliary dermatitis which is invariably FAD and dermatits allergic or otherwise with another cause. Atopy seems to be fairly rare in cats so a high proportion of the non-responders may be food allergies. Elimination diets can be difficult with cats but worth a try. IME a very high proportion of these cats are obsessive groomers and FAD is just the trigger because of stress/psycological problems so use Feliway +/- behavioural modifying drugs/diets and discuss their home situation to see where these problems can be addressed. In some Omega 3 supplement can be very helpful. I might try a quick shot of dexamethasone just to break the cycle and follow the above treatment plans and 90% of these cats with even severe dermatitis will respond satisfactorily. Of the remainder alternate dose preds will be effective, Cortavance and a buster collar for a few days also works, I may have once since the last blue moon given a cat with an owner who couldn't comply with tablets a shot of depomed but I cant remember when. When I qualified it was taught that miliary dermatiits was a hormone deficiency and that was why Ovarid works because of course the vast majority of cats are neutered so q.e.d! Now I believe it works because it is metabolised to an anti-prostaglandin/cortiocosteroid like substance so why not start with the corticoid in the first place? All this assumes that you did a proper derm. work-up to start with. If you still want to use Ovarid or depot cortico-steroids I would suggest that you ask your clients if they would rather put up with a bit of an itchy cat or risk mammary carcinoma and/or diabetes, I have seen a few of those - from other vets I hasten to add.

Re: Eosinophilic granuloma in 5 month old cat

mariette asselbergs — Thu, 30 Jun 2011 14:07:21 GMT

And behavioural problems, I don't know, they don't show any behaviour problems, are free to go outside, seem to be perfectly happy.

The owners and the cats were driven to despair, one of them is a persian, and it is now a gorgeously looking cat again, calm and contented. Has been on it for 2 years now, no problems.

Mariette

Re: Eosinophilic granuloma in 5 month old cat

mariette asselbergs — Thu, 30 Jun 2011 14:02:37 GMT

They used stronghold consistently every month, no result in terms of licking them selves raw and being full of scabs.

Mariette (Kidderminster, UK)

Re: Eosinophilic granuloma in 5 month old cat

Martin Atkinson — Thu, 30 Jun 2011 13:53:38 GMT

[quote user="mariette asselbergs"]

Mariette

[/quote]

Don't you have flea control in The Netherlands? 99% of miliary dermatitis is caused by flea hypersensitivity. Frontline does not work for this because the cats lick it off, use Stronghold and sort out the the behavioural problems that are aggravating the condition causing the cats to obsessively groom and FAD will be a thing of the past. For sure Ovarid will work fantastically well but the H bomb on Nagasaki made the Japanese surrender! You're treating the symptoms not the cause, you've not 'cured' anything and when you have seen some Ovarid induced mammary tumours and unstable diabetes maybe you'll change your opinion.

Re: Eosinophilic granuloma in 5 month old cat

Kate Richardson — Thu, 30 Jun 2011 13:51:36 GMT

[quote user="mariette asselbergs"]

[/quote]

Re: Eosinophilic granuloma in 5 month old cat

mariette asselbergs — Thu, 30 Jun 2011 13:03:16 GMT

Mariette