Recurrent feline gastrointestinal eosinophilic sclerosing fibroplasia and presumptive eosinophilic cystitis in a domestic short-haired cat: a case report

Abstract

This report describes recurrent feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) and eosinophilic cystitis in an 8-year-old domestic short-haired cat. The cat presented with incontinence, pollakiuria, vomiting and weight loss. An abdominal mass was palpated and ultrasonography revealed severe segmental thickening of the jejunal wall with loss of layering. Complete resection of the jejunal mass was performed. The resected mass was composed of branching trabeculae of dense collagen, intermixed with bundles of large fibroblasts and inflammatory cells, which is consistent with FGESF. One year later, a new mass reoccurred in another intestinal segment. Between both FGESF occurrences, mycoplasmas were cultured from urine and fine needle aspiration of the urinary bladder wall showed numerous eosinophils only; therefore, a presumptive diagnosis of eosinophilic cystitis was made. All haematological analyses performed within the one-year period revealed eosinophilia.

Feline gastrointestinal eosinophilic sclerosing fibroplasia presenting as a rectal mass

“…Up to 58% of patients with FGESF reported in the current literature showed a systemic eosinophilia, suggesting a potential, unusual presentation of feline eosinophilic granuloma complex. 4,7,9,10 However, our case, and cats reported elsewhere, 1,10 did not show systemic eosinophilia, indicating that a lack of systemic eosinophilia does not rule out FGESF. Furthermore, it is unclear whether the development of systemic eosinophilia is a negative prognostic factor for FGESF.…”

“…11 Interestingly, elevated CK levels were not seen in previously reported cases. [1][2][3][4][5][6][7][8][9][10][11][12][13] Another important aspect of FGESF is the therapeutic approach. Currently, multimodal therapy combining surgical debulking of the mass (biopsy vs complete surgical resection), symptomatic therapy, antibiotic therapy (especially if intralesional bacteria are found) and immunosuppressive therapy using prednisone or ciclosporin A has been described in the literature.…”

What is your diagnosis? Granulated cells in the urine of a cat

“…Eosinophilic cystitis has also been reported in dogs with uroliths and secondary non‐neoplastic bladder wall masses 5 . Eosinophilic cystitis has been reported in a single cat with recurrent feline gastrointestinal eosinophilic sclerosing fibroplasia; and whose urine also cultured positive for Mycoplasma 6 . There was no previous history of drug therapy in this animal, and no uroliths, sclerosing fibroplasia, or neoplasms were found in the bladder at post mortem.…”

Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia

“…2,[13][14][15] A mass in a second location develops in some of the cases, after surgical removal of the initial mass. 16,17 The prognosis varies between studies; however, no large studies on prognosis or response to treatment have been reported. 2 The objective of this study was to retrospectively evaluate a large number of cats with GESF, including their presentation, diagnosis, treatment, and outcome.…”

“…Surgical removal of the mass has been performed in most cases; however, several studies report medical management with administration of corticosteroids, cyclosporine, and mycophenolate 2,13‐15 . A mass in a second location develops in some of the cases, after surgical removal of the initial mass 16,17 …”