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Eosinophilic Granuloma Treated with Prednisolone and Azathioprine in a Dog

  • Jang, Moonseok (College of Veterinary Medicine, Chungnam National University) ;
  • Lee, Wanghui (College of Veterinary Medicine, Chungnam National University) ;
  • Park, Seongjun (College of Veterinary Medicine, Chungnam National University)
  • Received : 2022.04.18
  • Accepted : 2022.07.13
  • Published : 2022.08.31

Abstract

A two-year-old, intact male, 45 kg Doberman Pinscher was referred with dermal nodular lesions affecting the left hindlimb. The cytological examination revealed eosinophilic inflammation. Skin biopsy specimens showed canine eosinophilic granuloma (CEG). The dog was administered oral prednisolone (1.5 mg/kg/day) and azathioprine (2 mg/kg/day). After one week, the skin lesions diminished dramatically, but the dog presented with severe watery diarrhea. The prednisolone dose was reduced by 0.9 mg/kg/day. The lesions and diarrhea improved markedly after one week. Prednisolone was tapered by 25% of the previous dose every week to 0.2 mg/kg/day. Azathioprine was also reduced to therapy every other day. After seven weeks of combination treatment, the medications were withdrawn, but the dog had a recurrence one week later. Azathioprine (2 mg/kg/EOD) was reintroduced for two weeks. There was no relapse after all the medications had been withdrawn. This case indicates that CEG can be managed with prednisolone and azathioprine. Azathioprine may be an effective adjunctive immunosuppressive agent, and may be considered as a well-tolerated prednisolone sparing agent to treat CEG.

Keywords

Acknowledgement

This work was supported by research fund of Chungnam National University.

References

  1. Declercq J, Vercauteren G. Necrotizing eosinophilic dermatitis in three dogs. Vlaam Diergeneeskd Tijdschr 2019; 88: 91-96. https://doi.org/10.21825/vdt.v88i2.16030
  2. Emery CB, Affolter VK, Outerbridge CA, Lam ATH, White SD. A case of atypical multifocal nodular eosinophilic dermatosis in a Labrador retriever dog. Vet Dermatol 2020; 31: 321-e82. https://doi.org/10.1111/vde.12850
  3. Gross TL, Ihrke PJ, Walder EJ, Affolter VK. Nodular and diffuse diseases of the dermis with prominent eosinophils, neutrophils, or plasma cells. In: Gross TL, Ihrke PJ, Walder EJ, Affolter VK, editors. Skin diseases of the dog and cat: clinical and histopathologic diagnosis. 2nd ed. Oxford: Blackwell Science Ltd. 2005: 342-372.
  4. Gross TL, Ihrke PJ, Walder EJ, Affolter VK. Pustular and nodular diseases with adnexal destruction. In: Gross TL, Ihrke PJ, Walder EJ, Affolter VK, editors. Skin diseases of the dog and cat: clinical and histopathologic diagnosis. 2nd ed. Oxford: Blackwell Science Ltd. 2005: 450-453.
  5. Kim JH, Jung JY, Kang SC, Lee YR, Lee JY, Hwang EK, et al. Eosinophilic granulomas in two dogs. Korean Soc Vet Sci 2011; 51: 69-72.
  6. Knight EC, Shipstone MA. Canine eosinophilic granuloma of the digits treated with prednisolone and chlorambucil. Vet Dermatol 2016; 27: 446-e119. https://doi.org/10.1111/vde.12355
  7. Mendelsohn D, Lewis JR, Scott KI, Brown DC, Reiter AM. Clinicopathological features, risk factors and predispositions, and response to treatment of eosinophilic oral disease in 24 dogs (2000-2016). J Vet Dent 2019; 36: 25-31. https://doi.org/10.1177/0898756419834785
  8. Miller WH, Griffin CE, Campbell KL. Miscellaneous skin diseases. In: Miller WH, Griffin CE, Campbell KL, editors. Muller and Kirk's small animal dermatology. 7th ed. St. Louis: Elsevier. 2013: 707-711, 714-718.
  9. Norris JM. Cutaneous eosinophilic granuloma in a crossbred dog. Aust Vet Pract 1994; 24: 74-78.
  10. Poulet FM, Valentine BA, Scott DW. Focal proliferative eosinophilic dermatitis of the external ear canal in four dogs. Vet Pathol 1991; 28: 171-173. https://doi.org/10.1177/030098589102800210
  11. Scott DW. Cutaneous eosinophilic granulomas with collagen degeneration in the dog. J Am Anim Hosp Assoc 1987; 19: 529-532.
  12. Sykes JM 4th, Garner MM, Greer LL, Lung NP, Coke RL, Ridgley F, et al. Oral eosinophilic granulomas in tigers (Panthera tigris)--a collection of 16 cases. J Zoo Wildl Med 2007; 38: 300-308. https://doi.org/10.1638/1042-7260(2007)038[0300:OEGITP]2.0.CO;2
  13. Vercelli A, Cornegliani L, Portigliotti L. Eyelid eosinophilic granuloma in a Siberian husky. J Small Anim Pract 2005; 46: 31-33. https://doi.org/10.1111/j.1748-5827.2005.tb00272.x
  14. Viviano KR. Update on immununosuppressive therapies for dogs and cats. Vet Clin North Am Small Anim Pract 2013; 43: 1149-1170. https://doi.org/10.1016/j.cvsm.2013.04.009
  15. Wallisch K, Trepanier LA. Incidence, timing, and risk factors of azathioprine hepatotoxicosis in dogs. J Vet Intern Med 2015; 29: 513-518. https://doi.org/10.1111/jvim.12543