CHAPTER 23 EOSINOPHILIC DISEASE (GRANULOMA) COMPLEX 355
Injectable methylprednisolone: 20 mg/cat by subcutaneous route; repeat in 2 weeks (if
needed); tachyphylaxis common with repeated administration; not advised for long-
term therapy; increased risk for diabetes mellitus with repeated administration.Prednisolone (2–4 mg/kg PO), dexamethasone (0.1–0.2 mg/kg PO) or triamcinolone
(0.1–0.2 mg/kg PO); initial daily dosage tapered to minimal dose and frequency
required to control lesions; tachyphylaxis may occur and may be specific to the drug
administered.Cyclosporine: 7.5 mg/kg PO initial daily dosage tapered to minimal dose and fre-
quency required to control lesions.
Topical: fluocinolone/DMSO (Synotic lotion) to individual lesions; not practical
and/or may cause systemic effects in patients with large numbers of lesions.
Alternate Drugs
Chlorambucil: 0.1–0.2 mg/kg PO q48h to q72h.
Indolent ulcer: alpha-interferon: 300–1000 IU PO q24h in cycles of 7 days on, 7 days
off; limited success; side effects rare; no specific treatment monitoring required.
Doxycycline: 5–10 mg/kg PO q24h.
Megestrol acetate: 2.5–5 mg PO every 2–7 days; significant incidence of side effects
(diabetes, mammary cancer, epidermal atrophy) preclude use in all but severe, recal-
citrant cases (Figure 23.19).CEG (dog)
Oral prednisolone: 0.5–2.2 mg/kg PO q24h initially; then taper gradually (78% of
cases responsive to corticosteroids as a sole therapeutic).
Intralesional corticosteroids: 5 mg/lesion methylprednisolone.
Chlorambucil: 0.1–0.2 mg/kg PO q24h to q48h initial dosage.
Azathioprine: 1 mg/kg PO q24hrto q48h initial dosage.
Cyclosporine: 5 mg/kg PO BID to q24h initial dosage.
Cessation of therapy without recurrence is common.
Surgical excision of appropriate lesions/carbon dioxide (CO 2 ) laser ablation of the
site.
COMMENTS
Patient Monitoring
Treatment monitoring is based on medications prescribed (e.g., CBC, serum chem-
istry profile, and urinalysis with culture recommended frequently during treatment
induction and then every 6–12 months for patients on chronic immunomodulatory
therapy).Cats: patients must be FeLV/FIV negative; initial exposure to toxoplasmosis during
treatment with cyclosporine may be fatal.