Successful management of feline gastrointestinal eosinophilic sclerosing fibroplasia with mycophenolate mofetil and prednisolone following surgical resection in a cat

Abstract

A 1-year-old castrated male Ragdoll who showed a series of vomiting and had reduced appetite presented to a local animal hospital. Hyperthermia and tachypnea were observed in physical examination, and leukocytosis was detected in hematological examination. Abdominal ultrasonography revealed an intramural mass with irregular echogenicity extending from the pylorus to the duodenum and loss of intestinal wall layer with regional lymph node enlargement. After exploratory laparotomy for biopsy and symptomatic alleviation, histopathological evaluation revealed densely infiltrated eosinophils within the branching and anastomosing trabecular pattern of collagen by several spindle-shaped cells. Finally, the patient was diagnosed with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). Since the pathogenesis of FGESF is known to be abnormal immune response, immune-modulatory treatment was recommended following surgical resection. According to previous studies, mycophenolate mofetil (MMF) is known to potentiate the efficacy of prednisolone (PDS) for treating other immune mediate disease. Therefore, combination therapy was conducted in this patient. There has been no evidence of recurrence since the initiation of immunotherapy. This case showed the importance of accurate diagnosis as well as suggested one of therapeutic options for veterinary clinicians in medical treatment following resection of FGESF.