Dexamethasone for treatment of multisystemic eosinophilic epitheliotropic disease in a horse.
A 4-year-old Paint mare was examined because of respiratory tract infection, dermatitis, and weight loss of 2 months' duration. Initial examination revealed generalized pruritic dermatitis, ocular and nasal discharges, and stranguria. Laboratory abnormalities included leukopenia and hypoalbuminemia. Further examination of the respiratory tract revealed grade III of IV pharyngitis and pyogranulomatous pneumonia. Endoscopic examination of the bladder revealed a prolific mass at the junction of the bladder and urethra. Hypoproteinemia was suspected to be caused by protein-losing enteropathy. On histologic examination, skin, rectal, pharyngeal, and urethral biopsy specimens were characterized by infiltration of eosinophils and lymphocytes, and a diagnosis of multisystemic eosinophilic epitheliotropic disease was made. The horse improved following treatment with dexamethasone, trimethoprim-sulfamethoxazole, and an antihistamine and was discharged after 19 days of hospitalization. Treatment with dexamethasone was continued for 4 weeks after hospitalization but was then discontinued. Eight months after discharge, the horse was performing as a pleasure horse and did not require any medical treatment. Multisystemic eosinophilic epitheliotropic disease is typically associated with a poor prognosis in horses. The dermatitis, protein-losing enteropathy, and lower respiratory tract disease in this horse were consistent with previous reports; however, pharyngitis and urethritis have not, to our knowledge, been previously reported in horses with this disease.
McCue
Molly E
ME
Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
Davis
Elizabeth G
EG
Rush
Bonnie R
BR
Cox
Judy H
JH
Wilkerson
Melinda J
MJ
D000818:Animals; D003907:Dexamethasone / Q000627:therapeutic use*; D004802:Eosinophilia / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary; D005938:Glucocorticoids / Q000627:therapeutic use*; D006734:Horse Diseases / Q000188:drug therapy* / Q000473:pathology; D006736:Horses; D011379:Prognosis; D012140:Respiratory Tract Diseases / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary; D012871:Skin Diseases / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary; D016896:Treatment Outcome
D005938:Glucocorticoids; D003907:Dexamethasone