title: Canine eosinophilic granuloma of the digits treated with prednisolone and chlorambucil.
abstract: BACKGROUND
  Canine eosinophilic granuloma (CEG) is an uncommon disease. Lesions are typically located in the oral cavity and other cutaneous sites, but are rarely reported to affect the digits. The majority of cases are treated with prednisolone as a monotherapy; alternative treatment options include corticosteroids administered in combination with azathioprine, antihistamines, electrochemotherapy with bleomycin, and surgical resection. Neither chlorambucil nor laser previously have been reported as treatments.
  
  
  OBJECTIVE
  To describe an alternative therapy for treatment of CEG; using chlorambucil in combination with prednisolone for those cases that fail to respond to prednisolone alone. The new treatment was chosen according to good clinical practice and after owner consent.
  
  
  METHODS
  Two client owned dogs.
  
  
  METHODS
  One case was initially treated with carbon dioxide laser to debulk the lesions. Both cases were treated with a combination of oral prednisolone and chlorambucil.
  
  
  RESULTS
  Both dogs experienced rapid resolution of lesions with prednisolone and chlorambucil therapy. Case 1 remained in remission three months after withdrawing medication. Case 2 experienced relapse 10 weeks after discontinuing therapy but was well controlled on maintenance prednisolone with chlorambucil at low, well tolerated doses.
  
  
  CONCLUSIONS
  Although CEG appears to be an uncommon disease, it should be included as a differential diagnosis for dermal, nodular lesions affecting the digits. Chlorambucil appears to be an effective and well tolerated prednisolone sparing agent for treatment of CEG. Carbon dioxide laser ablation appears to be an effective method of debulking CEGs.
authors.affiliation: Dermatology for Animals, 263 Appleby Road, Stafford, Queensland, 4053, Australia. evie.knight@live.com.au.
authors.forename: Evie C
authors.initials: EC
authors.lastname: Knight
authors.affiliation: Dermatology for Animals, 263 Appleby Road, Stafford, Queensland, 4053, Australia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Shipstone
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D002699:Chlorambucil / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy* / Q000473:pathology; D004285:Dogs; D004803:Eosinophilic Granuloma / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy / Q000662:veterinary*; D053685:Laser Therapy / Q000662:veterinary; D054020:Lasers, Gas; D011239:Prednisolone / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D018906:Antineoplastic Agents, Alkylating; D002699:Chlorambucil; D011239:Prednisolone