Peer-reviewed veterinary case report
Dexamethasone for treatment of multisystemic eosinophilic epitheliotropic disease in a horse.
- Journal:
- Journal of the American Veterinary Medical Association
- Year:
- 2003
- Authors:
- McCue, Molly E et al.
- Affiliation:
- Department of Clinical Sciences · United States
- Species:
- horse
Plain-English summary
A 4-year-old Paint mare was brought in for a respiratory infection, skin issues, and weight loss that had been going on for two months. Upon examination, she had severe itching, discharge from her eyes and nose, and trouble urinating. Tests showed low white blood cell counts and low protein levels, and further checks revealed serious throat and lung infections, along with a mass in her bladder. After a thorough evaluation, she was diagnosed with multisystemic eosinophilic epitheliotropic disease, which is a condition where certain white blood cells invade various tissues. The mare responded well to treatment with dexamethasone, an antibiotic, and an antihistamine, and after 19 days in the hospital, she went home. She continued on dexamethasone for four weeks after that, and eight months later, she was doing well as a pleasure horse without needing any further treatment.
Abstract
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.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/14621221/