This week I attended to one of those cases that never fails to affect me. The patient was an eight-year-old white female shorthaired cat named Sweetie. Over the phone, Sweetie’s elderly owner told me that something was wrong with his cat’s face. As soon as I saw Sweetie, I knew what the problem was. Sweetie had a rodent ulcer.
Cat rodent ulcer, also referred to as indolent ulcer, is the common name used to describe one of the variants of the feline eosinophilic granuloma complex of diseases.
The label ‘cat rodent ulcer’ is a misnomer. Historically, the name was conceived by farmers whose cats developed facial ulcers after hunting rats. We now know that these ulcers have nothing whatsoever to do with rodents but the name has stuck.
The medical term eosinophilic granuloma complex more accurately describes the condition.
Eosinophils form part of the immune system. They are one of the types of white blood cells that moves around the body of the cat with the specific purpose of seeking out allergies or parasites.
When an allergen is detected, or a parasite invades the body of the cat, the cat’s immune system releases bio-chemical signals that eosinophils detect.
The allergy might be, for example, an allergy to fleas, plastic bowls, pollen, dust, mould and food, while the parasite might be, for example, tapeworms or roundworms. Either way, the eosinophils interpret them as a threat to the health of the cat and home in to the bio-chemical signal to attack the source of allergen or parasite. But sometimes, the eosinophil cells can go into overdrive.
Eosinophil cells may ‘over-react’ to a perceived threat, or the cat may have an auto-immune disease that makes the body attack itself.
Either way, the reaction of the body is highly visible. In some cases, the cells inflame to form a granuloma in the shape a lump, in others they may cause a rash-like reaction, and with the cat rodent ulcer variant, it forms a lesion.
The unfortunate aspect of the cat rodent ulcer is that it usually develops on the face of the cat and it has the potential to permanently disfigure the cat if not treated quickly enough.
The ulcer generally forms on the upper lip of the cat, though it has been known to affect the lower lip, tongue, or inside of the mouth as well. It starts as a yellowish pink spot located on one or both sides of the upper lip. It then develops into a clearly-defined, reddish-brown shiny sore without fur.
The ulcer does not weep or bleed but, as it advances, the lips soon start to look as if they have been gnawed off – hence the historical misconception of farmers.
In very serious cases, the ulcer advances so much that the cat loses its entire lips and nose, leaving the teeth, gums and nasal cavity exposed.
The disease affects mostly in young to middle-aged cats, and more female than male, but there is no specific breed that is more susceptible to the disease.
Perhaps the merciful aspect with this terrible affliction is that cat rodent ulcers are not painful and, while this complex of diseases is not yet fully understood, there have been advances in recent years that have helped veterinarians to control the condition.
Some studies have found that viral infections such as feline leukaemia virus, or genetic predisposition, might be a contributing factor. The important thing is that should your cat develop any unusual facial growth or start to behave differently, for example, all the time licking its nose, you should take your pet to the vet before any real damage is done.
You vet will start by examining the lesion and discussing your cat’s lifestyle and living environment. Depending upon the nature of the case, your vet may also opt to test for Felv/FIV, take a complete blood count, skin scrapings and fungal culture. The vet may additionally opt to take a biopsy or needle aspiration to rule out malignancy.
Treatment will depend upon the cause of the ulcer and may range from anti-flea treatment to food allergy diet trials among others.
Medication will be administered and prescribed to prevent further deterioration resulting from the ulcer. Reversal of the loss of lip flesh very much depends on how advanced the condition is. In its early stages, sufficient scar tissue can develop that restores the cat’s dignity. But when the condition is so advanced that erosion of the face is severe, there is not much that can be done to restore the face.
Sweetie’s condition was thankfully not too advanced and she was spared permanent disfigurement with timely intervention.
Her owner has taken steps to treat the house for the flea invasion that flared up during the warm summer months and he has promised to keep an eye on Sweetie.
Dr Martin Debattista is a veterinary surgeon.
thisweekwiththevet@gmail.com